Renal Flashcards
1
Q
DM complicated by neuropathy and nephropathy which can lead to end stage renal disease. The risk of progression is reduced by appropriate glycemic and _________ control and the use of ______ such as lisinopril or ______ such as losartan
A
blood pressure
ACEI
ARBs
2
Q
________ bias occurs when investigators misclassify data due to preconcieved expectations or prior knowledge concerning the study or its participants
A
observer
3
Q
___________ and ____________ due to nephrotoxicity are common electrolyte disturbances in patients undergoing treatment with amphotericin B for disseminated fungal infection and can result in weakness and __________
A
hypokalemia
hypomagnesemia
arrhythmias
4
Q
acidosis stimulates renal ________, a process by which renal epithelial cells metabolize _______ to glutamate, generating ammonium that is excreted in the urine and ______ that is absorbed into the blood.
A
ammoniagenesis
glutamine
HCO3
5
Q
facial and periorbital edema, mild HTN, hematuria in a child post infection suggests _______ syndrome with a diagnosis of _______. On light microscopy, the glomeruli are enlarged and hypercellular, IF studies reveal _______ of IgG, IgM and C3 along the BM and in mesangium. IMmune complexes are seen as electron dense deposits in electron microscopy on the ________ side of the basement membrane
A
nephritic
poststreptococcal glomerulonephritis
granular deposits
epithelial
6
Q
young child with generalized edema, massive proteinuria after an URTI likely has ______, which is the most common cause of ________ syndrome in ages 2-6. Caused by immune dysregulation, an overproduction of golmerular permeability factor (cytokine that directly damages ________ and decreases the ___________ charge of GBM), which leads to a selective loss of _____ in the urine.
A
minimal change disease
nephrotic
podocytes
anionic
albumin
7
Q
inadequate canalization of the ____________ is the most common cause of unilateral feta hydronephrosis
A
ureteropelvic junction
8
Q
fever, rash, acute renal failure (inc creatinine, oliguria) occurring within a few weeks of starting a beta lactam antibiotic (ampicillin) is highly suggestive of _________. Peripheral eosinophilia and eosinophiluria are important clinical cues.
Other drugs involved
A
acute interstitial nephritis
quinolone antibiotics, NSAIDs, sulfonamides, rifampin, diuretics
9
Q
the blood supply to the proximal ureter comes from _______, whereas the distal ureter is supplied by _______
A
renal artery
superior vesical artery
10
Q
in the setting of acute hemorrhage (MVA), patients are at risk for _______, which has 3 phases: an initiation phase, a maintenance phase, and a ________ phase characterized by ___________
A
acute tubular necrosis
initiation
maintenance
recovery
re epithelization of tubules
11
Q
digoxin is a cardiac glycoside that is predominantly cleared by the ______.
A
kidneys
12
Q
patient with pulmonary and peripheral edema due to HF and CKD experiencing hearing problems is most likely being treated with ________, which inhibit Na/K/2Cl symporters and runs the risk of causing ________
A
loop diuretics (furosemide)
ototoxicity
13
Q
aldosterone receptor antagonists like _____________ inhibit resorption of Na, H20 and allow resorption of _____ and ______
A
spironolactone, eplerenone
H+, K+
14
Q
__________ rejection is seen in the first 6 months after renal transplant and can be antibody or _____ mediated. Acute cellular rejection is associated with diffuse lymphocytic infiltrate of the renal vasculature, tubules, and interstitium
A
Acute
cell
15
Q
____________ occurs when tumors with a high cell turnover are treated with chemotherapy. One of the major ions released is ____, which is soluble at physiologic pH but can precipitate in the acidic environment of the _______ and _______.
prevented with urine _______ and hydration
A
tumor lysis syndrome
uric acid
distal tubules and collecting ducts
alkalinization
16
Q
patients with MS often develop a _________ a few weeks after developing an acute lesion of the spinal cord. These patients present with urinary frequency and urge incontinence. Urodynamic studies show the presence of ___________ due to the presence of an _____ lesion
A
spastic bladder
bladder hypertonia
UMN
17
Q
increased ______ activity in multiple myeloma leads to ______ serum calcium, _________ parathyroid hormone, _________calciuria. hypercalcemia and light chain cast nephropathy cause progressive ________, leading to _________ 1,25dihydroxyvitamin D synthesis
A
osteoclastic
elevated
reduced
hypercalciuria
renal failure
reduced
18
Q
selective vasoconstriction of the efferent arteriole causes an _______ in GFR and an _______ in FF. FF will also _______ with efferent arteriole constriction, whereas GFR will be begin to _______ as the arteriole becomes more constricted
A
increase
increase
increase
decrease
19
Q
______ renal allograft rejection manifests months to years after transplantation and presents with worsening HTN and a slowly progressive rise in _______. it is mediated by a chronic, indirect immune response against donor alloantigens and results in _________ intimal vascular thickening and kidney atrophy
A
chronic
creatinine
obliterative
20
Q
the ____________ is highly permeable to water, while the _____________ is impermeable to water regardless of serum vasopressin levels.
A
descending loop of Henle
ascending loop of Henle
21
Q
inulin is a ________ substance. THe net excretion rate of a freely filtered substance =
A
freely filtered
clearance)(plasma concentration) - (tubular reabsorption
22
Q
most ________________ also known as clear cell carcinomas originate from the epithelial cells of the proximal renal tubules
composed of?
renal tumors from collecting duct cells? Look like?
A
renal cell carcinoma
polygonal cells with abundant clear cytoplasm
Renal oncocytomas, large well differentiated cells that contain numerous mitochondria
23
Q
____________ is responsible for 90% of the tumors involving the renal pelvis, and often forms __________ composed of urothelium supported by a thin fibrovascular stalk
A
Transitional cell carcinoma
papillary tumors
24
Q
ADH or vasopressin acts on the __________ to increase urea and water reabsorption, allowing for the production of maximally concentrated urine
A
medullary segment of the collecting duct
25
net filtration pressure =
(Pc-Pi) - (nc-ni)
26
_______ rejection occurs immediately due to __________ against graft in recipients circulation and results in gross mottling and cyanosis
hyperacute
preformed antibodies
27
patients with post streptococcal GN is due to a strain of Group ______ streptocoocus. The glomerulonephritis is mediated by a _____________ hypersensitivity reaction
A beta hemolytic
Type III immune complex
28
humans acquire _____ via contact with foreign _________ that contain ________ infected with Schistomsoma larvae. S japonicum and S mansoni cause intestinal and hepatic schistosomiasis, while S __________ causes urinary schistosomiasis. Patients present with dysuria, blood in urine at the end of urination, with ulceration and scarring of the bowel or bladder or ureters. These result from a _______ granulomatous response directed against the eggs.
Schistosomiasis
freshwater
snails
haematobium
Th2 mediated
29
patient with membranous nephropathy, flank pain, new hematuria, elevated lactate dehydrogenase, and left varicocele likely has a ________ as a result of ______ syndrome, which is a hypercoaguable state, and leads to renal infarction. This is preceded by a loss of ________ such as antithrombin III
Renal vein thrombosis
nephrotic
anticoagulation factors
30
ACEI such as _______ reduce AngII levels and cause __________ dilation
ramipril
efferent arteriole
31
a patient presents with HTN, hematuria, and moderate proteinuria, suggesting _______. Renal biopsy shows ___________ of Ig along the GBM, which is characteristic of _______________. The deposits are composed of _____ and C3
nephritic
linear cresent formation
anti glomerular basement membrane
IgG
32
the bladder is _______. In placement of a suprapubic cystostomy, the tracar and cannula will pierce the layers of the abdominal wall, including the _____________ but will not enter the peritoneum
extraperitoneal
anterior abdominal aponeurosis
33
ACEI can cause an acute rise in serum creatinine by dilating the efferent arteriole, which leads to a reduction in ____. For patients with renal artery stenosis, ACEI can be detrimental by precipitating _______
filtration fraction
ARF
34
extensive smoking history, painless hematuria, polycythemia indicated by elevated hematocrit and a left sided renal mass =
gene
Renal cell carcinoma
chrom 3p: VHL
35
dehydration stimulates ____ secretion, which acts on the _______ to increase their permeability to water. The lowest osmolarity occurs in the __________
ADH
collecting ducts
distal convoluted tubule
36
patients with chronic kidney disease may develop ______ from secondary hyperparathyroidism which is caused by _____________ and hypocalcemia
renal osteodystrophy
hyperphosphatemia
37
the ureteric bud ultimately gives rise to the _______ of the kidney, while the metanephric mesoderm (blastema) gives rise to the glomeruli, Bowman's space, PT, loop of henle, and the _____
collecting system (major/minor calyces, pelvis, ureters)
DCT
38
Most of the K+ filtered by the glomeruli is resorbed in the ________ and the ______. The late _______ and __________ are the primary sites for regulation of K+ concentration in the urine.
K depleted stimulates ______ to reabsorb extra K
Increased K stimulates _______ to secrete K
proximal tubule
loop of Henle
distal and cortical collecting tubules
alpha intercalated cells
principal cells
39
during the _______ (polyuric phase) of acute tubular necrosis, patients can become dehydrated and can develop severe ________ due to high volume, hypotonic urine
recovery phase
hypokalemia
40
Acyclovir can cause _______ if adequate _____ is not also provided
crystalline nephropathy
hydration
41
_______ is a DNA dependent RNA polymerase that incorporates short RNA primers (uracil containing) into replicating DNA
Primase
42
following desmopressin administration during water deprivation test, urine osmolarity ______ to normal levels in central DI, but __________ in complete nephrogenic DI
increases
does not change
43
Goodpasture syndrome is caused by autoantibodies against the ____________ of type _______ collagen found in the _______ and pulmonary capillary membrane (anti-GBM antibodies). Manifests with rapidly progressive glomerulonephritis and _______ hemorrhage (shortness of breath, hemoptysis)
alpha 3
IV
GBM
alveolar
44
Potter sequence in infant is caused by a _____anomly that leads to decreased urine output by the fetus, which leads to oligohydraminos. The lack of amniotic fluid causes ______ of the fetus which leads to flat facies, limb abnormalities, and pulmonary hypoplasia which leads to death
renal
compression
45
inappropriately elevated aldosterone with renin is indicative of _______ hyperaldosteronism, which is caused by renovascular disease, malignant hypertension, and ____________
secondary
renin secreting tumors
46
marked unilateral kidney atrophy is suggestive of
HTN and ______ are often present
renal artery stenosis
abdominal bruit
47
Erythropoiesis stimulating agents used to treat ______ of chronic kidney disease and dialysis patients are associated with an increased risk for ____ and thromboembolic events
anemia
HTN
48
increased ASO and anti NAD, AntiDNase and AHase, increased serum creatinine, decreased C3 in young child with periorbital edema and tea colored urine =
PSGN
49
glomerulonephritis, photosensitive rash, and arthralgias in a young woman are suggestive of _______. 30% of patients have _____, which can cause paradoxical aPTT prolongation and a false positive _____. The patients are at risk for venous and arterial thromboembolism and unexplained recurrent ________ loss
SLE
ANA+
RPR/VDRL
pregnancy
50
_______ is an _____ disorder caused by defective transportation of cystine, ornithine, arginine, and lysine across the intestinal and renal tubular epithelium. Recurrent ________ is the only clinical manifestation. Urinalysis shows pathognomonic hexagonal cystein crystals. _______ type stones are the most common
Cystinura
AR
Nephrolithiasis
Calcium oxalate
51
anatomic or functional _______ is almost always necessary for the development of acute pyelonephritis
vesicoureteral reflux
52
the principle lesion of minimal change disease can be seen on ______
electron microscopy
53
___________ is the most common cause of calcium kidney stone disease. This condition is characterized by normal serum _______ levels with ______. Other risk factors include ________, hyperuricosuria, low urine volume, and hypocitraturia
idiopathic hypercaciuria
calcium
hypercalcuria
hyperoxaluria
54
palpable lower extremity purpura, abdominal pain, arthralgias, hematuria in a child =
it is a _______ in children that follows an infection due to deposition of _______ in small vessels
Henoch Schonlein purpura
IgA mediated Type III hypersensitivity reaction
IgA containing immune complexes
55
nephromegaly with cysts in a fetus on US =
caused by a mutation in ____ that codes for ____
inheritence
most likely complication is _____ due oligohydraminos
autosomal recessive polycystic kidney disease
PKHD1, fibrocystin
AR
respiratory distress
56
fracture of the 12th rib, most likely injured organ?
kidney
57
____________ often results in progressive proteinuria with the eventual development of nephrotic symptoms and renal failure. ____________ (Kimmelstiel-Wilson nodules) are seen on renal biopsy and indicates irreversible glomerular damage and rapid decline in kidney function
Diabetic nephropathy
nodular glomerulosclerosis
58
common side effects of _________ include decreased glomerular filtration rate, hyperK+, cough. _______ is a rare by life threatening side effect
ACEI
Angioedema
59
The most concentrated tubular fluid is found
at the junction between the dscending and ascending limbs of loop of Henle
60
the majority of water reabsorption, regardless of hydration status, occurs in the _______
proximal tubule
61
the concentrations of PAH, creatinine, inulin, and urea ________ as fluid runs along the proximal tubule, while the concentrations of bicarbonate, glucose, and amino acids ________
increase
decrease
62
patient presents with severe right side eye pain, ipsilateral headaches, nausea, and seeing halos around objects =
treated wiht =
also experiences ______ and highly alkaline urine
mechanism
acute angle glaucoma
acetazolamide
diuresis
inhibits carbonic anhydrase
63
easy fatigability, constipation, back pain, elevated serum protein, and azotemia in an elderly patient =
large ______ casts composed of Bence Jones proteins seen in the tubular lumen in myeloma cast nephropathy
multiple myeloma
eosinophilic
64
mannitol is an _______ used to help reduce edema in the brain and intracranial pressure. One of the more severe toxicities of this therapy is pulmonary edema
osmotic diuretic
65
in metabolic acidosis, urinary pH decreased due to increased excretion of free H+, NH4+, and ______. _______ is completely reabsorbed from the tubular fluid in acidotic states
H2PO4
HCO3
66
loop diuretic act by inhibiting _______ cotransporter in the medullary and cortical _____ of the loop of Henle, increasing Na, Cl, and H2O excretion. Used as a first line therapy for rapid relief of symptoms in patients with acute decompensated HF
Na-K-2Cl
Thick ascending limb
67
postoperative urinary retention, with incomplete bladder emptying treated using ________, a muscarinic agonist and alpha 1 blocking drug
bethanechol
68
PAH is primarily ________ into the nephron by the ______ and is not reabsorbed. Therefore, concentration of PAH is lowest in Bowman's space
secreted
PT
69
the _____ run in close proximity to the pelvic lymph nodes and the uterine artery in the female pelvis,, which predisposes them to injury during pelvic surgery
ureters
70
________ ingestion leads to toxic ___________ with vacuolar degeneration and abllooning of the PT cells. Findings include high anion gap metabolic acidosis, increased osmolar gap, and calcium oxalate crystals in urine
ethylene glycol
acute tubular necrosis
71
metabolic acidosis is characterized by a decrease in serum______ and serum ______. PaCO2 will also _____ as a result of respiratory compensation
pH
HCO3
decrease
72
treatment of choice for DKA is __________, which will increase serum HCO3, Na, and ________ serum glucose, osmolality and potassium
IV normal saline and insulin
decrease
73
thiazide diuretics are more likely to cause ______ and _______, while loop diuretics cause ______
hyponatremia
hypercalcemia
hypocalcemia
74
renal artery stenosis causing significant renal hypoperfusion will result in ______ GFR and activation of ______ system. Chronically, this can lead to hyperplasia of modified smooth muscle cells of the afferent arterioles, known as ______ cells
decreased
RAA
JG
75
crescent formation on light microscopy is diagnostic for _____________. These crescents consist of glomerular parietal cells, monocytes, macrophages, as well as abundant _____. crescents eventually become ________
rapidly progressive glomerulonephritis
fibrin
sclerotic
76
__________ classically presents with gross hematuria, acute flank pain, and passage of tissue fragments in urine. It is most commonly seen in patients with ______, DM, analgesic nephropathy, or severe obstructive pyelonephritis
renal papillary necrosis
sickle cell disease or trait
77
the filtration fraction = ___________ and is usually equal to ______ in healthy individuals
GFR/RPF
20%
78
Eosinophils play a role in host defense during ______ infection. They destroy the parasite via ________ . another function of eosinophils is the regulation of ______ hypersensitivity reactions
parasite
antibody dependent cell mediated cytotoxicity
Type I
79
___________ is an oxidase positive, non lactose fermenting, gram (-) organism and is a common cause of urinary tract infections in patients with ________
pseudomonas aeruginosa
indwelling bladder catheters
80
DKA is characteried by polydipsia, polyuria, and a fruity odor to the _______. Shows a ____pH, _____ HCO3, and _____ PaCO2
breath/urine
low
low
low
81
PSGN: immunofluorescence microscopy shows granular deposits of ___, ____, and ____ in the mesangium and basement membranes
IgG
IgM
C3
82
_____ associated chronic renal injury is morphologically characterized by __________ and papillary necrosis with shrunken and irregular kidneys and papillary calcifcations
NSAID
Chronic interstitial nephritis
83
_______ is the most common pathogen causing cystitis and acute pyelonephritis.
______ is the second most common cause of UTI in sexually active women
E coli
Staphylcoccus saprophyticus
84
______ disease presents with neuropathic pain, angiokeratomas, telangiectasia, glomerular disease (proteinuria), and cerebral and cardiovascular disease. It is an ____ linked recessive lipid storage disorder charcterized by ________ deficiency, which is responsible for the breakdown of glotriaosylceramide (Gb3), which accumulates in the body
Fabry
X linked
alpha galactosidase A
85
the serum threshold at which glycosuria begins, called the threshold of glucose, is approximately ____mg/dL, while the transport maximum of glucose is _____mg/dL
200
375
86
crescent formation on LM is diagnostic of ______
frequently occurs as a manifestation of ______ associated vasculitides with the absence of ________
rapidly progressive (crescenteric) glomerulonephritis
ANA
Ig or complement deposits
87
Acute organ rejection occurs at
due to sensitization of ____ against donor _____
<6months
host T cell
donor MHC
88
fever, chills, hypotension, dyspnea, chest/back pain, hemoglobinuria after transfusion =
hypersensivity type ____ which is _____ mediated
leads to ______ mediated cell lysis
acute hemolytic transfusion reaction
II, antibody
complement
89
patients with evidence of atherosclerosis may have _______. The use of _______ and ARBs such as ______ or losartan cause efferent arteriolar vasodilation that causes the GFR to fall and may lead to _______
bilateral renal artery stenosis
ACEI
ramipril
acute renal failure
90
the compound papillae in the upper and lower poles of the kidney are most susceptible to _____ induced damage in _____________, which appears as dilated calyces with overlying renal cortical scarring and atrophy. Patients present with secondary HTN
reflux
vesicoureteral reflux
91
metabolic alkalosis is characterized by a high aterial blood ____, _____, ______. determining the patients _________ concentration can help to identify the cause of metabolic alkalosis
pH, HCO3, pCO2
urinary chloride
92
loop diuretics also stimulate ______ release to inc renal blood flow. The concurrent use of _____ can result in a decreased diuretic response
prostaglandin
NSAIDs
93
diabetic autonomic neuropathy is common in T1DM and can cause ___________ due to the inability to sense a full bladder along with ________. PVR testing with ultrasound or catheter can confirm inadequate
overflow incontinence
incomplete emptying
bladder emptying
94
ADH causes V2 receptor mediated increase in ____ and ______ permeabiliity at theinner medullary collecting duct, which results in maximally concentrated urine
water
urea
95
IL2 is produced by ____ and stimulates the growth of CD4, CD8, and B cells. It also activates _____ and monocytes. The activation of _____ cell is responsible for IL2s anticancer effect on metastatic melanoma and ____
Th2
Natural Killer
NK
RCC
96
inhibition of glucose reabsorbtion would cause glucose clearance to approach the value of GFR which is typically estimated by calculating the clearance of
inulin
97
stress incontinence (cough or laugh) is due to loss of pelvic floor support and incompetence of the __________
urethral sphincter
98
_________ induced DI is the result of the drugs antagonizing effect on the action of vasopressin on principal cells within the collecting duct system.
patients?
lithium
bipolar
99
the ureters pass posterior to the _______ vessels within the retroperitoneum and ______ to the common/external iliac arteries to reach the true pelvis
gonadal
anterior
100
frothy or foamy urine may be caused by _______. If heavy, like in nephrotic syndrome, can cause regional or generalized interstitial edema because the decrease in serum albumin and total protein lowers the _____ pressure
proteinuria
plasma oncotic pressure
101
ACEIs _____ renin, _____ ATI, ______ ATII, _____ aldosterone, _______ bradykinin
increase
increase
decrease
decrease
increase
102
hypovolemia results in ______ RPF, ______ GFR, _____ FF
big decrease
decrease
increase
103
discharge of urine from the umbilicus in an infant = failure of____________, which is a remnant of the ______
urachus to obliterate
allantois
104
_________ is used as an antiviral for ganciclovir resistant CMV infections, and can result in renal wasting, _____, and _______
Foscarnet
hypocalcemia
hypomagnesemia
105
urge incontinence or overactive bladder is caused by ________. Pharmacologic therapy with a ___________ targeting ______ can help improve symptoms
detrustor instability
antimuscarinic drug
M3
106
36 yrold man with hemoptysis, hypertension, hematuria, + cANCA =
cause of
deposits on IF?
Granulomatosis with polyangiitis (Wegener's)
cresenteric (rapidly progressive) glomerulonephritis type 3 (pauci)
no
107
In the kidney, AngII preferentially constrict the ____ arteriole, while ACEI promote ______ arteriole dilation
Efferent
Efferent
108
HSP generally affects young children and is classically preceded by ______. This _____ mediated hypersensitivity vasculitis commonly causes colicky abdominal pain, ______, lower extremity palpable purpura, and hematuria
URTI
IgA
joint pain
109
thiazide diuretics such as ________ decrease intravascular fluid volume, which stimulates aldosterone secretion and leads to increased excretion of _____ and _____ ions in the urine, resulting in _____ and metabolic alkalosis
chlorthalidone
potassium
hydrogen
hypokalemia
110
acute ureteral constriction or obstruction _________ GFR and FF
decreases
111
BPH leads to intermittent bladder outlet obstruction and overflow incontinence. Urinary retention results in inc. pressure in the urinary tract and resultant reflux nephropathy, which lead to
interstitial atrophy and scarring
112
the risk factors for nephrolithiasis include
primary hyperparathyroidism, which leads to
Crohn disease, which leads to
distal renal tubular acidosis, which leads to
gout, which leads to
also
low fluid, low calcium intake, high oxalate intake, high protein intake, high sodium intake, high fructose intake
hypercalciuria
hyperoxaluria
hypocitraturia
hyperuricosuria
113
diuretic that causes hypercalcemia
thiazide
114
CKD can result in hypocalcemia and ___________
secondary hyperparathyroidism
115
________ manifest in patients 40-50 years old with enlarged kidneys, HTN, and renal failure
gene
extrarenal manifestations
Autosomal dominant polycystic kidney disease
PKD-1, 2
liver cysts and cerebral aneurysms
116
fever, neuro symptoms, renal failure, anemia, thrombocytopenia in setting of GI illness is =
results in (to the kidneys)
TTP-HUS
platelet rich thrombi in glomeruli and arterioles
117
_______ stones are yellow/brown and diamond shaped crystals. Patients with chronic diarrhea develop metabolic acidosis and excrete ____ ions to compensate, increasing the conversion of soluble urate salts into insoluble
uric acid
hydrogen ions
uric acid stones
118
diffusion speed increased with
decreases with
high concentration gradient, large SA, and increased solubility
membrane thickness, small pore size, high molecular weight, low temp
119
___________ results in hexagonal shaped crystals on urinalysis due to an AR disorder causing elevated urinary cysteine levels (______). The sodium cyanide nitroprusside test is a screen, and it is treated with urinary alkalinization
cystinuria
aminoaciduria
120
patients with MS commonly develop _____ due to loss of CNS inhibition of detrusor contraction in the bladder
urge incontinence
121
medication most likely to prevent recurrent calcium oxalate stone formation =
hydrochlorothiazide
122
homogenous deposition of eosinophilic hyaline material of the intima and media of small arteries and arterioles characterize _______________ from untreated HTN or ___________
hyaline arteriolosclerosis
diabetes
123
constriction of the efferent arteriole will ____ RPF and _________ filtration fraction
decrease
increase
124
RBF =
PAH clearance/(1-hematocrit)
125
PSGN has a poorer prognosis and a higher risk of chronic HTN and renal insufficiency if the patient is
an adult
126
______________ presents as gross hematuria in an elderly man with a history of smoking or occupational exposure to rubber, plastics, aromatic amine containing dyes, textiles, or leather
transitional cell carcinoma of the bladder
127
grapefruit juice inhibits
increases nephrotoxicty of
CYP3A4
cyclosporine
128
spironolactone has significant __________ and can cause gynecomastia
antiandrogenic effects
129
medical therapy for Conn syndrome
spironolactone or eplerenone
130
the most common renal malignancy is RCC, and those clear cells are generally those with a high _____
glycogen or lipid content
131
flulike symptoms, fever, anew systolic murmur suggest
can be complicated by
causes
infective endocarditis
deposition of circulating immune complexes
glomerulonephritis
132
blue toe, livedo reticularis following an invasive vascular procedure =-
may involve the kidneys and will show
atheroembolic disease
needle shaped cholesterol clefts within the atheromatous thrombus
133
serum antibodies to PLAR2 with circulating IgG4 antibodies is associated with
idiopathic membranous nephropathy
134
secondary to malignant tumor, infections, certain meds; thickening of the GMN on LM w/o increase in cellularity; spike and dome appearance on methenamine silver stain =
membranous glomerulopathy (nephrotic)
135
CKD with mineral bone disease usually presents w/ ____ phosphate, _______ parathyroid, and _______ calcitriol
weakness, bone pain, fractures
increased
increased
decreased
136
the risk for UTI can be reduced by avoiding unnecessary catheterization and ____________
removing the catheter as soon as possible
137
pyuria and bacteriuria are found in both upper and lower UTI. ___________ only form in the renal tubules and are pathognomonic for acute pyelonephritis
white blood cell casts
138
recurring painless hematuria in a older child or young adult within a week of an URTI =
biopsy shows
IgA nephropathy
mesangial hypercellularity and mesangial IgA deposits
139
_______ binds to the immunophilin FK-506 binding protein in the cytoplasm and inhibits mTOR, effectively blocking ____ signal transduction and prevents cell cycle progression and lymphocyte proliferation
Sirolimus
IL2
140
linear IgG and C3 deposits =
lumpy bumpy granular deposits of IgG and C3
Goodpastures
PSGN
141
in horsehoe kidney, the kidneys are fused at the poles. The isthmus of the kidney usually lies anterior to the _____ and posterior to the _______ (which limits the ascent of the horeshoe kidney)
aorta
IMA
142
C3 level in PSGN =
decreased
143
___________ can be caused by decreased renal perfusion due to severe hypovolemia, shock, surgery. The ______ and the Thick ascending loop of Henle are most commonly affected. ________casts are pathognomonic
acute tubular necrosis
proximal tubule
muddy brown casts
144
moderately increased ________is the earliest manifestation of diabetic nephropathy
albuminuria
145
beta blockers inhibit ____ release, resulting in a reduction in angI, II, aldosterone
renin
146
liver will ______ lipoprotein synthesis in secondary response to PSGN
increase
147
________ is a common cause of ARF in children. triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury following diarrheal illness caused by
HUS
E coli O157:H7 or Shigella dysenteriae
148
everytime GFR halves, serum creatinine
doubles
149
_______ is the most common cause of nephrotic syndrome in children. Systemic T cell dysfunction leads to the production of glomerular permeability factor, which leads to a loss of negative charge and _________
minimal change disease
selective albuminuria
150
FF =
RPF =
GFR/RPF
RBF x (1 - hematocrit)
