GLOMERULAR MICROANATOMY AND DISORDERS

GLOMERULAR MICROANATOMY AND DISORDERS

QUESTION 1: GLOMERULAR MICROANATOMY AND DISORDERS
The kidneys may be regarded as the urinary organs which have the function of maintaining the volume and electrolyte balance of body fluids. Microscopic examination of the kidney shows many minute structures called nephrons which are composed of the renal corpuscle and renal tubules. The renal corpuscle, in turn comprises the glomerulus and glomerular (or Bowman’s) capsule. Observe the two slides of the renal corpuscle below. Slide A shows a normal glomerulus and slide B shows a glomerulus with a specific pathology.
Answer the questions that relate to illustration A (the normal glomerulus) below.
Q1a. Which region of the kidney is being viewed in this slide? (1 mark)
Q1b. How does the composition of the fluid in the glomerular (Bowman’s) capsule compare to the composition of the blood in the glomerulus? (1 mark)
Observe the illustration of a glomerulus with a specific pathology in illustration B and answer the questions below:
Q1c. What is the pathology shown here? (1 mark)
Q1d. Describe two pathological features you observe in the slide that indicate the presence of this disorder (2 marks)
Q1e. Identify and describe the pathological process that accounts for the main manifestation of this disease? (2 marks)
QUESTION 2: GROSS ANATOMY OF THE RENAL SYSTEM: RENAL PATHOLOGY 1
Observe the photograph of an abnormal kidney below.
Q2a. Identify the main pathological features you observe and name the regions of the kidney where they are found. (2 marks)
Q2b. What is the disease based on these features? (1 mark)
Q2c. Describe the 3 factors that are required to promote the pathogenesis of this disorder. (3 marks)
Q2d. Infection is implicated in both the development and as an outcome of the disease. Explain why this is the case in both instances (2 marks)
QUESTION 3: GROSS ANATOMY OF THE RENAL SYSTEM: RENAL PATHOLOGY 2
Observe the illustration of an abnormal kidney below.
Q3a. Name the condition shown in this slide (the pathology illustrated in the previous slide could have been a causal factor for this condition) and describe two features on which you have based your decision. (3 marks)
Q3b. If this condition was confined to one kidney, where would the problem likely originate? Why? (2marks)
Q3c. If this condition was bilateral (in both kidneys), where would the problem likely originate? Why? (2marks)
QUESTION 4: GROSS ANATOMY & ANALYSIS: RENAL SYSTEM PATHOLOGY 3
Observe the illustration of a renal system pathology below.
Macroscopic and microscopic urinalysis was performed with the following notable results:
Characteristic
Result
Color
Amber
Appearance
Hazy
pH
5
Protein
Trace
Blood
Positive
RBC
Positive
Casts
Occasional hyaline casts
Other
Atypical urothelial cells present
Q4a. What is the organ illustrated here? What type of epithelium lines this organ and how does this type of epithelium assist in the function of the organ? (3 marks)
Q4b. Name the pathology shown in the illustration, identifying its extent or type. Describe three features or test results that are suggestive of this condition, explaining how each indicates the pathology. (2+3 = 5 marks)
QUESTION 5: URINE ANALYSIS CASES
Urine analysis is an important procedure in determining the health of a person. Testing color, odor and turbidity as well as for the presence of protein, glucose, ketones, bilirubin, blood, nitrite or changes of pH in the urine are important considerations in deciding whether or not a diseased state is present in conjunction with other signs and symptoms.
For this question you are provided with case notes and results of visual and test stick urinalysis for two individuals:
For specimen A
Q5a. Identify the abnormal urine characteristics or constituents and suggest a likely explanation for the patient’s condition. How does this agree with the case notes? (4 marks)
Q5b. How might alcohol affect this condition? Which case notes and results would indicate that alcohol may have been consumed? (2 marks)
Q5c. What indications are there that this patient is suffering from acidosis? (2 marks)
For specimen B: Q5d. Identify the abnormal urine characteristics or constituents and suggest a likely explanation for the patient’s condition. How does this agree with the case notes? (3 marks)
Q5e. What would suggest that this is an ascending condition? (1 mark)