renal

Question 1

most common histological type of malignant renal cancer?

Answer 1

clear cell carcinoma (80%)

Question 2

malignant renal cancer triad?

Answer 2

1. haematuria
2. loin pain
3. abdo mass
   (+weight loss)

Question 3

biochemical abnormalities most likely in prolonged diarrhoea?

Answer 3

metabolic acidosis
normal anion gap
hypokalaemia (GI losses of K+)

Question 4

calculate anion gap? normal range?

Answer 4

(sodium + potassium) - (bicarbonate + chloride)
8-14 mmol/L

Question 5

gynaecomastia in testicular cancer?

Answer 5

increased oestrogen:androgen ratio

Question 6

amyloidosis biopsy findings?

Answer 6

Congo red stain shows apple-green birefringence under polarised light

Question 7

what is primary amyloidosis?

Answer 7

describes extracellular deposition of an insoluble fibrillar protein (amyloid)
seen in patients w/ immune dycrasias (eg. multiple myeloma)

Question 8

most common subtype of bladder cancer?

Answer 8

transitional cell carcinoma (strongly linked to smoking)

Question 9

which structure is most commonly affected in nephrogenic diabetes insidious?

Answer 9

vasopressin (ADH) receptor - due to X-linked mutation
(less common, auto recessive mutation in gene for aquaporin 2 channel

Question 10

polyuria due to alcohol bingeing?

Answer 10

leads to ADH suppression in post pituitary gland subsequently leading to polyuria

Question 11

how do ARBs work? give an example?

Answer 11

reduce renal perfusion by blocking the action of angiotensin II
Losartan

Question 12

treatment for central diabetes insidious?

Answer 12

Desmopressin - synthetic exogenous ADH to replace the deficit

Question 13

what part of the kidney does renal cell carcinoma arise from?

Answer 13

proximal renal tubular epithelium

Question 14

classic cause of central pontine myelinolysis

Answer 14

low levels of sodium in the blood

(Hypernatraemia = high to low, the brain will blow - cerebral oedema)
(Hyponatraemia = low to high, the pons will die - central pontine myelinolysis)

Question 15

Diabetic nephropathy histological findings- Kimmelstiel-Wilson lesions (nodular glomerulosclerosis) and hyaline arteriosclerosis. This is due to nonenzymatic glycosylation.