Quiz 2 Renal Part 3 and 4

Question 1

where is toxic tubular necrosis found?

Answer 1

proximal tubule

Question 2

where is ischemic tubular necrosis found?

Answer 2

distal tubule

Question 3

hist of toxic acute tubular necrosis

Answer 3

absence of nuclei
homogenous cytoplasm that stains intensely eosinophilic
normal shape

Question 4

what is pathognomonic for ATN?

Answer 4

muddy brown casts found in urine

Question 5

what causes skip lesions through tubules?

Answer 5

ischemic ATN

Question 6

Acute interstitial nephritis

Answer 6

does not effect tubule, glomerulus

does effect cells outside (interstitum)

Question 7

what causes acute interstitial nephritis?

Answer 7

strep
legionella
CMV
allergic response to drug
rejection of renal transplant
NSAIDS

Question 8

what causes chronic interstitial nephritis?

Answer 8

diseases that lead to progressive scarring
cancers
exposure to lead
if drugs are removed

Question 9

what would have eosinophils in blood or urine?

Answer 9

Acute interstitial nephritis (AIN)

Question 10

hist of chronic interstitial nephritis

Answer 10

thin wire appearance

Question 11

Fanconi’s syndrome

Answer 11

disease of proximal renal tubule
gluocse, amino acids, uric acid, phosphate, and bicarb passed into urine instead of being reabsorbed
- caused by drugs or heavy metals

Question 12

what is Fanconi’s associated with?

Answer 12

renal tubular acidosis (RTA)

- accumulation of acid in body due to failure of kidneys to acidify urine

Question 13

analgesic nephropathy

what can it lead to?

Answer 13

occurs after ingestion of large amounts of analgesics over long period of time
- can lead to papillary necrosis

Question 14

cause of benign nephrosclerosis

Answer 14

DM with HTN

Question 15

Cause of malignant nephrosclerosis

Answer 15

changes to vessels of kidneys

Question 16

hist of benign nephrosclerosis

Answer 16

thickening of walls of small arteries

granular appearance

Question 17

hist of malignant nephrosclerosis

Answer 17

onion ring appearance of blood vessels

Question 18

what is number one cause of secondary HTN?

Answer 18

renal artery stenosis

Question 19

what are two main reasons for RAS

Answer 19

atherosclerosis
fibromuscular dysplasia of renal artery
atheroembolic renal disease
scar formation of renal artery

Question 20

which conditions commonly have thrombotic microangiopathy?

Answer 20

HUS (hemolytic uremic syndrome)

TTP (trhombotic thrombocytopenic purpura)

Question 21

what is most common bacteria to cause HUS?

Answer 21

E. Coli 0157:H7

Question 22

Who gets HUS?

Answer 22

children

• also postpartum women
• clotting and bleeding simultaneously with HUS

Question 23

hist of HUS

Answer 23

capillary lumen occluded by necrotic debris and thrmobi

Question 24

where do emboli to renal artery come from?

Answer 24

heart

Question 25

what does kidney tissue look like after cell death due to tissue infarct?

Answer 25

wedge shaped because lose blood to whole area. (not sure how to explain this better)

Question 26

what is the most common type of kidney stone?

Answer 26

calcium oxalate (75%)

Question 27

What are the 4 types of kidney stones?

Answer 27

``` calcium oxalate (75%) triple phosphate (15%) uric acid (5%) cystine (1%) ```

Question 28

which stones show up on X-ray?

Answer 28

ca oxalate

Question 29

what type of stones are pyramidal?

Answer 29

struvite and triple phosphate

Question 30

which type of stones are seen most common in association with urinary tract infections by bacteria that are urea-splitting?

Answer 30

magnesium ammonium phosphate stones (triple phosphate stones) *increased urine pH

Question 31

what causes staghorn triple phosphate stones?

Answer 31

urea splitting bacteria

Question 32

what is pH of urine with uric acid crystals/stones

Answer 32

acidic urine with pH of 5.5 or less

Question 33

what is the most common type of stone in children?

Answer 33

cystine stones

Question 34

why is ca elevated in cancer?

Answer 34

bone mets cause the release parathyroid hormone which boosts ca levels

Question 35

what are the benign renal tumors?

Answer 35

renal papillary adenoma renal fibroma or hamartoma angiomyolipoma oncocytoma

Question 36

which type of tumor has hist of fronds?

Answer 36

papillary adenoma

Question 37

hist of oncocytoma

Answer 37

uniform large polygonal cells | numerous mitochondria

Question 38

most common primary renal tumor in children?

Answer 38

Wilm's tumor/ nephroblastoma

Question 39

what tissue does primary renal tumor originate in?

Answer 39

kidney

Question 40

what is the most common malignancy?

Answer 40

RCC

Question 41

what chromosome is affected in children with Wilm's?

Answer 41

11

Question 42

what is the second most common renal malignancy?

Answer 42

mets from another tissue

Question 43

most common primary malignancy?

Answer 43

RCC

Question 44

Second most common primary malignancy (not including mets from another tissue)?

Answer 44

transitional cell carcinoma

Question 45

most common tumor in UG tract?

Answer 45

TCC

Question 46

hist of wilm's tumor

Answer 46

nests of cells deep purple/blue basophilic staining

Question 47

risk factors for RCC

Answer 47

tobacco exposure to cadmium and asbestos dialysis leads to cystic dz which is a risk factor

Question 48

Most common type of RCC

Answer 48

clear cell carcinoma (75-85%) | -contain a lot of glycogen

Question 49

#1 cause of hydronephrosis in kids

Answer 49

renal pelvic junction obstruction

Question 50

where does clear cell carcinoma arise from?

Answer 50

proximal tubule

Question 51

most common location for mets of RCC?

Answer 51

lung and brain from renal vein to vena cava