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MHD > Renal > Flashcards

Renal Flashcards

1
Q

Pre-renal BUN:Cr

A

Increased ratio: low RBF activates RAAS, increased BUN absorption

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2
Q

Post-renal BUN:Cr

A

Early: high ratio, increased pressure “forces” BUN out
Late: low ratio, tubular damage–less absorption

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3
Q

Fanconi syndrome

A

PCT dysfunction

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4
Q

Bartter’s syndrome

A

TAL dysfunction

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5
Q

Gitelman’s syndrome

A

DCT dysfunction

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6
Q

Pre-renal FENa

A

Low FENa (RAAS activation)

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7
Q

Acute Tubular Necrosis FENa

A

High FENa: Na not reabsorbed due to tubular damage

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8
Q

Pyuria + WBC casts

A

Interstitial nephritis

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9
Q

“Muddy brown” granular casts, isosthenuria

A

Acute tubular necrosis (ATN)

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10
Q

Hematuria, RBC casts

A

Acute glomerulonephritis

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11
Q

Subepithelial “hump”

A

Post-infectious glomerulonephritis (immune complex deposition)

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12
Q

IF: granular mesangium

A

IgA nephropathy

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13
Q

What complement pathway is used in IgA nephropathy?

A

Alternative

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14
Q

What is Henoch-Schönlein Purpura (HSP)?

A

IgA nephropathy + extra-renal symptoms

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15
Q

Cause of Hereditary Nephritis?

A

Mutation in collagen type IV (Alport syndrome)

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16
Q

Hereditary nephritis triad

A

Isolated hematuria, hearing, and ocular abnormalities

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17
Q

RPGN Type I

A

Anti-basement membrane antibodies

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18
Q

RPGN Type II

A

Immune complex depositions

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19
Q

RPGN Type III

A

ANCAs cause activation of neutrophils and release of lytic enzymes

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20
Q

IF: linear

A

RPGN Type I, Goodpasture syndrome

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21
Q

Hematuria + Hemoptysis

A

RPGN Type I: antibodies against basement membrane in kidneys and lungs (Goodpasture syndrome)

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22
Q

“Spike and dome” on silver stain

A

Membranous nephropathy

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23
Q

What is membranous nephropathy?

A

Autoimmune response against renal antigen (PLA2R)

24
Q

Effacement of podocytes

A

Minimal change disease or FSGS

25
Q

APOL1

A

Risk allele for FSGS, Africans at higher risk (confers resistance to trypanosomes)

26
Q

“Tram track” or “double contour”

A

Membranoproliferative glomerulonephritis (MPGN): immune complex formation with classical pathway of complement

27
Q

Dense deposits in lamina densa

A

Dense deposit disease (DDD)

28
Q

“Basket weave” lamina densa splitting

A

Hereditary nephritis

29
Q

Libman-Sacks Endocarditis

A

SLE

30
Q

Oxalate crystals in urine

A

Ethylene glycol (antifreeze) poisoning (nephrotoxic ATN)

31
Q

What can be found in urine in acute interstitial nephritis?

A

Eosinophils

32
Q

Dense deposit disease

A

C3 nephritic factor: autoantibody stabilizes C3 convertase, leads to over activation of complement, inflammation, and low levels of C3

33
Q

What causes Kimmelstiel-Wilson (KW) nodules?

A

Diabetes mellitus (sclerosis of the mesangium)

34
Q

“Apple-green birefringence” after congo red staining

A

Systemic amyloidosis

35
Q

What are “crescents”?

A

Fibrin and macrophages in Bowman’s space seen in Rapidly Progressive Glomerulonephritis (RPGN)

36
Q

Berger disease

A

IgA nephropathy

37
Q

Alport syndrome

A

Inherited defect in Type IV collagen

38
Q

“Thyroidization” of the kidney

A

Chronic pyelonephritis (atrophic tubules containing eosinophilic proteinaceous material)

39
Q

What causes hypocalcemia in chronic renal failure?

A

Decreased conversion of vitamin D into (1,25)-OH-Vitamin D (happens in kidney) – will also cause hyperphosphatemia which exacerbates the hypocalcemia by binding serum Ca

40
Q

What causes stag horn calculi in adults? In children?

A

Adults: ammonium magnesium phosphate (AMP) (A=A)
Children: cystine (C=C)

41
Q

What is a major risk of dialysis?

A

Renal cell carcinoma: cysts often develop within shrunken end-stage kidneys

42
Q

Describe pathogenesis of renal cell carcinoma.

A

Loss of VHL tumor suppressor gene leads to increased IGF-1 (growth) and HIF transcription factor

43
Q

What is the most common malignant renal tumor in children?

A

Wilms tumor

44
Q

What locus is implicated in many autoimmune diseases?

A

HLA locus

45
Q

What causes Libman-Sacks Endocarditis?

A

SLE

46
Q

What’s the major cause of mortality in SLE?

A

Cardiovascular disease

47
Q

Sjogren’s syndrome

A

Lymphocytic infiltration of exocrine glands (risk of lymphoma)

48
Q

What’s the major cause of mortality in systemic sclerosis?

A

Pulmonary complications

49
Q

Cause of DIFFUSE scleroderma

A

Anti-topoisomerase I antibody

50
Q

Cause of LIMITED scleroderma

A

Anti-centromere antibody

51
Q

Cause of scleroderma renal crisis

A

Anti-RNA polymerase III antibody

52
Q

What is limited scleroderma?

A

CREST syndrome

53
Q

What is CREST syndrome?

A

Limited scleroderma: calcinosis, Raynaud, esophageal dysmotility, sclerodactyly, telangiectasia

54
Q

What is the most common and most severe stage of lupus nephritis?

A

Stage IV (diffuse proliferative nephritis)

55
Q

What autoantibody is found in membranous nephropathy?

A

Anti-PLA2R

56
Q

What gene is mutated in adult polycystic kidney disease?

A

PKD1 or PKD2

MHD (1 decks)

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