434
edits
Changes
→Journal Articles
== Autopsy Findings ==
The autopsy showed the expected left ventricular hypertrophy, a large acute myocardial infarction, and a large right cerebral infarction. The pancreas showed amyloidosis of the islets. There was extensive atherosclerosis and arteriolosclerosis. The kidneys were largeslightly enlarged, weighing 220 and 240 grams respectively, and had smooth glistening rough surfaces, a few cortical scars, and blurring of the corticomedullary junctions.
== Images ==
File:IPLab5DM7.jpg|This is a photomicrograph of kidney with a focal exudative lesion in a glomerulus (arrow) and sclerosis, interstitial fibrosis, and congestion.
</gallery>
== Virtual Microscopy ==
<peir-vm>IPLab5DM</peir-vm>
== Study Questions ==
* <spoiler text="What is another term for nodular glomerulosclerosis?">Kimmelstiel-Wilson disease.</spoiler>
* <spoiler text="What material is found within these sclerotic nodules and what happens to these lesions over time?">The Kimmelstiel-Wilson (K-W) lesions are ovoid or spherical, often laminated, hyaline masses situated in the periphery of the glomerulus. They are usually within the mesangium of the glomeruli. The nodules are composed of lipids and fibrin. As the disease progresses the K-W nodules enlarge until they compress and obliterate the glomerular tuft. Because of these glomerular and arteriolar lesions, the blood flow to the kidney is compromised and the kidney becomes ischemic. This results in tubular atrophy and interstitial fibrosis and leads to a roughened renal cortical surface.</spoiler>
* <spoiler text="What percent of diabetics develop this lesion and what are the functional consequences?">Approximately 15-30% of long term diabetics develop K-W lesions and in most instances it is associated with renal failure.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/117739-overview eMedicine Medical Library: Type 1 Diabetes Mellitus]
* [http://emedicine.medscape.com/article/117853-overview eMedicine Medical Library: Type 2 Diabetes Mellitus]
* [http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/diabetes_mellitus_and_disorders_of_carbohydrate_metabolism/diabetes_mellitus_dm.html Merck Manual: Diabetes Mellitus (DM)]
=== Journal Articles ===
* Herzenberg AM, Holden JK, Singh S, Magil AB. [http://www.ncbi.nlm.nih.gov/pubmed/10469869 Idiopathic nodular glomerulosclerosis]. ''Am J Kidney Dis'' 1999 Sep;34(3):560-4.
* Vinik AI. [http://www.nejm.org/doi/full/10.1056/NEJMcp1503948 Diabetic Sensory and Motor Neuropathy]. ''N Engl J Med" 2016 April 14; 374:1455-1464.
* Kamel KS and Halperin ML. [http://www.nejm.org/doi/full/10.1056/NEJMra1207788 Acid–Base Problems in Diabetic Ketoacidosis]. ''N Engl J Med" 2015 Feb 5;372:546-554.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/137-diabetic_glomerulosclerosis PEIR Digital Library: Diabetic Glomerulosclerosis Images]
* [http://library.med.utah.edu/WebPath/RENAHTML/RENALIDX.html#3 WebPath: Interstitial Diseases of the Kidney]
== Related IPLab Cases ==
* [[IPLab:Lab 1:Kidney Infarction|Lab 1: Kidney: Infarction (Coagulative Necrosis)]]
{{IPLab 5}}
[[Category: IPLab:Lab 5]]
