Quiz 2 Renal Part 1 and 2

Question 1

what activates cascade of angiotensinogen to angio 1 to angio 2?

Answer 1

Renin

Question 2

Absence of one or both kidneys

Answer 2

renal agenesis

Question 3

• Condition in which kidneys are fused at either upper or lower pole.
• Which location is most common?

Answer 3

• Horseshoe kidney

- lower pole

Question 4

what is the difference between adult and child PKD (polycystic kidney disease)?

Answer 4

• adult: autosomal dominant

- child: autosomal recessive

Question 5

hist of childhood PKD

Answer 5

large cysts lined with flattened cuboidal epithelium and intervening parenchyma that is fibrotic with islands of blue cartilage

Question 6

What is adult PKD associated with?

Answer 6

concurrent liver cysts

Question 7

What does dialysis cause? And what does this predispose these pt for?

Answer 7

• chronic dialysis cysts

- predisopose for RCC

Question 8

Do simply cysts and dialysis cysts both cause an increased risk for RCC?

Answer 8

No, just dialysis cysts

Question 9

which glomerular diseases present as nephrotic syndrome?

Answer 9

lipoid nephrosis/minimal change nephrosis
membranous glomerulopathy
focal-segmental glomerulosclerosis
nodular and diffuse glomerulosclerosis
*they are all non-proliferative

Question 10

What are the 4 characteristics of nephrotic syndrome?

Answer 10

1. porteinuria >3gm per 24 hours
2. decreased serum proteins
3. increased serum lipid levels
4. edema

Question 11

What do you call edema everywhere?

Answer 11

anasarca

Question 12

What are the 6 characteristics of nephritic syndrome?

Answer 12

1. proteinuria (less than nephrotic syndrome)
2. gross hematuria
3. RBC casts
4. azotemia (increased BUN)
5. oliguria (urine

Question 13

What is #1 type of nephrotic syndrome in children?

Answer 13

minimal change/lipoid nephrosis

Question 14

hist of lipoid nephrosis

Answer 14

normal

Question 15

Most common adult nephrotic syndrome and what is cause?

Answer 15

membranous glomerulopathy
caused by response to antigenic stimulation by an infectious agent or toxin (hep B and C, syphilis, malaria, schistosomiasis)

Question 16

hist of membranous glomerulopathy

Answer 16

diffusely thickened basement membrane and spiked appearance

- capillary loops are thickened and prominent

Question 17

most common type of nephrotic syndrome in African American adults?

Answer 17

Focal Segmental glomerulosclerosis

Question 18

hist of focal segmental glomerulosclerosis

Answer 18

some parts are normal and some parts are abnormal

Question 19

what causes post-infectious glomerulonephritis?

Answer 19

immune response to previous infection with GABHS

Question 20

What two diseases can cause glomerulosclerosis and their hist?

Answer 20

diabetes: hyaline degeneration
amyloidosis: pink, fibrils of protein line up in amyloid. And foot processes coming off

Question 21

1 cause of glomerulonephritis worldwide?

Answer 21

IgA/Bergers type III immune reaction

Question 22

1 cause of chronic renal failure in US?

Answer 22

Diabetes mellitus

Question 23

characteristics of diabetic nephropathy

Answer 23

slow progressing
proteinuria
glucosuria
*spilling microalbumin

Question 24

What is nodular glomerulosclerosis related to diabetes referred to as?

Answer 24

Kimmelstiel-Wilson disease

Question 25

mnemonic for nephritic syndrome characteristics

Answer 25

``` PHAROH Proteinuria Hematuria Azotemia RBC casts Oliguria Hypertension ```

Question 26

Bergers disease/IgA nephropathy

Answer 26

marked hypersecrtion of IgA in response to antigenic stimulus * common in pt with celiac

Question 27

Another disease state of IgA over-secretion?

Answer 27

Henoch-Schonlein purpura

Question 28

Characteristics of Henoch-Schonlein purpura

Answer 28

``` skin lesions joint tenderness hematuria vasculitis in kids ```

Question 29

List types of non-proliferative glomerulonephritis

Answer 29

minimal change GN focal segmental GN membranous GN

Question 30

What is the most common cause of acute nephritic syndrome?

Answer 30

Post-streptococcal glomerulonephritis | GABHS

Question 31

hist of post-strep GN

Answer 31

clumps of humps

Question 32

hist of rapidly progressing GN (RPGN)

Answer 32

crescent shape: bands of fibrin deposited throughout capillary tufts

Question 33

what conditions increase risk of RPGN>

Answer 33

vasculitis collagen vascular (Goodpasture and Henoch-schonlein) IgA nephropathy Membranoproliferative GN

Question 34

Goodpasture

Answer 34

type II hypersensitivity | basement membrane changes in kidney and lungs

Question 35

Wegener's granulomatosis

Answer 35

involves kidney and other organs (mucosa, otitis, conjunctivitis, gums) sores ulcers

Question 36

lab for Wegener's granulomatosis

Answer 36

+ C- ANCA | anti neutrophil cytoplasmic antibodies

Question 37

What would P-ANCA be positive in?

Answer 37

polyartaritis nodosum (PAN)

Question 38

Adult PKD is known to have cysts where?

Answer 38

kidney and liver

Question 39

what is the worst biopsy finding in Wegeners?

Answer 39

crescentic