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First Aid > cram.pathoma > Flashcards

cram.pathoma Flashcards

1
Q

Dx

Bilateral cysts in the kidney, but NOT inherited

A

Dysplastic kidneys

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2
Q

Dx

Potter sequence, HTN, renal failure in child

A

Autosomal Recessive Polycystic Kidney Disease

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3
Q

Associated with renal cysts

A

Hepatic cysts

Both ADPKD and ARPKD

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4
Q

Dx

HTN, hematuria, renal failure in young adult, berry aneurysm, hepatic cysts, mitral valve prolapse

A

Autosomal Dominant Polycystic Kidney Disease

Cysts in Kidney, Liver, and Brain

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5
Q

Renal cysts: Medullary Cystic Kidney Disease vs Polycystic Kidney Disease

1) Kidney size
2) Location of cysts

A

MDCK = Small, Cysts in Medulla

PKD = Large, Cysts in Cortex and Medulla

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6
Q

Why does BUN/Cr increase in Prerenal azotemia?

A

BUN is resorbed in tubule. Cr is not. Nl BYN:Cr is 15:1. Prerenal will cause increased Aldosterone –> Inc Na resorption –> Inc water resorption –> Inc BUN resorption.

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7
Q

Signs of Tubular damage

5

A

1) BUN:Cr 2%
3) Urine Osm <500
4) Hyperkalemia
5) Metabolic Acidosis

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8
Q

Why does ATN cause azotemia/renal failure?

A

Dead tubule cells slough off and block filtrate causing backpressure that prevents Filtering –> Renail failure/azotemia

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9
Q

Dx

Brown granular cast

A

ATN

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10
Q

Dx

Eosinophils in urine

A

Drug induced ATN

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11
Q

Characteristics of Nephrotic Sx

4

A

1) Hypoalbuminemia
2) Hypogammaglobulinemia
3) Hypercoagulable (ATIII decreased)
4) Hyperlipidemia

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12
Q

Kidney disease in Hodgkin’s Lymphoma

A

Minimal Change Disease (bc of cytokines!)

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13
Q

Dx

Nl glomeruli, effacement on EM, negative IF

A

Minimal Change Disease

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14
Q

Tx

Minimal Change Disease

A

Steroids

only Nephrotic sx with excellent response to steroids

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15
Q

Dx
HIV pt develops Nephrotic sx
(or heroin, or sickle cell, basically someone from The Wire)

A

Focal Segmental Glomerular Sclerosis

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16
Q

Dx

Lupus pt gets Nephrotic Sx

A

Membranous Nephropathy

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17
Q

Dx

Thick basement membrane, Granular on IF, Spike and dome on EM

A

Membranous Nephropathy

spikes/domes from immune deposits

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18
Q

Dx

Thick capillary membrane in Glomerulus, Tram Track appearance, IF deposits

A

Membranoproliferative Glomerulonephritis

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19
Q

Which Nephrotic sx is called -nephritis

A

Membranoproliferative Glomerulonephrtitis

Can cause Nephritic or Nephrotic or Both

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20
Q

Types of Membranoproliferative Glumerulonephritis
C3 Nephritic Factor, Intramembranous

HBV/HCV, Subdendothelial

A

1) Type I
2) Type II

(Membranous deposits are above BM)

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21
Q

Mech Nephrotic sx in Diabetes

A

High Sugar glycosylates vascular membrane –> Hyaline arteriosclerosis of Efferent > Afferent –> High filtration –> Microalbuminuria

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22
Q

Tx

Nephrotic sx due to Diabetes

A

ACE-Is

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23
Q

Dx

Nephrotic sx, apple-green birefrigence

A

Systemic Amyloidosis

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24
Q

Characteristics of Glomerulonephritis

4

A

Glomerular Inflmmation with

1) Oliguria
2) Salt retention and edema
3) RBC casts
4) Limited proteinuria

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25
Q

What carries Nephritic potential on Strep bugs

A

M Factor

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26
Q

What is Crescent in RPGN?

A

Fibrin and Macrophages

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27
Q

Dx

Linear immunoflouorescence pattern

A

Goodpasture’s

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28
Q

Dx: Pauci-Immune IF
cANCA:

pANCA:

A

cANCA: Wegener’s Granulomatosis

pANCA: Churg-Strauss and Microscopic Polyangiitis

Churg-Strauss has Eos and Asthma

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29
Q

Dx

Isolated hematuria, sensory hearing loss, ocular disturbances

A

Alport Sx

Type IV collagen defect

30
Q

What do urine nitrItes show?

A

That bacteria turned NitrAtes into NitrItes

31
Q

Dx

Pyruria with negative urine cx

A

Urethritis (Gonorrhea or Chlamydia)

32
Q

Tx

Calcium oxalate/phosphate

33
Q

Dx
Staghorn caliculus
(2)

A

Proteus or Klebsiella

34
Q

Tx

Uric acid stone

A

Hydration and alkalinization of urine

35
Q

Which cells make EPO

A

Renal Peritubular Interstitial cells

36
Q

Renal risk for Dialysis

2

A

1) Cysts

2) Renal Cell Carcinoma

37
Q

Dx

Hematuria, palpable mass, flank pain

A

Renal Cell Carcinoma

38
Q

Paraneoplasms of Renal Cell Carcinoma

4

A

1) EPO - PV
2) Renin - HTN
3) PTHrP - Osteomalcia
4) ACTH - Cushings

39
Q

Mech Renal Cell Carcinoma

A

Loss of VHL tumor supressor gene, Inc IGF-1, Inc HIF and VEGF

40
Q

Dx

Blastema (i.e. small dark blue cells in kidney mass)

A

Wilms Tumor

41
Q

Wilms tumor associations

2

A

1) Beckwith-Wiedemann Sx

2) WAGR syndrome

42
Q

Dx

Middle eastern male with urogenital cancer

A

Squamous Cell Carcinoma

43
Q

Where do Adenocarcinoma of Bladder originate from

3

A

1) Urachal remnant (dome of bladder)
2) Bladder extrophy
3) Cysitis Glandularis

44
Q

How to predict what Healthy Kidneys will do if extra-renal perturbation?

A
  • ADH and Water Retention/Excretion will always respond to NATREMIA
  • Na Retention/Excretion will always respond to VOLEMIA
  • Exception: In Hypovolemic Hyponatremia the low volume trumps the hyponatremia causing Water Retention not loss
45
Q

Which Renal diseases are both Nephritic and Nephrotic?

2

A

Diffuse Proliferative Glomerulonephritis

Membranoproliferative Glomerulonephritis

46
Q

Type of Hypersensitivity reaction in Post Strep GN?

A

Type III (Immune complex mediated)

47
Q

Dx

Increased thickness of glomerular basement membrane, granular deposits on IF, spike and dome deposits

A

Membranous Nephropathy

48
Q

Dx

Palpable abdominal mass with pain to groin after cervical cancer

A

Hydonephrosis due to ureteral damage during hysterectomy

49
Q

Where doe ADH act SPECIFICALLY?

A

MEDULLARY portion of Collecting Duct

50
Q

Potassium reabsorption and regulation along Nephron

  • Proximal Tubule =
  • Loop of Henle =
  • Collecting Duct =
A
  • Proximal Tubule = 70% Does not regulate K
  • Loop of Henle = 20% Does not regulate K
  • Collecting Duct = Where K is regulated
51
Q

Things that increase K secretion at Collecting Duct

4

A

1) Hyperkalemia
2) Aldosterone
3) Alkalosis
4) Thiazide Diurecics

52
Q

Diuretics that

  • Waste Ca
  • Retain Ca
A
  • Waste Ca = Loop Diuretics

- Retain Ca = Thiazides

53
Q

Which part of Nephron is Impermeable to water?

A

Thick Ascending Limb of LoH

54
Q

What is interesting about Minimal Change disease’s protein loss?

A

It is Selective and thus loses much albumin but little Ig for example

55
Q

Dx

Microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure

A

Henoch-Schonlein Purpura

56
Q

Causes of HUS

A

Shigella
or
E Coli O157

57
Q

What constitutes deposits in Post Strep GN?

3

58
Q

Tx

To prevent recurrent Ca stones

A

Thiazide diuretics

59
Q

Renal S/e
Amphotericin B
(2)

A

Hypokalemia
and
Hypomagenesemia

60
Q

Where is urine the most dilute in Nephron?

A

Distal tubule

61
Q

Dx

Bilateral Renal Angiomyolipoma

A

Tuberous sclerosis

62
Q

Dx

Anti alpha3-chain of collagen Type IV Abs

A

Goodpature’s

63
Q 
Dx
Nodular glomerulosclerosis (Kimmelstiel-Wilson disease)
A

Diabetic Nephropathy

64
Q

Tx
Diabetic nephropathy
(2)

A

ACE-I or

ARB

65
Q

Dx

IgG4 Abs to Phospholipase A2 receptor

A

Membranous nephropathy

66
Q

Which polymerase incorporates Uracil into DNA in prokaryotes?

67
Q

Where does AngII cause vasoconstriction in kidney?

A

1) EFFERENT arteriole

68
Q

Which parts of nephron are most susceptible to ischemia?

A

Proximal Tubule

then Thick Ascending Limb of LoH

69
Q

S/e

Antidiuretic causes Ototoxicity

A

Furosemide

70
Q

What is gene on C’some 3 causing Renal Cell Carcinoma

A

von Hippel Lindau

71
Q

What happens to Phos in urine during Acidosis?

A

Acidosis = Titratable acids (H2PO4- and NH4+ are excreted)

First Aid (23 decks)

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