Infections/Necrosis

Question 1

Suprapubic pain, dysuria, urinary frequency and urgency NO SYSTEMIC SIGNS

Answer 1

Acute Infectious cystitis

Question 2

Most common cause of Acute Infectious cystitis

Answer 2

E. coli

Question 3

Sexually active young women

Answer 3

S. saprophyticus

Question 4

ammonia scent

Answer 4

Proteus mirabilis

Question 5

hemorrhagic cystitis

Answer 5

adenovirus

Question 6

sterile pyuria and negative urine cultures

Answer 6

N. gonorrhea, and chlamydia

Question 7

Positive leukocyte esterase

Answer 7

acute infectious cystitis

Question 8

Nitrates in urine

Answer 8

Gram negative organisms

Question 9

Culture > 100,000 CFU

Answer 9

gold standard for acute infectious cystitis

Question 10

Dysuria, fever, costovertebral angle tenderness, N/V

Answer 10

Acute Pyelonephritis

Question 11

White cell casts in urine

CT shows striated parenchymal enhancement

Answer 11

acute Pyelonephritis

Question 12

Risk factors for acute pyelonephritis

Answer 12

indwelling catheter; urinary obstruction; DM; pregnancy

Question 13

Tx of Acute pyelonephritis

Answer 13

Antibiotics

Question 14

Causes of Acute Pyelonephritis

Answer 14

UTI (E. coli); VUR; hematogenous spread to kidney

Question 15

Causes of Chronic Pyelonephritis in Kids

Answer 15

VUR

Question 16

Causes of Chronic Pyelonephritis in Adults

Answer 16

recurrent kidney stones

Question 17

Thyroidization of Kidney

Answer 17

Chronic Pyelonephritis (eosinophilic casts in tubules)

Question 18

Coarse, asymmetric corticomedullary scarring, blunted calyx

Answer 18

Chronic Pyelonephritis

Question 19

Drugs that can cause interstitial nephritis 1-2 weeks after taking them

Answer 19

diuretics, penicillin, sulfonamides, rifampin (or months after starting NSAIDs)

Question 20

Cause of diffuse cortical necrosis

Answer 20

combo of DIC and vasospasm; associated with abruptio placentae and septic shock

Question 21

Most common cause of intrinsic renal failure

Answer 21

Acute tubular necrosis

Question 22

“muddy brown casts”

Answer 22

Acute tubular necrosis

Question 23

Most common areas of ischemic injury to nephron

Answer 23

Proximal tubule and TAL

Question 24

Most common area of nephrotoxic injury to nephron

Answer 24

Proximal tubule

Question 25

Toxic substances to nephron

Answer 25

aminoglycosides, radiocontrast, lead, cisplatin, crushinjury so myoglobinuria, hemoglobinuria

Question 26

tubules lose nuclei and slough off into tubule

Answer 26

Acute tubular necrosis

Question 27

Death most likely occurs in what phase of acute tubular necrosis

Answer 27

oliguric phase

Question 28

Renal papillary necrosis triggers

Answer 28

DM; Acute pyelonephritis; Sickle cell anemia and trait; Chronic phenacetin use like acetaminophen

Question 29

Prerenal azotemia

Answer 29

decrease in RBF; decrease GFR; BUN/creatinine ratio increases

Question 30

Intrinsic renal failure

Answer 30

due to acute tubular necrosis or ischemia/toxins; patchy necrosis blocks tubule and fluid backflows decreasing GFR. decrease in BUN/creatinine ratio

Question 31

Postrenal Azotemia

Answer 31

Outflow obstruction/stones, BPH, neoplasia, only occurs with BL obstruction. decreased GFR

Question 32

Consequences of Renal Failure

Answer 32

``` MAD HUNGER Metabolic Acidosis (anion gap); Dyslipidemia (TGs); Hyperkalemia; Uremia; Na retention; Growth retardation; Erythropoietin failure; Renal osteodystrophy ```

Question 33

Uremia

Answer 33

increased BUN and creatinine; nausea and anorexia; pericarditis; asterixis; encephalopathy; platelet dysfunction

Question 34

Renal Osteodystrophy

Answer 34

can't make vit D do damage to bone like osteitis fibrosa cystica; osteomalacia; osteoporosis

Question 35

Innumerable cysts causing BL enlarged kidneys with increased renin; autosomal dominant disease

Answer 35

ADPKD

Question 36

#1 mutation associated with ADPKD

Answer 36

PKD1 on chromosome 16 (85%) | PKD2 on chromosome 4 (15%)

Question 37

Associated with berry aneurysms, MVP, benign hepatic cysts

Answer 37

ADPKD

Question 38

Congenital hepatic fibrosis is associated with this kidney disease

Answer 38

Infantile or ARPKD

Question 39

Potter Sequence

Answer 39

Significant failure of kidneys in infants; associated with ARPKD

Question 40

shrunken kidneys on ultrasound

Answer 40

Medullary cystic disease (auto dominant)

Question 41

inherited disease causing tubulointerstitial fibrosis and progressive renal insufficiency; can't concentrate urine

Answer 41

Medullary cystic disease

Question 42

Simple Kidney Cysts

Answer 42

Found in outer cortex filled with ultrafiltrate - usually asymptomatic

Question 43

Complex Kidney Cysts

Answer 43

septated, enhanced or have solid components | increased risk of renal cell carcinoma