Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UWORLD QuestionQuestions > Renal > Flashcards

Renal Flashcards

1
Q

Abs associated with Goodpastures? Where else can these Abs React on?
With what specific collagen?

A

Anti-GBM Abs- Cross react with BM of lung alveoli- Hemoptysis!

@ alpha 3 chain of Collaen Type IV-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

GoodPastures Disease presents with what renal disease?
With what Immunoflorescent findings?
EM?

A

RPGN
IgG & C3 in Linear Deposits
GBM diruptions and fibrin deposition on EM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What stones can precipitate from ACIDIC urine?

A

Uric Acid, Cysteine, Calcium Oxalate stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What stones can precipitate from ALKALINE urine?

A

struvite, Calcium PHOSPATE stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What 2 things can dissipate Stones (specifically calcium precipitated stones)

A

Citrate (binds free Ca2+ => excretion)

High fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oncotic Pressure is what?

How does it relate to Hyper/HypoProtein/Albuminemia

A

Pressure that keeps and fluid within the vessel/plasma.

Hyper= high oncotic pressure => plasma fluid retention due to high amount of albumin/protein in the blood

Hypo= low oncotic pressure => intersitial edema formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MCC of ESRD in US? (renal disease)

best method for early detection?

A

Diabetic Nephropathy

Microalbuminuria detection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does Autosomal Reessive Polycystic kidney disease usually present? and how

A

At birth/early childhood

enlarged kidneys with cysts >1cm visble on US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how long after vasectomy is sperm still viable?

A

3months

20 ejaculations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

IV Acyclovir requires which co-administrative treatment and why?

A

aggressive IV hydration because crystalline nephropathy can occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of endocrine disorder is caused by Chronic renal failure commonly?

A

hyperparathyrioidsm

Increase PTH
Decr. Calcitriol
Low Calcium
High Phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What disease is an inborn defect of the transporter of cystine, ornithine, arginine & lysine? and when and which symptom is seen?

A

Cystinuria

renal colic @ 2-3rd decades of life

pathognomonic hexoganal cystine crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where does ADH act?

A

Medullary segment of the collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Predisposers to post-streptococcal glomerulonephritis? hypersensitivity reaction type?

A

impetigo
cellulitis
pharyngitis
FROM STREP (GrpA B-hemolytic Strep)

TypeIII HSR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

IL -2 actions? Which cancers can it effect and How?

A

Produced by Thelper => stimulates growth of CD4 & CD8 Tcells & BCells

activates NK cells & Monocytes

overall anti-cancer effect on metastatic melanoma & Renal Cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fabry’s disease (deficiency?)

early manisfestations?

without enzyme replacement what will this disease lead to?

A

alpha glalactosidase A deficiency (cant metabolize ceremide trihexoside)

hypohidrosis
acroparesthesia
angiokeratomas

renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Amphotericin B main side effect?

A

Nephrotoxicity

Hypokalemia hypomagnesmia => increase distal tubular membrane permiabilityy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NSAIDs do what to prostaglandin synthesis

A

inhibit it

ibuprofen, naproxen, indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What effect do Loop dieuretics have on prostaglandins?

what will happen with concurrent use of NSAIDs

A

Stimulate prostaglandin release.=> increased GFR and enhanced drug delivery

decreased diuretic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does Vasopressing affect the V2 reeceptor?

A

v2 receptor-mediated increase in permeability to water and urea at the luminal membrane of the inner medullary collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Winters Formula

PaCO2=?

A

(1.5 X HCO3-) + 8+/-2

PaCO2 > # => concurrent respiratory acidosis
PaCO2 < # => concurrent respiratory alkalosis

Use to evaluate respiratory compensation when there is metabolic ACIDOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Histology of postreptococcal glomerulonephritis (3)

A

Enlarged hypercellular glomeruli on light microscopy

Lumpy bumbpy granular deposits of igG and C3 on immunofluorescence.

Electron dense deposits on the epithelial side of basal membrane on e- microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which bugs lack:
peptidoglycan within cell wall
cell wall entirely

Rx?

A

Chlamydia Trachomatis
Ureaplasma urealyticum

Antiribosomal abx= Microlides/Tetracyclinnes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which portion of Kidney system is involved in acute renal colic due to nephrolithiasis?

A

Calices/Ureters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pts with sickle cell, DM , analgesic nephropathy, severe acute pyelonephritis can have which type of pathologic damage of the kidney?
Renal papillary necrosis
26
When and how does acute interstitial nephritis present?
Fever maculopapular rash and Acute renal failure sx, 1-3 wks post B-lactam ABx
27
Contraindications to OCP (oral contraceptive pills)
``` Hx of thromboemolic event/stroke Hx of estrogen dependent tumor >35 heavy smoker hypertriglyceridemia active liver disease pregnancy ```
28
What happens to Creatinine as GFR decreases? Increases?
Creatinine increase (when GFR halves-Creatinine doubles) small increase in creatinine
29
Standard treatment of dysuria and/or urethral discharge in young adult?
ceftriaxone | AZITHROMYCIN/Doxycycline
30
Flucanozole is used to treat?
``` candidiasis cryptococcosis histoplasmosis blastomycosis coccidiodomycosis ```
31
Why would prednisone and cyclosporin/Tacrolimus be used in a graft/transplant? how do the last two achieve this action?
immunosuppressantt drugs that reduce risk of developing acute rejection cyclosporin/tacrolimus inhibit calcineurin activation which ---| IL-2 activation ( aka no diffentiation of Tcells)
32
What is muromonab-CD3 (OKT3)? how does it work?
Anti-CD3 Monoclonal Ab that inhibit T-lymphocyes used in treatment of acute reection in kidney heart liver transplants
33
MCC of Urinary Tract obstruction in elderly male patients?
BPH
34
Activation of IL-2 via which protein? why would you inhibit this protein and its subsequent activation? what does IL-2 promote?
Calcineurin; for immuno supression promotes the growth and differentiation of T cells
35
MC subtype of RCC? histology of this type? Classical clinical triad ? (its rare to see) MC site of metastisis
Clear Cell Carcinoma large rounded/polygonal cells with clear cytoplasm. hematuria, flankpain, palpable mass lung
36
What is endometriosis? Symptoms seen? Pts have what 2 things on vaginal examination?
presence of endometrial glands and stroma outside the uterus dysmenorrhea dyspareunia= painful sex dyschezia (due to pelvic adhesions) infertility Nodularity of the uterosacral ligaments and fixed retroversion of the uterus!!!
37
Sexual characteristic manifestations of Turners (4)?
primary amenorrhea high arched palate widely spaced nipples Ovarian dysgenesis + STREAK GONADS
38
PCOS signs & symptoms? 6 categories with descriptions/levels/assoc. disorders
Menstrual irregularity = oligomenorrhea & infertility due to anovulation Hormonal dysregulation= unopposed estrogen INCR. risk for endometrial Adenocarcinoma (progestrone def. , estrogen prod., elevated LH) Increased insulin resistance => obesity/DM2 Hirsutism/Acne (incr. androgens) Dyslipidemia=> atherosclerosis &CAD bilateral ovarian enlargement (multiple enlarged sclerotic cystic follicles)
39
endometrial glands within the uterine myometrium? how is this distinguishable from Endometriosis?
Adenomyosis | ENLARGED UTERUS
40
When is basement membrane splitting scene?
Membranoproliferative glomerulonephritis and Alport syndrome
41
Light microscopy and clinical manifestations of nephrotic syndrome?
Uniform diffuse thickening of glomerular capillary walls Generalized edema, March proteinuria (> 3.5 g per day), hypoalbuminemia, hyperlipidemia and lipiduriia
42
``` Site of action of diuretics? name one Carbonic anhydrase Osmotic Diuretics Loop diuretics Thiazide diuretics Potassium sparing diuretics- ```
CA-proximal tubule Acetozolamide OD-descending limb of Henle's loop & proximal tubule Mannitol LD-Thick ascending limb of Henle's Loop Furosemide TD-Distal convoluted tubule Hydrochlorothiazide PSD- Collecting Duct Sodium Channel BLockers-Amiloride Aldosterone rec. Blockers- Spirinolactone
43
what is a cellular often myxoid stroma that encircles and sometimes compresses epithelium-lined glandular and cystic spaces?
Fibroadenoma
44
Hypersensitivity of a Hyperacute rejection? describe this type? another example of this
Type II mediated by preformed recipient antibodies against antigens on the host organ. ABO blood group antibodies and anti-HLA antibodies.
45
What Medium does Niesseria Gonnorrhea grow on? Why is it selective medium?
Thayer-Martin VCN Anitbiotics kill contaminants like Gm+ other Gm- (not gonorrhea) and fungi
46
Purpose of Differential media? | Name 2
differentiate btw biochemical and metablic properties EBM & MacConkeys
47
acid base abnormalities associated with salicylate intoxication? (2)
FIRST: Respiratory Alkalosis-stimulate medullary respiratory center => Hyperventilation=> increased CO2 lost in expired air. Anion Gap Metabolic Acidosis-accumulation of organic acids in the blood,
48
How do Ketoacids, lactate and pyruvate accumulate in salicylate poisoning? 3
Increase lipolysis Uncouple oxidative phosphorylation Inhibit the TCA cycle
49
The finding of mucopurulent cervicitis is typical for which disease in women? 2 bugs that cause this?
PID N.gonorrhea, C.Trachomatis
50
How is endometrial hyperplasia caused? | What are its clinical findings?
Caused by elevation in estrogen unopposed by progesterone acting on in the endometrial lining - exogenous : hormone replacement therapy - endogenous: estrogen secreting ovarian tumor, increase aromatization of androgens and obese women Dysfunctional uterine bleeding
51
What two things can PID potentially lead to? why?
Ectopic pregnancy Infertility Due to salpingitis leading to scarring of the fallopian tubes
52
how is LPS released from bacteria?
During division or by bacterial lysis. NOT actively secreted by bacteria.
53
What is the toxic component of LPS? What does it cause?
Lipid A Lipid a causes activation of macrophages leading to the widespread release of IL-1 and TNF – Alpha. => septic shock: fever, hypertension, diarrhea, oliguria, vascular compromise, DIC
54
how does a Competitive inhibitor change the log dose response curve?
Change ED 50 = shift right/L
55
How does a noncompetitive inhibitor change the lock those response curve?
Change E Max = shift down/up
56
in whom does an indirect inguinal hernia most commonly present? where does it occur? How does it occur?
Male infants Lateral to inferior epigastric vessels Persistent processes vaginalis, and failure of internal inguinal ring to close; covered by all 3 spermatic fascial layers
57
in whom does a direct inguinal hernia most commonly present? where does it occur? how does it occur?
Older man Medial to inferior epigastric vessels Weakness in transversalis fascia, external spermatic fascia covering only
58
in whom does a femoral hernia most commonly present? where does it occur?
Women Medial to the femoral vessels and inferior to the inguinal ligament
59
ANCA– associated RPGN is also called immune glomerulonephritis because the absence of what 2 things? Which type of RPGN is this? What presentation?
Ig and C3 deposits; TYPE 3 Renal failure, pulmonary symptoms, upper respiratory tract symptoms (epistaxes, mucosal ulceration, chronic sinusitis and parentheses CRESCENTS on Light Microscopy
60
Type 1 RPGN has which antibodies present and what is seen on IF microscopy?
Anti – GBM antibodies Goodpastures syndrom
61
Type 2 RGPN is associated with what deposits? what is seen on IF? What 4 diseases present with this RPGN?
Immune –Complex mediated Lumpy bumpy granular pattern on IF microscopy Post streptococcal Glomerulonephritis, SLE, IgA nephropathy, and Henoch-Schlonlein Purpura
62
When would a decrease serum C4 be present? Which pathway is activated?
Hereditary angioedema Classical pathway is activated secondary to a lack of C1 esterase inhibitor (breaks Down C4)
63
What is the diagnosis of a patient with a positive VDRL and pleocytosis in the CSF?
Neurosyphilis
64
``` Syphilis: primary- secondary- latent- tertiary- ```
1: painless ulcerated Chancre 1-3wks after contact & resolves in 3-6wks' 2: 5-10wks bacteremic stage with diffuse macular rash in the palms and soles, condylomata lata (grey-wartlike growths) L:asymptomatic = early latent and late latent (1yr post 2ndary symptoms) 3: syphilis years after infection includes subacute meningeal encephalitis, tabes dorsalis, Gummas
65
Where does ADH act upon? how? where would be most dilute/ concentrated portion of the nephron be?
Collecting ducks, increases their permit ability to water. Collecting ducts most concentrated fluid in the nephron thick ascending limb and distal convoluted tubules are most dilute.
66
Which part of the ovary can be affected by excessive hCG?
Theca–lutein cysts
67
clearance of PAH is equal to?
RPF
68
The secretion of PAH is through which process?
Carrier-enzyme mediated process Transport maximum= secretion plateau
69
What cells compose Crescents of RPGN?
Glomerular parietal cells, monocytes, macrophages, abundant fibrin
70
Beta-Lactamase inhibitors (name 3) extend the penicilin spectrum via which mechanism?
Clavulanic acid sulbactam tazobactam They decrease the destruction (via beta lactamase) of penicillins
71
Where is the lowest concentration of PA H?
In Bowman space
72
Acute tubular necrosis stage descriptions: Initiation- Maintenance- Recovery- plus serious complication
I- ischemic injury due to hemorrhage, acute MI, sepsis, surgery M-decreased urine output, fluid overload, increasing creatinine/BUN, hyperkalemia R-gradual increase in urine output = >high-volume diuresis. HYPOKALEMIA; decreased Mg, PO4, Ca due to slow tubular recovery
73
How to diagnose the maintenance stage of acute tubular necrosis
24-36hours after ischemic damage URINARY: pathognomonic muddy brown Casts, low urinary osmolality (less than sign 350), high urinary sodium (>30), high urinary fractional sodium excretion (FeNa>1). &&& hyperkalemia, high anion gap metabolic acidosis
74
Laboratory findings of PSGN: (4)
Elevated antistreptolysin-O (ASO) titers Elevated anti-DNase B titers Decreased C3 and total complement levels (c4 normal) Presence of cryoglobulins
75
Ruptured ectopic pregnancy symptoms? Biopsy findings?
Abdominal pain Vaginal bleeding Hemorrhagic shock History of amenorrhea Decidual changes in endometrium but NOT chorionic villa
76
(4) secondary hyperaldosteronism causes? What symptoms will the patients have (2) and what findings will they have (2)
Renovascular hypertension Malignant hypertension Renin secreting tumor Diuretic use Hypertension and hypokalemia Increase renin, increase aldosterone
77
(2) primary hyperaldosteronism causes Patient presents with (2) what symptoms and what clinical findings (2)
Aldosterone producing tumor Bilateral adrenal hyperplasia Hypertension and hypokalemia Decreased renin, increased aldosterone
78
Non-aldosterone causes of patients with hypertension and hypokalemia (4)? what clinical findings are seen (2)
Decrease renin decreased aldosterone CAH Deoxycorticosterone producing adrenal tumor Cushing syndrome Exoogenous mineralocorticoids
79
Gross painless hematuria and older adults to be considered what until proven otherwise?
Urothelial cancer
80
Reno clear-cell carcinomas originate from which type of cells?
Tubular epithelial cells
81
What happened to the blood in nephrotic syndrome? Common complication of nephrotic syndrome?
Hypercoagulable state Loss of antithrombin III Renal vein thrombosis; hematuria, left-sided varicocele or flank pain
82
Description of JG Aparatus subunits and where they are located? MOA?
JG cells - are modified smooth muscle cells located in the walls of the efferent and afferent arterioles macula densa cells- are tall narrow cells located in the distal tubule *MD cells monitor osmolarity/urine volume in DT and transmit information to JG cells where renin synthesis occurs
83
VHL (3) => three clinical syndromes associated with it Where and what are the genetic change associated with VHL gene? what type of gene is VHL
Cerebellar hemangioblastoma's Clear cell renal carcinoma (40%) Pheochromocytomas Deletion on chromosome 3p; tumor suppressor gene
84
Where is the RB anti-oncogene located? Mutations in this gene lead to which two disorders
Chromosome 13 Retinoblastoma Osteosarcoma
85
When would tubular affection with urate crystals occur? And which kind of patient is this seen?
Tumor lysis syndrome classically presenting as acute renal failure during chemotherapy for malignancy
86
Which two toxins bind to sodium channels inhibiting sodium influx and preventing action potential conduction?
tetrodotoxin -pufferfish | Saxitoxin- dinoflagellates
87
Which to toxins bind to sodium channels keeping them open and causing persistent depolarization?
Ciguatoxin- eel | Batrachotoxin (S.A. Frogs)
88
When is vitamin E deficiency seeing? (3) -lipid soluble & antioxidant what does it present similarly to? What symptoms? (3)
Fat malabsorption Abetalipoproteinemia Low birth weight infants ``` Degeneration of : spinocerebellar tracts Dorsal column of smile cord Peripheral nerves ==>Friedrech Ataxia (ataxia, dysarthria, loss of position & vibration) ```
89
What Activates CPS I of the Urea cycle? what is special of this enzyme?
N-Acetylglutamate (NAG) | RLS
90
What molecule does the Urea cycle derive its Nitrogen from?
Aspartate.
91
Which SE of opiod use does not change with increased tolerance? (2)
Constipation | Miosis
92
nephrotic syndrome (4)
``` massive proteinuria hypoalbuminemia generalized edema hyperlipidemia lipiduria ```

UWORLD QuestionQuestions (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions