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PATHOLOGY SEMINAR MedDeb

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PATHOLOGY SEMINAR MedDeb Powered By Docstoc
					     Diseases affecting
    tubules/instertitium
          Pathology Seminars
            Ravi Jobanputra
Email: Ravi_Jobanputra@hotmail.co.uk
   Acute pyelonephritis

    •ASCENDING
        •Adhesion
             •Bacterial fimbriae
        •Colonisation
        •Access to bladder
             •Instruments (cath,
             cystoscopy)
    •Hematogenous

     Normal urine: sterile
     Obstruction of bladder
     increases residual urine
      stasis  INFECTION


Incompetence of vesicoureteral
orifice  VUR
• Haematogenous metastatic infection
  – septicemia:
  – endocarditis
  – Diabetes: septicemia, necrotizing papillitis,
    recurrent infection (due to ↑ glucose)
• Blood stream  renal a.many small cortical
  abscesses
       chronic pyelonephritis & reflux
                nephropathy
•   ...entity...
•   Interstitial inflammation
•   Scarring of renal parenchyma
•   Important cause of renal failure
•   Chronic obstructive pyelonephritis
•   Recurrent infection  renal inflammation  CP
•   Latent infection: slow/continuous tubular
    destruction
    – Stones (unilateral)
    – Prostate abnormalities (bilateral)
           Reflux nephropathy
• Most Common form of CP
  – UTI
  – VUR (congenital)
• Scarring of kidney
• Atrophy
  – Effect one or both kidneys
• Scars: upper or lower poles of the kidney (pic)
               Drug induced
• Hypersensitivity reaction
  – Penicillin
  – Diuretics
  – Fever/E/rash/high igE
  – Hematuria/proteinuria
    Renal cysts, stones, nephrosis
• Renal cysts: simple cuboidal epithilal
  – Fluid: clear/hemorrhagic
  – Size: 1-5+ cm in size.
• Worry: destroy adjacent parenchyma  RF
  – Tumour?
  – Metastases?
     • Firm!!
          Adult polycystic kidney
•   AD
•   Multiple cysts
•   4kg kidney
•   Hematuria. Renal insufficiency
•   Hypertension
•   PKD 1/C 16  Polycystin
    – Mutation
                Childhood
• AR
• Birth
• Numerous small cysts
  – Cortex
  – Medulla
  – Sponge
• Fibrocystin mutation
AD.K
                  Simple cysts
• Single/multiple cysts
• Simple cuboidal ep.
• Cortex
• Hemorrhage/inflammation
RENAL STONES
• Calcium stones: hypercalcemia
• Struvite: alkaline pH, UTI!!!!!!!!!!!
• Uric acid: low pH: GOUT!!!!!!!!!!!!
• Cysteine : Low pH,
                Hydronephrosis
• Dilation: PELVIS/CALCYCES
  – Obstruction  atrophy of parenchyma
• Congenital:
  – Atresia: urethra
• Acquired
  – Infection
  – Tumor (prostatic hypertrophy)
  – Inflammation
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posted:4/10/2011
language:English
pages:15