Quizzam 1 Flashcards

1
Q

Eosinophilic casts wit thyroidization, blunted calyx and corticomedullary scarring

A

Chronic Pyelonephritis Nephritis

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2
Q

PLA2R (phospholipase), HLADQ1 and IgG4

A

Membranous nephropathy

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3
Q

If patient PMH of SLE then presents with Proteinuria over 3.5,

If pt PMH of SLE then presents with periorbital edema, inflammation and hematuria

A

Nephrotic = Membranous Nephropathy

Nephritic = Diffuse proliferative glomerulonephritis

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4
Q

Which ones progress to Chronic Kidney Disease in order?

A
RPGN
FSGS
Membranous GN
Membranoproliferative
IgA
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5
Q

WHich one’s the guy with C3 Nephritic Factor? What PMH causes this

A

Membranoproliferative GN

HBV and HPCV

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6
Q

What GN is associated with Hodgkin and respiratory disease

A

Minimal Change Disease

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7
Q

What is selectively proteinuric

A

Minimal Change DIsease

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8
Q

Which one is like, they have HIV they have this. Sickle cell and heroin also

A

Focal Segmental GN

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9
Q

How do you tell the difference between FSGN and MCD?

A

FSGN is nonselective proteinuria and has more hematuria

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10
Q

Nodular glomerulosclerosis

A

DM GN

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11
Q

A pt presents with hematuria, oliguria, and eosinophilia

A

Acute Interstital nephritis

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12
Q

How do you know when a UTI has become pyelonephritis?

A

Flank pain, fever, WBC casts

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13
Q

Child presents to the clinic with kidney problems. Bx shows corticomedullary scarring, blunted calyx. Tubules contain thyroid tissue. What is the dx and mx?
If it’s an adult, what’s the difference?

A

Dx: Chronic pyelonephritis
Mx: Has Vesicourteral reflex

ADult: Enlarged Prostate

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14
Q

A pt with a PMh of HTN presents with kidney problems.; bx shows:

  • Fibrinoid necrosis
  • Fibroelastic hyperplasia
A

Necrosis = Malignant Nephrosclerosis

Hyaline & fibroelastic hyperplasia: Benign

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15
Q

What’s an atypical cause of HUS?

A

Complement Proteins Mutations, contraceptives,

most common in pregnant adults

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16
Q

What vascular defect happens in OB emergencies

A

Diffuse cortical necrosis

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17
Q

What are the 4 associations of AD polycystic Kidney Disease?

Gnetics things

A
  • Berry anuerysms
  • Cystic lesions
  • Diverticulosis
  • MItral Valve Prolapse

PCKD1 mutations: bad. Chromosome 16
PCDK2: Chromosome 4 not as bad

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18
Q

Pt is experiencing polyuria and polydipsia (great thirst); No cysts are seen. US shows small kidneys; the child patient develops end stage renal disease. What is the dx? Gene?

A

dx: medullary cystic kidney disease

MCKD1

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19
Q

Pt with PMH of tuberous sclerosis is found to have profound hematuria; what gene is messed up? What are we watching for?

A

LOF TSC1;

can hemorrhage

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20
Q

WHere does chromophobe carcinomas arise from?

A

Type B intercalated cell

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21
Q

How will RCC present?

A

FEVER

flank pain, hematuria, mass

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22
Q

What 3 cell types does a Wilms tumor have? What is the most critical prognostic element?

A

Stromal, Blastemal, Epithelial

Presence of diffuse anaplasia

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23
Q

A pt receiving cyclophosphomide and gets polyomavirus, what iis he at risk for?

A

Hemorrhagic cystitis

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24
Q

What is characteristic of chronic cystitis?

A

Mast cells

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25
What cancer has the flat guys that are high grade and the papilla guys that are low grade? What is the prognostic factor of bladder cancers?
Urothelial Transitional Cell Carcinoma Depth of muscle invasion
26
Pt is given a drug and develops renal problems. How do you tell if it's a tubular necrosis or an interstitial nephritis?
Tubulointerstitial nephritis - 2 weeks after - HS reaction - Associated drugs: Diuretics, penicillin derivatives, PPI, Sulfa, NSAIDS - Has Eosinophils (bc HS rxn), fever and rash. Tubular Necrosis via toxins - Direct toxic, so happens immediately? - Drugs associated: Aminoglycosides, radiconstrast, lead, cisplatin (chemo), Ethylene glycol
27
What are the symptoms of High ANion Gap Metabolic Acidosis?
``` "flu" like then tachy, glucosuria mental status hyperventilation ```
28
A patient presents ith metabolic acidosis; on urine sample you see fluorescent pee and calcium oxalate stones. Why are they acidotic?
Ethylene glycol
29
Pt presents in metabolic acidosis, tachypneic, and tinnitis. Why are they acidotic?
Salicylate overdose
30
Pt presents with Phosphaturia, glycosuria, bicarbonaturia. What diuretic are they probably on? PMH revaels no diuretic. What is going on?
Acetazolamide bc of carbonic anhydrase deficiency | RTA 2, fanconi syndrome
31
You see pyuria composed of eosinophilis on urine analysis, what is the cause?
acute interstitial nephritis
32
You see muddy granular cysts
INtrinstinsic renal failure
33
diffuse cortical necrosis is seen when? what pathological processess cause it?
obstetric complciations; vasospasm and DIC
34
Complications of acute pylenopheritis if untreated?
Chronic pylenophritis, renal papillary necrosis, perinephric abscess, urosepsis
35
Pt has a BUN of 104 with altered mental status. What else do you expect to see?
Pericarditis, asterixis, encephalopathy, coagulation
36
A neonate develops hypertension. you should check for? What extrarenal complications are present?
ARPCKD; hepatic fibrosis --> portan HTN and cirrhosis
37
Pt presents with painless hematuria, flank pian, abdominal mass. On Bx they see large eosinophilic cells with abundant mitochondria.
Renal Oncocytoma!!
38
Striated paranechymal enhancement
Acute pyleonephritis
39
What can cause Renal papillary necrosis ?
SAAD: | Sickle cell, acute pylonephritis, NSAIDs, DM
40
Which two drugs can you not use together to treat uncomplicated cystitis?
Fluoroquinolones and nitrofurantoin
41
A pregnant woman presents with cystitis, what is the mechanism of the drug you give?
fosfomycin | inhibits enolpyruvate transferase
42
If patient is resistant to everything
ertapenem
43
A patient presents a couple months after being treated for cystiits with loss of hearing. What happened?
Was treated with genatmycin or tobramycin and developed ototoxicity
44
A patient has E.Coli, what is a selective beta lactam that you can use?
Gram (-) aerobe = aztreonam
45
SEvere pylonephritis caused by pseudomonas is treated with what? What about non-pseudomembranous
Piperacillin 3rd gen cephalosporin with a beta lastamase inhibitor
46
A patient with seizures develops pyelonephritis of pseudomonas do not treat with?
Carbepenem
47
What do you treat prostatitis
TMP/SMX; fluoroquinolones
48
how does alcholic Ketoacidosis work
no eating --> decrease NAD & Decrease gluconeogenesis = lactic acid and ketoacids
49
What are the charges of different parts of the filtration
Subepithelial = Cation GM = Subendothelial = Anion Mesangium = neutral
50
Patient presents with nephropathy and purpura. Tipo de patologica este?
IgA nephropathy, Berger disease | Henoch Schonlein
51
Essential mixed cryoglobulinemia
MPGN
52
HUS TTP DIC can all cause what?
Ischemic acute tubular necrosis
53
Which have decreased C3
PostStreptococcal and dense deposit MPGN
54
A child has a PKHD mutation. Where are the cysts located? | An adult has a PKD mutation, where are the cysts located?
Collecting ducts; fibrocystin cortex and medulla;polycystin
55
Pt presents for an ultrasound of baby. Incidentally they find small cysts in the kidney's medullary collecting ducts. WHat is the dx?
Medullar Sponge Syndrome
56
Mechanism of RCC
Chr. 3 VHL gene screwy --> increases IGF1 -->
57
IgG4 has caused fibrosis in a ureter. What is this called?
Ormond's Sclerosing Retroperitoneal fibrosis
58
``` Pt is experiencing persistant pain for over 3 months supra-pubically. A culture shows no nitrites, no leukocyte esterase, and culture is negative. What is (+) is mast cells! What is the pt at risk for? ```
Hunner ulcer!
59
A patient previously diagnosed with papillary adenocarcinoma gets a second opionion. to the relief of everyone involved, it's only a
polypoid cystitis
60
Describe Malakoplakia
- soft yellow slightly raised mucosal plaques - Foamy macrophages! → combine to make michaelis guttman bodies - Chronic E. Coli
61
A 20 yo man comes in with acute bacterial prostatitis. What are the most common causative bacteria in young male pts? Older?
Chlaymdyai and gonorrhea E. Coli
62
finasteride anything-fil alprostadil
``` Finasteride = SAR5 fil = PDE5 inhibitor (cGMP) alprostadil = PGE1 agonist --> AC --> cAMP ```
63
Priapism Phimosis Hyposthenia
Eretion lasting over 4 hours Foreskin too tight INability to concentrate urine
64
Causes of RTA 1
Lithium, Amophotericin B, SLE, AutoImmune
65
inaibiltiy to concentrate urine, small kidneys
Medullary cystic disesae/AD Tubulointerstitial