Renal

Question 1

Patients with CKD can receive erythropoiesis- stimulating agents (ESAs) for CKD-induced anemia. What is a side effect of ESA?

Answer 1

Hypertension- can present as hypertensive emergency 2-8 weeks after starting tx

Question 2

When do you get a urology consult for a symptomatic ureteral stone?

Answer 2

Stone greater than 10 cm in size, urosepsis, acute renal failure, or complete obstruction, uncontrolled pain with no stone passage in 4-6 weeks after medical management (hydration, pain control, alpha blockers, strain urine)

Question 3

Complication of nephrotic syndrome - acute presentation of increasing left flank pain, nausea, hematuria, swelling of the left testis?

Answer 3

Renal vein thrombosis 2/2 hypercoagulability caused by nephrotic syndrome (membranous nephropathy particularly)

Renal cell carcinoma can also block renal vein but this would be a more chronic presentation of sxs

Question 4

Renal insufficiency (high cr) with bland UA and granular casts, back pain, hypercalcemia?

Answer 4

Multiple myeloma

Question 5

Muddy Brown Casts (pigmented granular)

Answer 5

ATN

Question 6

RBC Casts

Answer 6

glomerulonephritis

Question 7

WBC Casts

Answer 7

interstitial nephritis, pyelonephritis

Question 8

Fatty casts (oval fat bodies)

Answer 8

nephrotic syndrome

Question 9

Broad and waxy casts

Answer 9

Chronic renal failure

Question 10

Indications on RBC character of glomerular vs. nonglomerular causes of hematuria

Answer 10

Glomerular: RBC casts, dysmorphic RBCs, darker/cola colored urine
Nonglomerular: no protein, normal RBCs, pink/bright red urine

Question 11

Metabolic acidosis in septic shock is due to:

Answer 11

increased anaerobic metabolism = increased tissue metabolic acid production (lactic acid)

Question 12

Clinical correlations of Nephrotic syndromes

FSGS (most common in adults) 
Membranous nephropathy 
Mempranoproliferative glomerulonephritis 
Minimal change disease 
IgA nephropathy

Answer 12

FSGS (most common in adults) - African American/Hispanic, obesity, HIV, heroin use

Membranous nephropathy - adenocarcinoma, NSAID, hep B, SLE

Mempranoproliferative glomerulonephritis - Hep B/C, lipodystrophy

Minimal change disease - NSAID, lymphoma

IgA nephropathy - URI infection

Question 13

Acute transplant rejection can happen within what time frame?

Answer 13

6 months (heavy lymphocyte infiltration with vascular involvement and swelling of intima)

Chronic= months to years- fibrosis

Question 14

Which immunosuppressants are nephrotoxic?

Answer 14

calcineurin inhibitors- cyclosporine, tacrolimus

Question 15

Treatment for anaphylaxis

Answer 15

Epinephrine and isotonic fluids

Question 16

Pterygium

Answer 16

Benign growth of conjunctival tissue (nasally) exposure to UV light