13. Renal Disease

Question 1

What is azotemia?

Answer 1

Build up of nitrogenous products in blood

Question 2

What are the common findings of chronic renal failure?

Answer 2

*Pruritis
Vomiting
Muscle twitches and cramps

Question 3

What are the 2 most important labs for diagnosing chronic renal failure?

Answer 3

BUN

Creatinine

Question 4

What is the most common ocular finding of chronic renal failure?

Answer 4

Band K

Question 5

What is te most common nephrotic syndrome?

Answer 5

Diabetic nephropathy

Question 6

What causes diabetic nephropathy?

Answer 6

Glomerular sclerosis and fibrosis from metabolic changes in DM

Question 7

How is an albumin screening done?

Answer 7

24 hour urine analysis

Question 8

Nephropathy occurs how long after onset of DM?

Answer 8

10 years

Question 9

Renal failure occurs how long after nephropathy?

Answer 9

10 years

Question 10

What is the Alport syndrome triad?

Answer 10

Hereditary nephritis
Deafness
Ocular anomalies

Question 11

Alport syndrome includes a basement membrane disorder specific to what?

Answer 11

Renal glomeruli

• Cochlea
• Retina

Question 12

What is the hallmark anterior seg finding in Alport syndrome?

Answer 12

Anterior lenticonus

Question 13

What are the ocular findings in Alport syndrome?

Answer 13

PDS
Anterior lenticonus
Retinal flecks
May have S and P fundus

Question 14

What are the three forms of aniridia syndrome associated with Wilm’s tumor?

Answer 14

AN1
AN2
AN3

Question 15

What are the findings of AN1?

Answer 15

Only ocular

Question 16

What are the findings of AN2?

Answer 16

WAGR complex (includes the following):
Wilm's tumor
Aniridia
genitourinary anomalies
Mental retardation

Question 17

What are the findings of A3?

Answer 17

AR
Aniridia
Mental deficiency
Ataxia

Question 18

What should happen to respiratory rate in lactic (metabolic) acidosis?

Answer 18

Increased respiratory rate

Question 19

What is Phenylketonuria?

Answer 19

Inability to metabolize phenylalanine to tyrosine

Question 20

What is the most common systemic finding of phenylketonuria?

Answer 20

Mousy body odor

Question 21

What organs does amyloidosis affect?

Answer 21

Heart
Kidneys
Adrenals
Liver

Question 22

What are the systemic findings of amyloidosis?

Answer 22

Cutaneous hemorrhages - bloodhound appearance

Question 23

When is secondary amyloidosis seen?

Answer 23

After chronic infectious or inflammatory disease (TB, leprosy, RA, AS, IBS)

Question 24

What are the common ocular findings of secondary amyloidosis?

Answer 24

Prominent corneal nerves

“string of pearls” vitreous

Question 25

What is Meretoja Syndrome?

Answer 25

Familial amyloidosis and corneal lattice dystrophy 2

Question 26

What is Gaucher's disease?

Answer 26

Products of fat metabolism depositied in bone marrow

Question 27

What are the ocular findings of Gaucher type 1?

Answer 27

Severe uveitis

Question 28

What are the ocular findings of Gaucher type 2?

Answer 28

Blindness | Cherry red spot

Question 29

What is Neiman-Pick?

Answer 29

Build up of sphingo-myelin or cholesterol in the tissues

Question 30

What are the common findings of Nieman-Pick?

Answer 30

Cherry red spot Corneal opacities Brown lens capsule Peri-foveal crystalloid deposits in adults

Question 31

What things cause a cherry red spot?

Answer 31

Methanol poisoning Quinine poisoning Dapsone toxicity Storage diseases

Question 32

What are the causes of acidosis with elevated anion gap?

Answer 32

Ketoacidosis | Intoxication

Question 33

What is the important cause of acidosis with a normal anion gap?

Answer 33

Acetazolamide

Question 34

What drug type can cause chloride responsive alkalosis?

Answer 34

Diuretics

Question 35

What drug type can cause chloride resistant alkalosis?

Answer 35

Loop diuretics | Thiazides

Question 36

What causes cystinosis?

Answer 36

Error of amino acid metabolism

Question 37

What causes Fanconi syndrome?

Answer 37

Defective carrier mediated transport of cystine

Question 38

What is the common problem caused by Fanconi syndrome?

Answer 38

Progressive renal dysfunction

Question 39

All 3 types of Fanconi present in the cornea how?

Answer 39

As crystals

Question 40

Which type of cystinosis presents with symptomatic corneal crystals?

Answer 40

Infantile nephropathic cystinosis

Question 41

Homocystinuria is a metabolic disorder of what?

Answer 41

The amino acid methionine

Question 42

Homocystinuria is toxic to endothelial cells, causes what?

Answer 42

Increased platelet adhesion

Question 43

Because of the increased platelet adhesion, homocystinuria has a higher risk of what?

Answer 43

Thrombus formation

Question 44

What are the common ocular findings of homocystinuria?

Answer 44

``` Blue sclera Ectopia lentis Cataracts high myopia CRA occlusion ```