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2020 ABIM studying > Nephro > Flashcards

Nephro Flashcards

1
Q

Eosinophils in urine suggests what 5 diagnoses?

A

AIN, postinfectious GM, atheroembolic disease, septic emboli, small vessel vasculitis

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2
Q

Erythrocyte casts and Acanthocytes indicate what diagnosis?

A

Glomerular disease

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3
Q

Leukocyte casts indicate what 2 diagnoses?

A

Infection or inflammation of renal parenchyma

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4
Q

Muddy Brown casts indicate what diagnosis?

A

ATN

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5
Q

Broad casts indicate what diagnosis?

A

CKD

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6
Q

The patient’s anion gap is <4, what 2 Dx does this suggest?

A

Multiple myeloma or hypoalbuminemia

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7
Q

150-200 mg/g Proteinuria on urine sample suggests what 2 dx?

A

Tubulointerstitial or glomerular dx

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8
Q

> 3500 mg/g Proteinuria on urine sample suggests what dx?

A

Glomerular dz

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9
Q

What are the five causes of tubulointerstitial kidney disease?

A

Medications, infections, Immunologic, oncologic, obstructive.

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10
Q

What type of RTA is associated with multiple myeloma?

A

RTA Type 2

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11
Q

Sterile pyuria (leukocytes on UA & negative culture) Suggest what 4 diagnoses?

A

Genitourinary tuberculosis, interstitial cystitis, interstitial nephritis, STIs

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12
Q

How is urine anion gap calculated?

A

Urine na+ urine K - urine chloride.

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13
Q

What type of kidney stones are often implicated in recurrent UTIs?

A

Struvite (Magnesium Ammonium phosphate) stones

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14
Q

What would you expect the C3 complement levels to be (increased/decreased/same) in a patient with post-infectious glomerulonephritis?

A

Decreased

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15
Q

What kidney stones are most commonly missed on plain xrays?

A

Uric acid stones

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16
Q

Which form of nephrotic syndrome is often associated with lithium use?

A

Minimal change disease

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17
Q

Which form of nephrotic syndrome is most associated with heroin use, obesity, sickle cell dz, AA?

A

Focal segmental glomerulosclerosis

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18
Q

What is the most likely diagnosis in a patient on hemodialysis with skin ulcerations and an elevated calcium-phosphate product?

A

Calciphylaxis

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19
Q

What is the gold standard imaging modality for diagnosing kidney stones?

A

Noncontrast spiral CT

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20
Q

What is the goal hemoglobin level in patients with end stage renal disease?

A

11-12 g/dl (higher than this can increase risk of embolism or strokes)

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21
Q

What is the most common type of glomerulonephritis throughout the world?

A

IgA Nephropathy

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22
Q

Which type of renal tubular acidosis is associated with defect in proximal bicarbonate absorption?

A

RTA type 2

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23
Q

Which renal disorder can present both as nephritic and nephrotic syndrome?

A

Membranoproliferative glomerulonephritis (MPGN)

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24
Q

Which two CD markers are often deficient in individuals with paroxysmal nocturnal hemoglobinuria? (PNH)

A

CD55 and CD59

25
Q

Which subtype of nephrotic syndrome is most commonly associated with hepatitis B Infections?

A

Membranous nephropathy

26
Q

Rapid fire assoc:RBC casts in urine

A

Glomerulonephritis

27
Q

Rapid fire assoc: Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

28
Q

Rapid fire assoc: Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

29
Q

Rapid fire assoc: Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

30
Q

Rapid fire assoc:Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

31
Q

Polyuria, renal tubular acidosis type II, growth failure, electrolyte imbalances, hypophosphatemic rickets

A

Fanconi syndrome (multiple combined dysfunction of the proximal convoluted tubule)

32
Q

Periorbital and/or peripheral edema, proteinuria (>3.5g/day), hypoalbuminemia, hypercholesterolemia

A

Nephrotic syndrome

33
Q

Rapid fire assoc: “Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)

34
Q

Rapid fire txt: Pheochromocytoma

A

α-antagonists (eg, phenoxybenzamine) or alpha blockers (prazosin). Can use beta blockers (typically labetalol) only after adequate alpha blockade

35
Q

2º hyperparathyroidism is classically caused by what?

A

Hypocalcemia of chronic kidney disease

36
Q

Rapid fire txt: Cyclophosphamide-induced hemorrhagic cystitis

A

Mesna

37
Q

Rapid fire assoc:”Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

38
Q

Rapid fire assoc:WBC casts in urine

A

Acute pyelonephritis or AIN

39
Q

Rapid fire assoc:”Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

40
Q

Which nephrotic syndrome is typically associated with hepatitis C and cryoglobulinemia?

A

Membranoproliferative glomerulonephritis

41
Q

Rapid fire assoc:”Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy

A

Membranoproliferative glomerulonephritis

42
Q

Rapid fire assoc:Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

43
Q

Rapid fire assoc:”Spikes” on basement membrane, “dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

44
Q

Proximal bicarbonate reabsorption is seen in which renal tubular acidosis type?

A

Renal tubular acidosis type 2

45
Q

NSAIDS are known to cause allergic interstitial nephritis without eosinophils. What other class of medication is known to cause allergic interstitial nephritis without eosinophils about 33% of the time?

A

Proton pump inhibitors (PPI)

46
Q

Muddy brown casts in a urinalysis is a clue towards which renal process?

A

Acute tubular necrosis (ATN)

47
Q

In males, a creatinine level of this or higher is a contraindication to giving metformin? Or gfr less than what?

A

1.5 mg/dl or higher. 45

48
Q

How many days after aminoglycoside use can acute tubular necrosis arise?

A

4-5 days

49
Q

What is the cause of unexplained hypoK and Met ALk? How do you differentiate?

A

surreptitious vomiting or diuretic use. Elevated urinary cl >20 assoc with diuretics

50
Q

What are the organisms that may lead to struvite stones?

A

Urea-splitting bacteria (Proteus, Klebsiella, or Pseudomonas)

51
Q

Besides rhabdomyolysis, what three major conditions will produce blood in the urine without seeing RBCs in urine?

A

Contamination with povidine, vitamin C Excess, Paroxysmal nocturnal hemoglobinuria

52
Q

Bence Jones protein in urine suggests what dz?

A

Multiple myeloma

53
Q

What is the equation for osmolality?

A

(2xNa)+(gluc/18)+(BUN/2.8)+(EtOH/3.7)

54
Q

What is the urine anion gap Equation?

A

Urine Na+ urine K - urine Cl

55
Q

Which medicine when given with CCB can reduce peripheral edema?

A

Ace inhibitors

56
Q

Absolute iron deficiency in patients with CKD is suggested by what 2 parameters?

A

Ferritin less than 200 (in hemodialysis patients) and transferrin saturation less than 20%

57
Q

All patients with end stage renal disease on erythropoietin stimulating agents should be given IV iron unless what?

A

Ferritin is greater than 500

58
Q

Topamax and acetazolamide cause what acid/base disturbance?

A

Non-anion gap metabolic acidosis

59
Q

Na>145 with urine osm less than serum osm rules out what Dx? Suggests what Dx?

A

primary polydipsia; central DI

2020 ABIM studying (12 decks)

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