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Renal > Quiz #4 Highlights > Flashcards

Quiz #4 Highlights Flashcards

1
Q

Nephrotic Syndrome proteinuria levels?

A

> 3.0 and >300mg/mmol

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2
Q

The most common form of primary GN in the world?

A

IgA GN (Berger’s disease)

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3
Q

Most common symptom of Berger’s disease?

A

episodic gross hematuria

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4
Q

Describe the urine seen in Berger’s disease?

A

pink, cola, or tea

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5
Q

What is seen on biopsy for Berger’s disease?

A

IgA in mesangium

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6
Q

Glomerular crescent formation

A

RPGN

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7
Q

Most common vasculitis in children?

A

Henoch- Schonlein Purpura (HSP)

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8
Q

Occurs 1-2 days after a cold, sore throat, or URI?

A

acute IgA GN

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9
Q

Classic triad for Henoch Schonlein?

A

Palpable purpura
Arthralgia
Abdominal pain

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10
Q

Most common cause of nephritic disease in children 5-15y/o?

A

Poststreptococcal GN

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11
Q

Develops 1-3 wks after Group A beta-hemolytic strep throat or impetigo?

A

Poststreptococcal GN

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12
Q

Describe urine in Poststreptococcal GN?

A

cola-colored, brown, smoky or frank blood

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13
Q

Subepithelial deposits or “humps”

A

PSGN

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14
Q

“Starry sky” or granular appearance on the GBM and mesangium

A

PSGN

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15
Q

What is NOT used for txt in PSGN?

A

Corticosteriods!

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16
Q

Whom is lupus most common in?

A

AA and female child bearing age

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17
Q

How many classifications of Lupus Nephritis?

A

Class 1-6

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18
Q

Most common and most severe class of LN?

A

Class IV (4)

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19
Q

LN class that has thrombotic events?

A

Class V: Membranous GN with nephropathy

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20
Q

Butterfly or malar facial rash

A

LN

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21
Q

What is the most common type of MPGN?

A

Type 1

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22
Q

“Tram track” appearance on LM?

A

MPGN Type 1

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23
Q

Partial lipodystrophy?

A

MPGN Type II

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24
Q

NO tram tracks?

A

MPGN Type II

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25
Q

“Ribbon like” - “dense deposit disease”

A

MPGN Type II

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26
Q

Most common cause of Cryoglobulin- GN?

A

Hepatitis C

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27
Q

What is Meltzer’s triad?

A

Purpura
Arthralgia
Weakness

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28
Q

Where is Meltzer’s triad seen?

A

Cryoglobulin- GN

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29
Q

Comes out in cold weather “cold sensitive”

A

Cryoglobulin -GN

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30
Q

What is the most common presentation of HCV?

A

Cryoglobulinemia (30%)

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31
Q

What 3 dx are HCV seen in ?

A

Membranoproliferative GN Type I
Cryoglobulinemia
Membranous nephropathy

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32
Q

Type I RRGN?

A

Goodpasture’s Syndrome

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33
Q

Type III RRGN?

A

ANCA

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34
Q

What makes up ANCA?

A

cANCA (ctyoplasmic)

pANCA (perinuclear)

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35
Q

What makes up cANCA?

A

GPA

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36
Q

What makes up pANCA?

A

MPA

EGPA (Chrug-Strauss syndrome)

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37
Q

Hallmark of Goodpasture’s?

A

Anti-GBM antibodies

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38
Q

Linear deposition of IgG and C3 along the GBM

A

Goodpasture’s

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39
Q

Rapid renal loss and pulmonary hemorrhage?

A

Goodpasture’s

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40
Q

Classic triad of GPA?

A

URT
LRT
Renal

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41
Q

Classic triad of EGPA?

A

Asthma
Peripheral blood eosinophilia
Vasculitis

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42
Q

Gold standard for dx EGPA?

A

lung biopsy

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43
Q

What is txt of EGPA based on?

A

“five-factors score”

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44
Q

How many months for chronic kidney disease?

A

> 3mos

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45
Q

What is the #1 cause of CKD?

A

Diabetic nephropathy

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46
Q

What is the gold standard for CKD staging?

A

24-hour urine (to measure albuminuria)

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47
Q

What is the more practical way to stage CKD?

A

Albumin to Creatinine Ratio (ACR)

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48
Q

Alot of people are in what stage of CKD?

A

3A

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49
Q

What is classic finding on imaging for CKD?

A

bilateral or single SMALL kidney

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50
Q

What is a HIGH risk of CKD?

A

Cardiovascular risk

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51
Q

What is the most common complication of CKD?

A

HTN

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52
Q

What bone disorder is seen CKD?

A

Osteomalacia

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53
Q

What is the most common bone lesion seen in CKD?

A

Osteitis fibrosa cystica

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54
Q

How does anemia look in CKD?

A

Normocytic, normochromic anemia

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55
Q

AEIOU used for?

A

Dialysis

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56
Q

What does AEIOU stand for?

A 
Acid base problems
E- electrolyte
I- intoxication
O- overload of fluids
U-remic s/s
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57
Q

Most common complication of peritoneal dialysis?

A

Peritonitis

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58
Q

Most common infectious pathogen of hemodialysis?

A

Staphylococcus

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59
Q

1 complication of hemodialysis?

A

Hypotension

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60
Q

Txt of choice for ESRD?

A

Renal transplant

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61
Q

What is the most common cause of kidney transplantation (25%)

A

DM

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62
Q

Bence Jones protein?

A

Myoglobin

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63
Q

Myglobinuria

A

Rhabdo

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64
Q

RBC casts?

A

GN

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65
Q

WBC casts?

A

interstitial nephritis

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66
Q

Pigmented/muddy brown casts

A

acute tubular necrosis (ATN)

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67
Q

Absolute contraindications in renal biopsy?

A 
Uncorrected bleeding disorder
Severe uncontrolled HTN
Renal infection
Neoplasm
Hydronephrosis
Uncooperative pt
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68
Q

Relative c/I to renal biopsy?

A 
Solitary or ectopic kidney
Horseshoe
ESRD
Congenital anomalies
PCKD
Kidney transplant
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69
Q

The most common AKI?

A

pre-renal (80%)

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70
Q

The least common AKI?

A

post-renal (15%)

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71
Q

What is RIFLE used for?

A

AKI

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72
Q

RIFLE?

A 
Risk
Injury
Failure
Loss
End stage
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73
Q

Most common renal/intrinsic AKI?

A

acute tubular necrosis (ATN)

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74
Q

3RD leading cause on new onset AKI in hospitalized patients?

A

Radiographic contrast dye

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75
Q

Classic Traid for AIN?

A

Fever, rash, arthralgia post infection or medication

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76
Q

Serum eosinophilia and eosinophiluria?

A

AIN

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77
Q

Txt for AIN?

A

Methylprednisolone 500-1000mg for 3 days

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78
Q

Heart and kidney dysfunction due to other acute or chronic disease?

A

Type 5 Cardiorenal Syndrome

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79
Q

Acute HF results in AKI?

A

Type 1

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80
Q

Most common type of nephrotic syndrome?

A

Primary

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81
Q

Severe albuminuria/ proteinuria?

A

> 3.5 g/day

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82
Q

frothy urine?

A

nephrotic

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83
Q

Maltese cross

A

Nephrotic (lipiduria)

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84
Q

Fatty cast?

A

Nephrotic

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85
Q

Proteinuria txt?

A

ACEI or ARBs (monitor K+)

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86
Q

Edema txt?

A

Loop diuretics

Thiazide

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87
Q

Most common cause of nephrotic syndrome in children?

A

Minimal change disease (MCD)

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88
Q

Third most common form of primary nephrotic syndrome in adults?

A

MCD

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89
Q

What is seen on biopsy for MCD?

A

widespread effacement of foot processes of the podocytes

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90
Q

Txt for MCD?

A

Prednisone

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91
Q

Most common cause of nephrosis in adults?

A

Focal segmental glomerulosclerosis

92
Q

“Spike and dome” pattern?

A

Membranous glomerulonephritis (MGN)

93
Q

DVT or renal vein thrombosis initial presentation?

A

MGN

94
Q

Classic triad for Diabetic Nephropathy?

A

HTN, heavy proteinuria, and retinopathy

95
Q

Most common type of DN?

A

Type 1 DM

96
Q

What is the 1st stage of diabetic nephropathy?

A

hyperfiltration

97
Q

Nodular GS (Kimmelstiel Wilson)

A

DN

98
Q

Most common renal amyloid?

A

primary amyloidosis

99
Q

Swelling in the face, ankles, and legs?

A

Renal amyloid (RA)

100
Q

Dx for RA?

A

Abdominal fat pad biopsy

101
Q

Apple green under LM?

A

RA

102
Q

Congo red stain appears pink?

A

RA

103
Q

Most common cause of asymptomatic hematuria?

A

Thin basement membrane disease (TBMD)

104
Q

Txt for TBMD?

A

Reassurance

105
Q

Classic triad for Alport?

A

GN, ESRD, hearing loss, and eye problems

106
Q

Alport is what type of genetic problem?

A

X- linked (85%)

107
Q

Inherited defect in type IV collagen?

A

Alport Syndrome

108
Q

Dx of Alport?

A

woven basket or basket weave appearance

109
Q

woven basket or basket weave appearance

A

Alport Syndrome

110
Q

Most common ECF buffer?

A

carbonic acid (H2CO3)

111
Q

Most common ICF buffer?

A

Sodium carbonate (Na2CO) and proteins (albumin)

112
Q

Main independent urinary buffer?

A

Main independent urinary buffer?

113
Q

Anion gap and winter’s formula?

A

metabolic acidosis

114
Q

Formula for winter’s formula?

A

pc02= (1.5 x HCO3-) + 8 +/-2

115
Q

Hyperkalemia, COPD, drugs?

A

Respiratory acidosis

116
Q

Stimulate ventilation?

A

Doxapram HCL

117
Q

Anxiety, hyperventilation?

A

Respiratory alkalosis

118
Q

Hyperkalemia, Kussmal respirations (DKA)

A

metabolic acidosis

119
Q

Normal gap with INCREASE in chloride and DECREASE in bicarb?

A

Hyperchloremic metabolic acidosis

120
Q

pulling water into the bv

A

oncotic pressure

121
Q

Keeping fluid from leaving bv

A

hydrostatic pressure

122
Q

Most common hyponatremia?

A

hypotonic (90%)

123
Q

Most common electrolyte abnormality in hospitalized pts?

A

hyponatremia

124
Q

Txt for Respiratory Acidosis?

A

Doxapram HCL

125
Q

Txt for Respiratory Alkalosis?

A

Txt cause, relax, rebreathe

126
Q

Txt for Metabolic Acidosis <7.1?

A

IV bicarb

txt hyperkalemia

127
Q

Txt for DKA in metabolic acidosis?

A

fluids, insulin, bicarb

128
Q

Txt for ASA overdose?

A

bicarb

129
Q

Txt for alcoholic metabolic acidosis?

A

thiamine w/ glucose

130
Q

Txt for methanol metabolic acidosis?

A

Fomepizole w/wo dialysis

131
Q

Txt for RTA metabolic acidosis?

A

large amounts of alkali replacement w/ salts

132
Q

Txt for Hyperaldosteronism?

A

Fludrocortisone

133
Q

Txt for chloride metabolic alkalosis?

A

chloride and volume replacement

134
Q

Txt for non-chloride metabolic alkalosis?

A

Spironolactone or ACEI

135
Q

Dehydration txt?

A

prevention

PO fluid replacement w/ pure water

136
Q

Severe dehydration txt?

A

IV hydration w/ crystalloids

Monitor I + Os

137
Q

Causes for dehydration?

A 
Infants and elderly- thirst and access
Hemorrhage
Inadequate fluid replacement
Hot + Humid + High attitudes
Endurance activities
Chronic illness: Cardio, Renal, Hyperaldosteronism
138
Q

Txt for Hypovolemia?

A

Oxygen 1st
IVF- crystalloids, colloids, blood
Surgery

139
Q

Txt for hypervolemia?

A

Txt cause
Diuretics
Oral/ sodium restriction

140
Q

Txt for Hypokalemia?

A

Oral potassium replacement

IV K+

141
Q

Txt for Hyperkalemia?

A

Stop exogenous K+
Patiromer- FDA approved
Sodium polystyrene

142
Q

Txt for emergent Hyperkalemia (>6.5)?

A

insulin/glucose, bicarb, beta agonist
IV calcium stablize membrane
Hemodialysis

143
Q

Peaked T waves

A

Hyperkalemia

144
Q

Prominent U waves, Broadened T waves?

A

Hypokalemia

145
Q

Black licorice- glycyrrhizinc acid

A

metabolic alkalosis

146
Q

Lower number of nephrons, small kidneys without scarring on nuclear scan?

A

Simple renal hypoplasia

147
Q

No ureter development, with recurrent UTIs and impaired renal dysfunction?

A

Renal dysplasia

148
Q

Txt for bilateral severe renal dysplasia?

A

Family counseling

149
Q

Most common and severe form of non-heritable renal cystic disease?

A

Multicystic Dysplastic Kidney (MCDK)

150
Q

A non-functioning dysplastic kidney with no renal tissue present?

A

Multicystic Dysplastic

151
Q

US- shows multiple cysts on the periphery kidney

A

Dx for MCDK

152
Q

Most common HEREDITARY disease in the US?

A

Polycystic Kidney Disease (PCKD)

153
Q

What usually develops later in the 4th and 5th decade of life in PCKD?

A

ESRD

154
Q

Most common form of PKD?

A

Autosomal Dominant PKD (adult onset)

155
Q

Most common complication in females with PKD?

A

Liver cysts

156
Q

Classic symptoms seen with PCKD?

A

Abdominal, flank, or back pain, hematuria and HTN

157
Q

What is seen in the history of a PCKD pt?

A

Fhx of renal tract problems

158
Q

Dx for PCKD for confirmation?

A

US

159
Q

Dx for PCKD support?

A

CT scan

160
Q

How early is ARPKD detectable?

A

24 weeks

161
Q

Large “bright” cystic kidneys and hepatic cysts?

A

Autosomal Recessive PCKD

162
Q

What is Potter Syndrome?

A

pulmonary hypoplasia, flattened face, widely separated eyes, epicanthal folds, low-set ears, club foot

163
Q

Potter Syndrome

A

ARPKD

164
Q

Txt for ARPKD?

A

Supportive team therapy

165
Q

Renal agenesis txt?

A

counseling parents

166
Q

Rare, BUT most common genetic cause of childhood kidney failure?

A

Nephronophthisis

167
Q

Polyuria, Polydipsia, and salt wasting, HTN before 20y/o?

A

NPH

168
Q

“Swiss cheese appearance”

A

Medullary Syndrome (Cacci Ricci Disease)

169
Q

Fluid filled cysts form in the tubules?

A

Medullary sponge

170
Q

“Paintbrush- like appearance”

A

Medullary Sponge

171
Q

Most common congenital anomaly of the urinary tract

A

Duplication of ureters

172
Q

Most common renal fusion anomaly?

A

Horseshoe kidney

173
Q

Where is the horseshoe kidney connected?

A

isthmus

174
Q

What stops the horseshoe kidney?

A

inferior mesenteric artery

175
Q

When is horseshoe kidney found?

A

on autopsy

176
Q

2nd most common fusion anomaly?

A

crossed fused renal ectopia

177
Q

Txt of crossed fused renal ectopia?

A

pyeloplasty

178
Q

Txt for fetal hydronephrosis?

A

resolves own its on

179
Q

Prune belly syndrome?

A

hydronephrosis

180
Q

What is prune belly syndrome?

A

abdominal muscles, enlargement of the ureters and bladder, bilateral UDT and VUR

181
Q

Most common cause of hydronephrosis in adults?

A

BPH or stones

182
Q

Imaging for hydronephrosis?

A

US

183
Q

Txt for acute hydronephrosis?

A

percutaneous nephrostomy tube

184
Q

Txt for chronic hydronephrosis?

A

ureteric stent or pyeloplasty

185
Q

Txt for lower obstruction in hydronephrosis?

A

urinary or suprapubic catheter

186
Q

Most common causes of secondary hypertension?

A

Renal artery stenosis

Renal vein thrombosis

187
Q

What is a treatable cause of secondary HTN?

A

Renovascular disease

188
Q

90% of renal artery stenosis?

A

atherosclerosis plaque formation

189
Q

Who is at risk of RAS?

A 
ELDERLY
OBESE
>60
MALE
Elevated lipids
190
Q

Triple effect?

A

Juxtaglomerurlar cells
Macula densa cells
Renin

191
Q

Gold standard for dx RAS?

A

Renal angiography

192
Q

“Strings of pearls”

A

Fibromuscular dysplasia

193
Q

What medication should be AVOIDED in RAS txt?

A

ACEI

194
Q

Txt for RAS?

A

angioplasty w/wo stent

195
Q

MOST COMMON cause of Renal vein thrombosis?

A

Nephrotic syndrome (membranous nephropathy)

196
Q

Vircho’s Triad?

A

Endothelial damage
Low blood flow (dehydration/shock)
Increase coagulability of blood

197
Q

Vircho’s Triad seen in?

A

Renal vein thrombosis (RVT)

198
Q

Nephrotic pt has a PE?

A

RVT

199
Q

Imaging of choice for RVT?

A

CT angiography

200
Q

What is compressed in Nutcracker syndrome?

A

superior mesenteric artery

201
Q

Txt for Nutcracker syndrome

A

weight gain (fat pad)

202
Q

Most common type of kidney cancer?

A

Renal cell carcinoma

203
Q

Where is RCC mostly found?

A

PCT

204
Q

9TH MOST common cancer in US?

A

Renal cell carcinoma

205
Q

Increased risk and decrease risk for RCC?

A

Smoking- significant risk

Alcohol- protective effect

206
Q

Most common RCC type?

A

Clear cell

207
Q

Classic triad of RCC?

A

Flank pain, hematuria, abdominal mass

208
Q

Stauffer syndrome?

A

liver disease in the absence of mets

209
Q

What is renal hemartomas?

A

a bruise to the kidney (most common)

210
Q

What is angiomyolipoma?

A

blood vessels, muscle tissue, fatty tissue

211
Q

What is checked prior to treatment of RCC?

A

TSH

212
Q

What can be tested for in RCC?

A

Alkaline phosphatase

213
Q

Dx for RCC?

A

Renal US

214
Q

What detects nodal and organ mets in RCC?

A

MRI and CT

215
Q

WHAT SHOULD NEVER BE DONE IN RCC?

A

renal biopsy

216
Q

Treatment of choice for RCC?

A

Partial or radical nephrectomy

217
Q

When is a radical nephrectomy performed?

A

> 7cm or partial is not feasible

218
Q

When is partial nephrectomy performed?

A

single kidney, bilateral RCC, cancer in a kidney, significant renal disease

219
Q

If a partial or radical nephrectomy can’t be performed what txt is used?

A

cryotherapy or radio-frequency ablation

220
Q

Targets vascular?

A

Suniti(nib), Pazopanib, Cabozantinib (tyrosine inhibitors)

221
Q

Targets the cancer?

A

Temsiroli(mus) and everolimus (mTOR rapamycin inhibitors)

222
Q

Most common renal tumor in children?

A

Wilms tumor

223
Q

Second commn anomaly?

A

Hemihypertrophy

224
Q

WAGR?

A

Wilm tumor
Aniridia (no iris)
G-GU abnormalities
R- intellectual disability

225
Q

Painless, palpable abdominal mass found incidentally

A

Wilms tumor

226
Q

Dx for Wilm’s tumor?

A

Abdominal US

227
Q

What does Wilms tumor usually progress to by age 50y?

A

a 2nd malignant neoplasm (chest)

Renal (9 decks)

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