Renal

Question 1

Cloudy urine

Answer 1

Inc phosphates (w/ alk P)
Inc uric acid (acidic pH)

Question 2

Sp Gr > 1.023

Answer 2

Intrinsic renal disease

Question 3

Alkaline pH + ammonia

Answer 3

Proteus infx

Question 4

Alkaline pH

Answer 4

Vegan

Question 5

Acidic pH

Answer 5

meat eater

Question 6

CBG level that can cause glucosuria

Answer 6

> 200 mg/dL

Question 7

Ketones in urine

Answer 7

DKA
Starvation
Pregnancy

Question 8

Inc urine bilirubin

(-) Urobilinogen

Answer 8

Obstructive jaundice

Question 9

No urine bilirubin

Inc UBG

Answer 9

Hemolytic anemia

Question 10

Inc urine bilirubin

Inc UBG

Answer 10

Hepatitis

Question 11

Sterile pyuria

Answer 11

Chlamydia trachomatis

Question 12

Oval fat bodies in urine

Answer 12

nephrotic syndrome

Question 13

RBC cast

Answer 13

Nephritic syndrome

Question 14

WBC cast

Answer 14

Acute pyelonephritis

Acute tubulointerstitial nephritis

Question 15

Waxy cast

Answer 15

Chronic renal failure

Question 16

Granular cast (muddy ground)

Answer 16

Acute tubular necrosis

Question 17

Inc BUN and crea

Answer 17

Azotemia

Question 18

Inc BUN, Crea + symptoms

Answer 18

Uremia

Question 19

Nephritic syndrome
Hypercellularity, granular IF, subepith humps
GAHBS
Elevated ASO

Answer 19

PSGN

Question 20

Nephritic syndrome
Has 3 types (Anti-GBM, immunecomplex, pauci-immune)
Crescents, linear IF, rupture in GBM

Answer 20

RPGN

Question 21

Nephrotic syndrome
Diffuse uniform thickening
Subepith deposits
Spike and dome
Mostly idiopathic, if not 2ndary to solid tumors, penicillamine, SLE, infx

Answer 21

Membranous glomerulopathy

Question 22

MOA: Cytokine damaging visceral epith
Normal LM, IF
EM: effacement of foot processes
Tx: Steroids

Answer 22

Minimal change disease

Question 23

Nephrotic syndrome
Thickened GBM, tram-track
Granular dense deposits on IF
Subendothelial dense deposit on EM
May lead to RPGN

Answer 23

Membranoproliferative GN

Question 24

Secondary MPGN occurs in:

Answer 24

alpha-1 antitrypsin def
Chronic immune complex
CLL, lymphoma
Hereditary dse of complement CHONs

Question 25

``` Obese, heroin-addict, HIV-infected Sickle cell dse 2ndary event in other GN Most common cause of nephrotic syndrome in adults Renal failure in 2 yrs ```

Answer 25

FSGS

Question 26

Where does the pathology occur in IgA nephropathy?

Answer 26

Mesangium

Question 27

Isolated hematuria Defective GBM synthesis (AbN Collagen 4) (+) sensorineural HL (+) eye d/o

Answer 27

Alport's syndrome

Question 28

Isolated hematuria Involves type 4 collagen (-) hearing loss

Answer 28

Thin BM disease

Question 29

Hallmark of ESRD

Answer 29

Symmetrically contracted kidneys in Chronic GN

Question 30

Cortical thickness in Chronic GN

Question 31

Systemic diseases that cause glomerular lesions

Answer 31

``` SLE HSP Bac endocarditis DM Amyloidosis ```

Question 32

Syndrome assoc with lupus nephropathy types 1-4

Answer 32

Nephritic syndrome

Question 33

Syndrome assoc w/ Type V DM nephropathy

Answer 33

Nephrotic syndrome

Question 34

Kimmelsteil-Wilson nodules Fibrin caps Capsular drops

Answer 34

DM nephropathy

Question 35

Assoc w/ multiple myeloma Nephrotic (+) congo red stain

Answer 35

Amyloidosis

Question 36

2ndary hypovolemia Patchy necrosis Shorter tubules PCT and LH

Answer 36

Ischemic type ATN

Question 37

2ndary to aminoglycoside, IV contrast, heavy metals Extensive necrosis PCT, DT affected

Answer 37

Toxic type ATN

Question 38

Most common cause of tubulo-interstitial nephritis

Answer 38

Pyelonephritis

Question 39

Acute TI nephritis has intestitial edema and ___ infiltration

Answer 39

leukocyte

Question 40

Chronic TI nephritis has intestitial fibrosis and ___ infiltration

Answer 40

Monocyte

Question 41

Most common bacteria causing pyelonephritis

Answer 41

E. coli

Question 42

Pathognomonic findings of pyelonephritis

Answer 42

Pyuria + WBC casts

Question 43

Virus assoc w/ kidney transplant pts presenting w/ pyelonephritis

Answer 43

Polyoma virus

Question 44

Drug causing papillary necrosis

Answer 44

Phenacetin

Question 45

TI nephritis w/ renal scarring and blunting of calyces

Answer 45

Chronic TI nephritis

Question 46

How many days after drug intake will you expect sx of acute drug-induced intertstitial nephritis?

Answer 46

15 days

Question 47

Blood finding in analgesic nephropathy

Answer 47

Anemia out of proportion to renal insufficiency

Question 48

Nephropathy due to aristolocholic acid | Inc incidence if carcinoma of kidneys and urinary tract

Answer 48

Chinese herb nephropathy

Question 49

``` Bence jones proteins Tamm-Horsfall glycoCHONs Amyloidosis Light chain deposition HyperCa, Hyperuricemia ```

Answer 49

Multiple myeloma

Question 50

Most common renal disease in pts with essential HPN

Answer 50

Benign nephrosclerosis

Question 51

Nephrosclerosis assoc w/ malignant HPN Flea bitten kidneys onion-skinning, fibrinoid necrosis

Answer 51

Malignant nephrosclerosis

Question 52

Common in young F Small kidneys w/ diffuse ischemic atrophy d/t atheromatous plaque

Answer 52

Renal artery sclerosis

Question 53

Most common type of kidney stone

Answer 53

``` Calcium oxalate (adult) Calcium phosphate (children) ```

Question 54

Struvite stones Staghorn calculi assoc w/ Proteus Coffin-lid appearance

Answer 54

Mg NH4 stone

Question 55

Dx test of choice in diagnosing Kidney stones

Answer 55

CT stonogram

Question 56

Ca assoc w/ Von Hippel Lindau syndrome RF: M, smoking, APKD, obesity, asbestos exposure, Pb More on upper pole of kidney

Answer 56

Renal cell CA

Question 57

Most common type of renal cell CA

Answer 57

Clear cell

Question 58

Painless hematuria Transitional cell CA Causes: Phenacetin, Smoking, Aniline dyes, cyclophosphamide

Answer 58

Urothelial CA

Question 59

Black urine

Answer 59

Alkaptonuria