Nephro 2

Question 1

Bricker’s Intact Nephron Hypothesis

Answer 1

Compensation depends on adaptive changes produced by renal hypertrophy and adjustments in tubuloglomerular feedback and glomerulotubular balance

Question 2

Bricker’s Trade-Off Hypothesis

Answer 2

Physiologic adaptations to nephron loss also produce unintended clinical consequences

Question 3

Brenner’s Hyperfiltration Hypothesis

Answer 3

Some adaptations accelerate the deterioration of residual nephrons

Question 4

Acute Kidney Injury

Answer 4

A rise of at least 0.3 mg/dL or 50% higher than baseline within a 24-48-hour period; or
Reduction in urine output to 0.5 mL/kg per hour for longer than 6 hours

Question 5

Oliguria

Answer 5

Defined as

Question 6

High bone turnover with increased PTH levels

Answer 6

Osteitis fibrosa cystica: CLASSIC lesion for secondary hyperparathyroidism

Question 7

Low bone turnover with LOW or NORMAL PTH levels

Answer 7

Includes adynamic bone disease and osteomalacia

Question 8

Calciphylaxis (calcific uremic arteriolopathy)

Answer 8

Devastating condition seen almost EXCLUSIVELY in patients with advanced CKD; heralded by livedo reticularis

Question 9

“Restless leg syndrome”

Answer 9

Ill-defined sensations of sometimes debilitating discomfort in legs/feet relieved by frequent leg movement

Question 10

Uremic factor

Answer 10

A urine-like odor on the breath; derives from the breakdown of urea to ammonia in saliva and is often associated with an unpleasant metallic taste (dysgeusia)

Question 11

Nephrogenic Fibrosing Dermopathy

Answer 11

Seen in patients with CKD who have been exposed to gadolinum

Question 12

Current recommendation regarding gadolinum

Answer 12

CKD Stage 2 (GFR 30-59 mL/min) should MINIMIZE exposure to gadolinum
CKD Stages 3-5 (GFR

Question 13

By light microscopy, glomeruli (at least 10 and ideally 20) are reviewed individually for discrete lesions

Answer 13

50% involvement is DIFFUSE

Question 14

Injury in each glomerular tuft can be:

Answer 14

SEGMENTAL: involving a PORTION of the tuft (50%)

Question 15

Endocarditis-associated GN

Answer 15

Kidneys have subscapular hemorrhages with a “flea-bitten” appearance

Question 16

Granulomatosis with Polyangitis (Wegener’s)

Answer 16

Classically present with fever, purulent rhinorrhea, nasal ulcers, sinus pain, polyarthralgias/arthritis, cough, hemoptysis, shortness of breath, microscopic hematuria, and 0.5-1 g/24h of proteinuria

Question 17

Microalbuminuria

Answer 17

Albuminuria in the range of 30-300 mg/24h

Question 18

Anti-GBM Disease

Answer 18

Autoimmune disease where antibodies are directed agaisnt alpha-3 NC1 domain of collagen IV

Question 19

Bartter’s Syndrome

Answer 19

May result from mutations affecting any of five ion transport proteins in the TAL. Clinical syndrome mimics the effects of chronic ingestion of LOOP DIURETICS

Question 20

Gitelman’s Syndrome

Answer 20

Due to mutations in the thiazide-sensitive Na-Cl cotransporter, NCCT, in the DCT. Resembles the effects of thiazide diuretics

Question 21

Hyperprostaglandin E syndrome

Answer 21

Sever form of Bartter’s syndrome in which neonates present with pronounced volume depletion and failure to thrive, fever, vomiting, and diarrhea from PGE2 overproduction

Question 22

Liddle’s Syndrome

Answer 22

Mimics a state of aldosterone EXCESS by the presence of early and severe hypertension, often accompanied by hypokalemia and metabolic alkalosis, but plasma aldosterone and renin levels are LOW

Question 23

The Triad of heavy metal (lead) nephropathy

Answer 23

Saturnine gout
Hypertension
Renal Insufficiency

Question 24

Analgesic Nephropathy

Answer 24

Results from the long-term use of compound analgesic preparations containing phenacetin, aspirin, and caffeine

Question 25

Renal biopsy of chronic tubulointerstitial nephritis

Answer 25

Interstitial fibrosis & tubular atrophy OUT of PROPORTION to degree of glomerulosclerosis or vascular disease

Question 26

Chronic uric acid nephropathy

Answer 26

Degenerative changes of the renal arterioles OUT of PROPORTION to the other morphologic defects

Question 27

Hypercalcemic Nephropathy

Answer 27

Inability to maximally concentrate urine due to reduced collecting duct responsiveness to AVP and defective transport of sodium and chloride in the loop of Henle

Question 28

PENTAD of Thrombolic Thrombocytopenic Purpura (TTP)

Answer 28

Hemolytic anemia
Thrombocytopenia
Neurologic symptoms
Fever
Renal failure

Question 29

Scleroderma Renal Crisis (SRC)

Answer 29

MOST severe manifestation characterized by accelerated hypertension, a rapid decline in renal function, nephrotic proteinuria, and hematuria

Question 30

Renal lesion in SRC

Answer 30

ONION SKINNING and can be accompanied by glomerular collapse due to reduced blood flow

Question 31

Ureteropelvic and ureterovesical junctions, bladder neck, and urethral meatus

Answer 31

Normal points of narrowing (common sites of obstruction)