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Urinary tract Pathology - Coggle Diagram
Urinary tract Pathology
Renal components
Glomerular disease
Protein leakage
Proteinuria
Overwhelm PCT reabsorption capacity
Hypoproteinamia
Generalised oedema
Glomerulonephritis
Ag-Ab complex deposition
Complement activation
Neutrophils chemotaxis
Basement membrane damage
Persistent infections
Tubular disease
Acute tubular necrosis
Decreased renal perfusion
Acute renal failure
Causes
Nephrotoxins - concentrated
Obstruction - intratubular cast
Decreased blood flow - ischemic
Basement membrane damage
Replacement by cuboidal / squamous epithelium
Without brush border
Polyuria; isosthenuria
Tubulointersitial disease
Causes
Ascending infections (Suppurative)
Pyelonephritis
Systemic infections
Eg. Leptospirosis; FIP
Toxins; secondary (interdependence)
Nonsuppurative
Acute interstitial nephritis
Neutrophil infiltration
Chronic interstitial nephritis
Mononuclear inflammation
Pyelonephritis
Renal pelvis and parenchyma inflammation
(ureteritis ; cystitis)
Causes
Ascending bacterial infection
Adhesion mechanisms
Endotoxins
Prevent ureteral peristalsis
Immune compromise
Urine stagnation / reflux
Urothelium shedding ; phagocytosis
Mucoproteins - prevent bacterial adhesion
Medulla susceptibility
Poor blood supply; low phagocytic activity; inhibit complement
Types
Acute
Neutrophils + necrosis
Chronic
Fibrosis (repair)
Scarring - cortical depressions
Mononuclear infiltrates
Lower UT
Hydronephrosis
Causes
Cogenital; calculi; inflammation ; neoplasia
Obstructed urine outflow
Increased pressure
Renal pelvis swells
Renal parenchyma atrophy
Urolithiasis
Precipitation of excretory metabolites
Ureters
Predispositions
Urine pH
Acidic - oxalates
Alkaline - carbonates
Bacterial proliferation
Dehydration
Supersaturation - increased solute concentration
Dietary; metabolic defects; tubular dysfunction
Cystitis
Causes
Bacterial infection
Predispositions
Urine stagnation
Iatrogenic: Catheterisation; antibiotics
Glucosuria; immunodeficiency (IgA)
Other conditions
Circulatory disturbances
Hyperaemia / congestion
Shock
Congestive heart failure
Haemorrhages + thrombosis
Subcapsular + cortical
Petaechial (pinpoint)
Infarction
Thromboembolism - vascular obstruction
Necrosis
Deposits / pigmentation
Amyloidosis
Chronic inflammatory diseases
Glomerular
Subendothelial
Secondary site: tubules
Serum amyloid associated (SAA) protein
Haemosiderin ; bilirubin; lipofuscin
Renal calculi and crystals ; Haemoglobin / myoglobin
Degenerative disease
Renal cysts
Acquired renal cysts
(Neoplasia)
Obstructive lesions
Tubular basement membrane change
Polycystic kidney diseases
Heritable breeds
Response to injury (limited)
Interdependency
Entire nephron compromised
Clinical signs apparent at 75% tissue damage
Regneration
Intact basement membrane
Tubular
New nephrons not formed after maturation
Tissue repair (Fibrosis)
Tubular epithelium replacement
Non-absorptive epithelium
Causes - irreversible damage
Damaged basement membrane
High toxin dosage
Toxin not removed
End-stage kidney disease
DoG
Primary neoplasia (rare)
Enzoonotic haematuria
Prolonged ingestion - bracken fern
Tumours
Epithelial
Papilloma
Carcinomas
Spindle cell tumours
Persistent anaemia + haematuria
Congenital defects
Hyperplasia; dysplasia
Hydronephrosis
Metaplasia
Squamous cells; adenocarcinomas
Metastatic neoplasia
Urothelial cells
Renal failure
Electrolyte imbalance
Metabolic acidosis
Fluid dysregulation
Dehydration
Uraemia (severe)
Toxin accumulation
Multi-organ disease
Azotaemia
Endocrinopathies
Erythropoietin deficiency
Anaemia
Hyperthyroidism