Nephrology

Question 1

Goodpasture disease

Answer 1

Autoimmune type 2 sensitivity reaction.
Lung symptoms usually precede kidney symptoms and include hemoptysis, cough, shortness of breath, and chest pain.
Kidney symptoms usually include blood and protein in the urine, unexplained edema, elevated blood pressures.
kidney biopsy: crescentic glomerulonephritis pathology with linear anti-GBM antibodies.

Question 2

The 2 most important cause of metabolic acidosis with normal anion gap?

Answer 2

Renal tubular acidosis and diarrhea.

Question 3

Renal tubular acidosis type I

Answer 3

The distal tubule cannot generate bicarbonate, the acid cannot be excreted into the tubule = raising the PH in the urine.

Question 4

Renal tubular acidosis Type II

Answer 4

proximal tubule cannot reabsorb bicarbonate.

Question 5

Renal tubular acidosis type IV

Answer 5

Occurs most often in diabetes
Decrease amount of effect of aldosterone=loss of sodium and retention of potassium and hydrogen ions.
Urine PH low

Question 6

Patient shows signs of nephrotic syndrome and has Hodgkin’s lymphoma (HL), the nephropathy the patient is most likely experiencing?

Answer 6

The most common nephropathy associated with Hodgkin lymphoma and other hematologic malignancies minimal change disease.

Question 7

The most common nephropathy associated with solid tumors is?

Answer 7

Membranous nephropathy (immune complex mediated).

Question 8

Membranoproliferative glomerulonephritis

Answer 8

Nephrotic syndrome
Type I is generally a slower disease secondary to systemic lupus erythematosus (SLE), chronic hepatitis C, or hepatitis B. Type II is a more aggressive disease caused by autoimmune activation of complement by nephritic factor, an autoantibody against C3.

Both: low serum C3; however only type II is associated with C3 nephritic factor.

Biopsy: Type I, and type II shows intramembranous dense deposits.