حاجات دكتوره ورده ركزت عليهن

♦️Chronic glomerulonephritis
is one of the most common causes of chronic kidney disease in humans.
♦️ACUTE KIDNEY INJURY (AKI)most common cause of acute renal failure
♦️Diabetic glomerulosclerosis;
It is a major cause of chronic renal disease
📌Azotemia is : elevation of blood urea nitrogen
📌Uermia : is Azotemia + Clinical manifestations
📑 Uermia:-

1. (acidosis)
2. ( anemia and bleeding diathesis )

3. ( secondary hyperparathyrodism )
4. Uremic gastroenteritis
5. Uremic fibrinous pericarditis 6. Peripheral neuropathy

🪢 Nephrotic Syndrome v.imp


✔Heavy proteinuria >3.5 g/day
✔.Hypoproteinemia
✔Severe edema
✔Hyperlipidemia
✔Lipiduria

🪢 Nephritic Syndrome v.imp


✔Grossly visible hematuria (with Casts)
✔Mild to moderate proteinuria
✔Azotemia (with Oliguria)
✔Edema
✔HTN

💡Primary Glomerular Diseases


✔Minimal change glomerular disease
✔Membranous glomerulonephritis
✔Membranoproliferativeglomerulonephritis
✔IgA nephropathy
✔Acute diffuse proliferative glomerulonephritis

🔸️Minimal Change Disease


1,sudden onset
2,Children ( 2 -6 years)

3, after (respiratory infection
immunization.)

4,proteinuria highly selective,
5 Respond rapidly to corticosteroid therapy

🔸️Membranous glomerulonephritis

1,adults.

2 diffuse thickening

3,deposits along the subepithelialside

4,The basement membrane material protrudes between deposits as ‘spikes’ .

🏷these spikes thicken to produce domelike

5, non selective

🔸️Membranoproliferative GN


✔adults.
✔proliferation of mesangial cells & leukocytes.

✔The GBM is thickened
✔The GBM ↪↪"tram track"

▫️Type I MPGN)
🗯circulating immune complexes

🗯Subendothelial granular
deposits of C3 & IgG


▫️Type II MPGN
🗯C3 nephritic factor (C3NeF)
🗯Intra-membranous deposit
C3; deposit as
irregular
granular-linear
worse prognosis
📌Diabetic glomerulosclerosis;.
Nodular GS ( Kimmelsteil-Wilson disease);

🔹️Acute Proliferative
(Poststreptococcal, Post infectious)


✔group A β-hemolytic streptococci
✔ in children 6 to 10
✔hypercellularity
✔subepithelial (humps)
✔inflammatory manifestation
✔ urine appearing smoky brown( cola color 🥤 )

🔹️Rapidly progressive GN (RPGN)

✔crescents
✔ distinct ruptures in the GBM
✔three groups

✔ GOOD PASTURE SYNDROME (anti-GBM disease)↪Cross reaction of the antibody with pulmonary capillary basement membranes results in lung hemorrhage,

✔ endothelial proliferation, and mesangia

📣Crescents
are formed by proliferation of parietal cells 🔸️
may obliterate Bowman's space & compress the glomeruli tuft.

🔹️IgA nephropathy
is the commonest cause of recurrent gross hematuria or microscopic hematuria

& is the most common glomerular disease worldwide
🔹️IgA nephropathy
1. Children
2. 1-2 Days after Upper RTI or GI infection
3. mesengial proliferation
4. Mesengial Deposits
5. IgA granular deposits

🔹️Alport syndrome :
defect in the collagen IV X-chromosome,
males
splitting and lamination
of the lamina densa,
often producing a distinctive basket-weave appearance .🥅

🎗Lupus nephritis
▫️Class I : lupus with no renal lesion 20%
▫️ Class II : mesangail “ proliferative “ nephritis 10%
▫️Class III : focal proliferative nephritis 10%
▫️Class IV : diffuse proliferative nephritis 50%
▫️Class V : membranous nephritis
📌Class III, IV, V
may show:
🔸️Focal necrosis of capillary wall & PNL infiltrate
🔸️Fibrinoiddeposits
🔸️Capillary thrombi
🔸️Wire-loop thickening of capillary wallمهمه !
🔸️Crescent formation
🪢 Renal stone
Calcium oxalate (phosphate) 75%
🪢 Struvite --> (Mg, NH3. Ca, PO4)
🏷 sponge-like appearance
✔Childhood polycystic kidney disease
✔CYSTIC DISEASES OF RENAL MEDULLA
🏷 Swiss-Cheese appearance
CYSTIC DISEASES OF RENAL MEDULLA
📑BladderUrothelial (transitional) tumors :
1) papilloma
2) Papillary urothelial neoplasms of low malignant potential(PUNLMP)
3) Low grade and high grade papillary urothelial cancers
4) Carcinoma in situ.
📌types of transitional cell carcinoma ;
🔹️Flat type (10%) associated with early P53 mutations
#pathology
Renal

🔹️Papillary type (90%) not associated with Early P53 mutation
♦️Renal BENIGN TUMORS
✔Adenoma
✔Angiomyolipoma
✔Oncocytoma
🔹️The most common type of renal cancer in patients who develop dialysis-associated cystic disease Papillary types
#pathology
Renal