Nephrology

Question 1

Mastoiditis and filling defect of right IJ

Answer 1

Lemiere syndrome (Jugular vein septic thrombophlebitis) caused by Fusobacterium necrophorum

Question 2

Persistent isolated hematuria, differentials

Answer 2

Kidney stone and familial hematuria (if urine Ca to Cr ratio is <0.2, then unlikely stone)

Question 3

Nephritic syndromes associated with decrease C3

Answer 3

Poststrep glomerulonephritis, SLE/lupus nephritis (diffuse proliferative glomerulonephritis), membranoproliferative glomerulonephritis

Question 4

Type 1 RTA

Answer 4

Distal RTA => alpha-intercolated cells unable to secrete H+ => urine pH more than 5.5 (cause calcium phosphate kidney stones) and hypokalemia. All RTAs have non-AG hyperchloremic metabolic acidosis.

Question 5

Type 2 RTA

Answer 5

Proximal RTA => unable to reabsorb HCO3 => acidosis => alpha-intercolated still able to secrete H+ => urine pH less than 5.5 (no stones) and hypokalemia. All RTAs have non-AG hyperchloremic metabolic acidosis.

Question 6

Type 4 RTA

Answer 6

Hyperkalemic RTA => hypoaldosteronism = hyperkalemia