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Renal/Resp Pathology > Renal 2 > Flashcards

Renal 2 Flashcards

1
Q

pathogenesis of diabetic nephropathy

A

constriction of efferent arteriole due to non-enzymatic glycosylation –> increased GFR –> mesangial expansion

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2
Q

hallmarks of diabetic nephropathy (2)

A
  1. mesangial expansion

2. nodular glomerulosclerosis (Kimmelstein-Wilson lesion)

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3
Q

diabetic nephropathy: nephritic or nephrotic?

A

nephrotic

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4
Q

what characteristics are present in pre-diabetic nephropathy? (2)

A

inceased GFR, increased renal size

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5
Q

what drugs can cause a decrease in GFR but are renoprotective in the long-term?

A

ACE inhibitors (captopril, lisinopril, enalapril) and ARBs (losartan)

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6
Q

Alport syndrome: pathogenesis

A

X-linked, mutation in type IV collagen which leads to thinning and splitting of GBM, hematuria, deafness

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7
Q

amyloidosis: nephritic or nephrotic?

A

nephrotic

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8
Q

Alport syndrome: nephritic or nephrotic?

A

nephritic

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9
Q

X-linked, mutation in type IV collagen, hematuria

A

Alport syndrome

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10
Q

how does proteinuria cause edema?

A

glomerular disease –> glomerular proteins leak and overwhelms tubular reabsorption –> albumin cannot be reabsorbed –> low plasma oncotic pressure –> edema

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11
Q

what do muddy brown casts in urine indicate?

A

acute tubular necrosis

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12
Q

diagnostic criteria of acute kidney injury

A

ONE of these:

  1. increase in serum creatinine of 0.3 mg/dL
  2. more than a 1.5-fold increase of serum creatinine
  3. reduction in urine output less than 500 mL in 24 hours
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13
Q

define oliguria

A

urine output less than 400-500 mL/day

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14
Q

describe the autoregulation of GFR that happens in response to decreased perfusion pressure (2)

A
  1. increased vasodilatory prostaglandins dilate afferent arterioles
  2. increased angiotensin II constricts efferent arterioles
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15
Q

pathogenesis of prerenal azotemia

A

decreased RBF –> decreased GFR; increased retention of sodium, water, and urea causes oliguria, and increased BUN/creatinine ratio

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16
Q

which azotemia: decreased GFR, oliguria, increased BUN/creatinine ratio

A

prerenal azotemia

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17
Q

BUN/creatine ratio is ______ in prerenal azotemia and ______ in renal azotemia

A

increased, decreased

18
Q

FENa in acute tubular necrosis (renal azotemia)

A

greater than 2% (tubules are injured, so sodium reabsorption is impaired)

19
Q

FENa in prerenal azotemia

A

less than 1%, sodium reabsorption should be increased

20
Q

hydronephrosis on ultrasound –> what is the diagnosis

A

post-renal azotemia

21
Q

common cause of acute interstitial nephritis

A

hypersensitivity reaction to drugs

22
Q

common cause of acute pyelonephritis

A

ascending UTI

23
Q

caused by hypersensitivity to drugs, eosinophilia in blood and urine, hematuria

A

acute interstitial nephritis

24
Q

kidney disease caused by ascending UTI

A

acute pyelonephritis

25
Q

LM shows fractured casts

A

myeloma cast nephropathy

26
Q

treatment for recurrent calcium kidney stones

A

thiazide diuretics, citrate,

27
Q

what is the origin of cells forming the kidney and ureter?

A

intermediate mesoderm

28
Q

what is the origin of cells lining the bladder and urethra?

A

endoderm

29
Q

______ kidney functions as interim kidney for 1st trimester

A

mesonephric

30
Q

what is the origin of the mesonephric diverticulum (ureteric bud)?

A

caudal end of mesonephric duct

31
Q

what is the common cause of death with fetuses with Potter sequence?

A

pulmonary hypoplasia

32
Q

horseshoe kidney: what artery blocks the ascent?

A

inferior mesenteric artery

33
Q

most common renal malignancy of early childhood

A

Wilms tumor (nephroblastoma)

34
Q

Wilms tumor (nephroblastoma) pathogenesis

A

“loss of function” mutations of tumor suppressor genes WT1 or WT2 on chromosome 11

35
Q

what other conditions is ADPKD associated with?

A

berry aneurysms, mitral valve prolapse, benign hepatic cysts

36
Q

cystic, enlarge kidneys, berry aneurysms, mitral valve prolapse, benign hepatic cysts

A

ADPKD

37
Q

classic triad of symptoms of renal cell carcinoma

A

painless hematuria, palpable mass, flank pain

38
Q

common effects of paraneoplastic syndrome of renal cell carcinoma

A

secondary polycythemia, due to erythropoietin production by the tumor

39
Q

worst outcome of all kidney cancers

A

medullary carcinoma (subtype of renal cell carcinoma)

40
Q

key determination of TNM staging of bladder neoplasms

A

whether muscularis propria is invaded

Renal/Resp Pathology (4 decks)

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