reeeeenal

Question 1

type I RTA?

Answer 1

defect in H+ secretion - distal
hypokalemia
causes: cirrhosis, autoimmune, lithium, ampho
tx: give bicarb
complications: stones

Question 2

type II RTA>

Answer 2

defect in HCO3 reabsorption - proximal
hypokalemia
causes: Fanconi syndrom, carbonic anhydrase inhib, MM, amyloidosis, heavy metals, vit D deficiency
tx: thiazides, volume depletion
complications Rickets, osteomalacia

Question 3

type IV RTA?

Answer 3

aldo deficiency/resistance - distal
hyperkalemia
drugs: amiloride, spironolactone, deparin
tx: furosemide, replacement of mineralocorticoid +/- glucocorticoid

Question 4

hyaline casts?

Answer 4

if lots, suggests hypovolemia

Question 5

red cell casts?

Answer 5

suggest glomerulonephritis

Question 6

white cells in urine, eos in urine?

Answer 6

suggest allergic interstitial nephritis, ateroembolic dz

Question 7

granular casts, renal tubular cells, muddy brown casts?

Answer 7

ATN

Question 8

white cells and white cell casts in urine?

Answer 8

pyelo

Question 9

low C3, lumpy bumpy immunofluorescence?

Answer 9

post-infections glomerulonephritis

Question 10

normal c3, episodic gross hematuria, microscopic hematuria?

Answer 10

IgA nephropathy

tx: steroids, ACEis if proteinuria

Question 11

segmental necrotizing glomerulonephritis with few IG deposits?

Answer 11

Wegeners

Question 12

linear anti GBM deposits?

Answer 12

Goodpasture’s

tx: plasma exchange, pulse steroids

Question 13

GBM splitting on EM?

Answer 13

Alport’s

Question 14

causes of minimal change disease?

Answer 14

children - idiopathic, MCC

adults: NSAIDs, lymphoma

Question 15

normal light microscopy, fusion of foot process on EM?

Answer 15

minimal change dz

Question 16

sclerosis in capillary tufts?

Answer 16

FSGS

Question 17

causes of FSGS?

Answer 17

IV drugs
HIV
obesity
African American

Question 18

spike and dome appearance; granular IgG and C3 deposits at basement membrane?

Answer 18

membranous nephropathy

Question 19

causes of membranous nephropathy?

Answer 19

being white
HBV
syphilis
malaria
gold

Question 20

thickened GBM, increased mesangial matrix, nodular glomerulosclerosis?

Answer 20

diabetic nephropathy

Question 21

mesangial proliferation, subendothelial immune complex deposition?

Answer 21

lupus nephritis

** severity of renal disease determines overall lupus prognosis (often)

Question 22

noular glomerulosclerosis, apple-green birefringence?

Answer 22

amyloidosis

Question 23

tx of renal amyloidosis?

Answer 23

pred and melphalan

Question 24

tram track basement membrane, low serum C3?

Answer 24

membranoproliferative nephropathy

Question 25

causes of membranoproliferative nephropathy?

Answer 25

HCV
cryoglobulinemia
SLE
subacute bacterial endocarditis

Question 26

tx of uric acid stone?

Answer 26

citrate to alkalinize urine

Question 27

positive urinary cyanide nitroprusside test?

Answer 27

cystine stone!

from defective COLA (AA) transport

Question 28

swollen scrotum with transillumination?

Answer 28

hydrocele

Question 29

swollen scrotum worse with standing?

Answer 29

varicocele

Question 30

swollen scrotum better with lifting?

Answer 30

epididymitis

Question 31

swollen scrotum worse with lifting?

Answer 31

torsion

Question 32

marker of testicular choriocarcinoma?

Answer 32

bHCG

Question 33

marker of nonseminomatous germ cell testicular tumor?

Answer 33

AFP