13. Renal Diseases & Blood Vessel Disorders

Question 1

A 29 year old black man is suffered a sudden stroke and is taken to the ER. Examination is done and it is found that he has abnormal platelet aggregation leading to thrombosis in arterioles and capillaries throughout the body. What would be expected to be found in lab finding due to this man’s condition.

A. Schistocytes in peripheral blood smear
B. Asysmetial kidney size
C. Multiple fluid filled cyst 
D. Thin Basement Membrane 
E. Hyaline deposits  

RFA

Answer 1

Ans. A- the patient has HUS/TPP in lab finding he would present with microangiopathic hemolytic anemia that shown by schistocytes in peripheral blood smear.

B. Describes the finding of renal artery stenosis, the kidney with the stenosis will be smaller.

C. This is a finding of ADPKD

D. This would describe a condition like Alport syndrome, which is usually due to a X linked mutation in the Col4A4 & COL4A5 genes

E. Found in patient with Malignant hypertensive nephrosclerosis

Question 2

A 28 year old man goes to a medical school to work as a standardized patient. During ultrasound examination the students are alarmed to see lumpy and bumpy looking kidneys. The man currently has no health issues but his family does have a history of sudden death. Which of the following is a manifestation the man doesn’t have to worry about with his condition?

 A. Cerebral aneurysms 
B. Nerve Deafness. 
C. Cardiac Valve Disease 
D. Colonic diverticular disease 
E.  Hepatic Cysts 

RFA

Answer 2

B. The man is the decryption has ADPKD, all of the following are no kidney manifestation of the disease except for Nerve Deafness with is associated with Alport’s Syndrome.

Question 3

A 45 y/o African American man presents to the ED for a laceration on his right thigh. Incidentally his BP is found to be 180/130 mmHg. Which of the following would be present on H&E if his kidneys were biopsied?

A. Eosinophils
B. Neutrophils
C. Hyperplastic arterioles
D. Hyaline artheriolosclerosis
E. Thrombosis of capillaries 

SZ

Answer 3

Ans. C. Hyperplastic arterioles

The main is experiencing chronic malignant hypertensive nephrosclerosis

Question 4

A 35 y/o male with a hx HIV presents for new onset of seizures, confusion, and fever. Schistocytes appear in peripheral blood smear. Another cause of this renal disorder is hematological malignancy associated with which of the following?

A. COLA4A
B. PKHD1
C. PKD2
D. ADAMTS13
E. p-ANCA

SZ

Answer 4

Ans D. ADAMTS13

This is thrombotic thrombocytopenic purpura (TTP)