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Step 2 CK: UWorld Questions > Renal > Flashcards

Renal Flashcards

1
Q

DM complicated by neuropathy and nephropathy which can lead to end stage renal disease. The risk of progression is reduced by appropriate glycemic and _________ control and the use of ______ such as lisinopril or ______ such as losartan

A

blood pressure

ACEI

ARBs

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2
Q

________ bias occurs when investigators misclassify data due to preconcieved expectations or prior knowledge concerning the study or its participants

A

observer

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3
Q

___________ and ____________ due to nephrotoxicity are common electrolyte disturbances in patients undergoing treatment with amphotericin B for disseminated fungal infection and can result in weakness and __________

A

hypokalemia

hypomagnesemia

arrhythmias

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4
Q

acidosis stimulates renal ________, a process by which renal epithelial cells metabolize _______ to glutamate, generating ammonium that is excreted in the urine and ______ that is absorbed into the blood.

A

ammoniagenesis

glutamine

HCO3

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5
Q

facial and periorbital edema, mild HTN, hematuria in a child post infection suggests _______ syndrome with a diagnosis of _______. On light microscopy, the glomeruli are enlarged and hypercellular, IF studies reveal _______ of IgG, IgM and C3 along the BM and in mesangium. IMmune complexes are seen as electron dense deposits in electron microscopy on the ________ side of the basement membrane

A

nephritic

poststreptococcal glomerulonephritis

granular deposits

epithelial

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6
Q

young child with generalized edema, massive proteinuria after an URTI likely has ______, which is the most common cause of ________ syndrome in ages 2-6. Caused by immune dysregulation, an overproduction of golmerular permeability factor (cytokine that directly damages ________ and decreases the ___________ charge of GBM), which leads to a selective loss of _____ in the urine.

A

minimal change disease

nephrotic

podocytes

anionic

albumin

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7
Q

inadequate canalization of the ____________ is the most common cause of unilateral feta hydronephrosis

A

ureteropelvic junction

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8
Q

fever, rash, acute renal failure (inc creatinine, oliguria) occurring within a few weeks of starting a beta lactam antibiotic (ampicillin) is highly suggestive of _________. Peripheral eosinophilia and eosinophiluria are important clinical cues.

Other drugs involved

A

acute interstitial nephritis

quinolone antibiotics, NSAIDs, sulfonamides, rifampin, diuretics

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9
Q

the blood supply to the proximal ureter comes from _______, whereas the distal ureter is supplied by _______

A

renal artery

superior vesical artery

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10
Q

in the setting of acute hemorrhage (MVA), patients are at risk for _______, which has 3 phases: an initiation phase, a maintenance phase, and a ________ phase characterized by ___________

A

acute tubular necrosis

initiation

maintenance

recovery

re epithelization of tubules

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11
Q

digoxin is a cardiac glycoside that is predominantly cleared by the ______.

A

kidneys

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12
Q

patient with pulmonary and peripheral edema due to HF and CKD experiencing hearing problems is most likely being treated with ________, which inhibit Na/K/2Cl symporters and runs the risk of causing ________

A

loop diuretics (furosemide)

ototoxicity

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13
Q

aldosterone receptor antagonists like _____________ inhibit resorption of Na, H20 and allow resorption of _____ and ______

A

spironolactone, eplerenone

H+, K+

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14
Q

__________ rejection is seen in the first 6 months after renal transplant and can be antibody or _____ mediated. Acute cellular rejection is associated with diffuse lymphocytic infiltrate of the renal vasculature, tubules, and interstitium

A

Acute

cell

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15
Q

____________ occurs when tumors with a high cell turnover are treated with chemotherapy. One of the major ions released is ____, which is soluble at physiologic pH but can precipitate in the acidic environment of the _______ and _______.

prevented with urine _______ and hydration

A

tumor lysis syndrome

uric acid

distal tubules and collecting ducts

alkalinization

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16
Q

patients with MS often develop a _________ a few weeks after developing an acute lesion of the spinal cord. These patients present with urinary frequency and urge incontinence. Urodynamic studies show the presence of ___________ due to the presence of an _____ lesion

A

spastic bladder

bladder hypertonia

UMN

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17
Q

increased ______ activity in multiple myeloma leads to ______ serum calcium, _________ parathyroid hormone, _________calciuria. hypercalcemia and light chain cast nephropathy cause progressive ________, leading to _________ 1,25dihydroxyvitamin D synthesis

A

osteoclastic

elevated

reduced

hypercalciuria

renal failure

reduced

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18
Q

selective vasoconstriction of the efferent arteriole causes an _______ in GFR and an _______ in FF. FF will also _______ with efferent arteriole constriction, whereas GFR will be begin to _______ as the arteriole becomes more constricted

A

increase

increase

increase

decrease

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19
Q

______ renal allograft rejection manifests months to years after transplantation and presents with worsening HTN and a slowly progressive rise in _______. it is mediated by a chronic, indirect immune response against donor alloantigens and results in _________ intimal vascular thickening and kidney atrophy

A

chronic

creatinine

obliterative

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20
Q

the ____________ is highly permeable to water, while the _____________ is impermeable to water regardless of serum vasopressin levels.

A

descending loop of Henle

ascending loop of Henle

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21
Q

inulin is a ________ substance. THe net excretion rate of a freely filtered substance =

A

freely filtered

clearance)(plasma concentration) - (tubular reabsorption

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22
Q

most ________________ also known as clear cell carcinomas originate from the epithelial cells of the proximal renal tubules

composed of?

renal tumors from collecting duct cells? Look like?

A

renal cell carcinoma

polygonal cells with abundant clear cytoplasm

Renal oncocytomas, large well differentiated cells that contain numerous mitochondria

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23
Q

____________ is responsible for 90% of the tumors involving the renal pelvis, and often forms __________ composed of urothelium supported by a thin fibrovascular stalk

A

Transitional cell carcinoma

papillary tumors

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24
Q

ADH or vasopressin acts on the __________ to increase urea and water reabsorption, allowing for the production of maximally concentrated urine

A

medullary segment of the collecting duct

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25
Q

net filtration pressure =

A

(Pc-Pi) - (nc-ni)

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26
Q

_______ rejection occurs immediately due to __________ against graft in recipients circulation and results in gross mottling and cyanosis

A

hyperacute

preformed antibodies

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27
Q

patients with post streptococcal GN is due to a strain of Group ______ streptocoocus. The glomerulonephritis is mediated by a _____________ hypersensitivity reaction

A

A beta hemolytic

Type III immune complex

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28
Q

humans acquire _____ via contact with foreign _________ that contain ________ infected with Schistomsoma larvae. S japonicum and S mansoni cause intestinal and hepatic schistosomiasis, while S __________ causes urinary schistosomiasis. Patients present with dysuria, blood in urine at the end of urination, with ulceration and scarring of the bowel or bladder or ureters. These result from a _______ granulomatous response directed against the eggs.

A

Schistosomiasis

freshwater

snails

haematobium

Th2 mediated

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29
Q

patient with membranous nephropathy, flank pain, new hematuria, elevated lactate dehydrogenase, and left varicocele likely has a ________ as a result of ______ syndrome, which is a hypercoaguable state, and leads to renal infarction. This is preceded by a loss of ________ such as antithrombin III

A

Renal vein thrombosis

nephrotic

anticoagulation factors

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30
Q

ACEI such as _______ reduce AngII levels and cause __________ dilation

A

ramipril

efferent arteriole

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31
Q

a patient presents with HTN, hematuria, and moderate proteinuria, suggesting _______. Renal biopsy shows ___________ of Ig along the GBM, which is characteristic of _______________. The deposits are composed of _____ and C3

A

nephritic

linear cresent formation

anti glomerular basement membrane

IgG

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32
Q

the bladder is _______. In placement of a suprapubic cystostomy, the tracar and cannula will pierce the layers of the abdominal wall, including the _____________ but will not enter the peritoneum

A

extraperitoneal

anterior abdominal aponeurosis

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33
Q

ACEI can cause an acute rise in serum creatinine by dilating the efferent arteriole, which leads to a reduction in ____. For patients with renal artery stenosis, ACEI can be detrimental by precipitating _______

A

filtration fraction

ARF

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34
Q

extensive smoking history, painless hematuria, polycythemia indicated by elevated hematocrit and a left sided renal mass =

gene

A

Renal cell carcinoma

chrom 3p: VHL

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35
Q

dehydration stimulates ____ secretion, which acts on the _______ to increase their permeability to water. The lowest osmolarity occurs in the __________

A

ADH

collecting ducts

distal convoluted tubule

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36
Q

patients with chronic kidney disease may develop ______ from secondary hyperparathyroidism which is caused by _____________ and hypocalcemia

A

renal osteodystrophy

hyperphosphatemia

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37
Q

the ureteric bud ultimately gives rise to the _______ of the kidney, while the metanephric mesoderm (blastema) gives rise to the glomeruli, Bowman’s space, PT, loop of henle, and the _____

A

collecting system (major/minor calyces, pelvis, ureters)

DCT

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38
Q

Most of the K+ filtered by the glomeruli is resorbed in the ________ and the ______. The late _______ and __________ are the primary sites for regulation of K+ concentration in the urine.

K depleted stimulates ______ to reabsorb extra K

Increased K stimulates _______ to secrete K

A

proximal tubule

loop of Henle

distal and cortical collecting tubules

alpha intercalated cells

principal cells

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39
Q

during the _______ (polyuric phase) of acute tubular necrosis, patients can become dehydrated and can develop severe ________ due to high volume, hypotonic urine

A

recovery phase

hypokalemia

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40
Q

Acyclovir can cause _______ if adequate _____ is not also provided

A

crystalline nephropathy

hydration

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41
Q

_______ is a DNA dependent RNA polymerase that incorporates short RNA primers (uracil containing) into replicating DNA

A

Primase

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42
Q

following desmopressin administration during water deprivation test, urine osmolarity ______ to normal levels in central DI, but __________ in complete nephrogenic DI

A

increases

does not change

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43
Q

Goodpasture syndrome is caused by autoantibodies against the ____________ of type _______ collagen found in the _______ and pulmonary capillary membrane (anti-GBM antibodies). Manifests with rapidly progressive glomerulonephritis and _______ hemorrhage (shortness of breath, hemoptysis)

A

alpha 3

IV

GBM

alveolar

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44
Q

Potter sequence in infant is caused by a _____anomly that leads to decreased urine output by the fetus, which leads to oligohydraminos. The lack of amniotic fluid causes ______ of the fetus which leads to flat facies, limb abnormalities, and pulmonary hypoplasia which leads to death

A

renal

compression

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45
Q

inappropriately elevated aldosterone with renin is indicative of _______ hyperaldosteronism, which is caused by renovascular disease, malignant hypertension, and ____________

A

secondary

renin secreting tumors

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46
Q

marked unilateral kidney atrophy is suggestive of

HTN and ______ are often present

A

renal artery stenosis

abdominal bruit

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47
Q

Erythropoiesis stimulating agents used to treat ______ of chronic kidney disease and dialysis patients are associated with an increased risk for ____ and thromboembolic events

A

anemia

HTN

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48
Q

increased ASO and anti NAD, AntiDNase and AHase, increased serum creatinine, decreased C3 in young child with periorbital edema and tea colored urine =

A

PSGN

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49
Q

glomerulonephritis, photosensitive rash, and arthralgias in a young woman are suggestive of _______. 30% of patients have _____, which can cause paradoxical aPTT prolongation and a false positive _____. The patients are at risk for venous and arterial thromboembolism and unexplained recurrent ________ loss

A

SLE

ANA+

RPR/VDRL

pregnancy

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50
Q

_______ is an _____ disorder caused by defective transportation of cystine, ornithine, arginine, and lysine across the intestinal and renal tubular epithelium. Recurrent ________ is the only clinical manifestation. Urinalysis shows pathognomonic hexagonal cystein crystals. _______ type stones are the most common

A

Cystinura

AR

Nephrolithiasis

Calcium oxalate

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51
Q

anatomic or functional _______ is almost always necessary for the development of acute pyelonephritis

A

vesicoureteral reflux

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52
Q

the principle lesion of minimal change disease can be seen on ______

A

electron microscopy

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53
Q

___________ is the most common cause of calcium kidney stone disease. This condition is characterized by normal serum _______ levels with ______. Other risk factors include ________, hyperuricosuria, low urine volume, and hypocitraturia

A

idiopathic hypercaciuria

calcium

hypercalcuria

hyperoxaluria

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54
Q

palpable lower extremity purpura, abdominal pain, arthralgias, hematuria in a child =

it is a _______ in children that follows an infection due to deposition of _______ in small vessels

A

Henoch Schonlein purpura

IgA mediated Type III hypersensitivity reaction

IgA containing immune complexes

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55
Q

nephromegaly with cysts in a fetus on US =

caused by a mutation in ____ that codes for ____

inheritence

most likely complication is _____ due oligohydraminos

A

autosomal recessive polycystic kidney disease

PKHD1, fibrocystin

AR

respiratory distress

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56
Q

fracture of the 12th rib, most likely injured organ?

A

kidney

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57
Q

____________ often results in progressive proteinuria with the eventual development of nephrotic symptoms and renal failure. ____________ (Kimmelstiel-Wilson nodules) are seen on renal biopsy and indicates irreversible glomerular damage and rapid decline in kidney function

A

Diabetic nephropathy

nodular glomerulosclerosis

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58
Q

common side effects of _________ include decreased glomerular filtration rate, hyperK+, cough. _______ is a rare by life threatening side effect

A

ACEI

Angioedema

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59
Q

The most concentrated tubular fluid is found

A

at the junction between the dscending and ascending limbs of loop of Henle

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60
Q

the majority of water reabsorption, regardless of hydration status, occurs in the _______

A

proximal tubule

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61
Q

the concentrations of PAH, creatinine, inulin, and urea ________ as fluid runs along the proximal tubule, while the concentrations of bicarbonate, glucose, and amino acids ________

A

increase

decrease

62
Q

patient presents with severe right side eye pain, ipsilateral headaches, nausea, and seeing halos around objects =

treated wiht =

also experiences ______ and highly alkaline urine

mechanism

A

acute angle glaucoma

acetazolamide

diuresis

inhibits carbonic anhydrase

63
Q

easy fatigability, constipation, back pain, elevated serum protein, and azotemia in an elderly patient =

large ______ casts composed of Bence Jones proteins seen in the tubular lumen in myeloma cast nephropathy

A

multiple myeloma

eosinophilic

64
Q

mannitol is an _______ used to help reduce edema in the brain and intracranial pressure. One of the more severe toxicities of this therapy is pulmonary edema

A

osmotic diuretic

65
Q

in metabolic acidosis, urinary pH decreased due to increased excretion of free H+, NH4+, and ______. _______ is completely reabsorbed from the tubular fluid in acidotic states

A

H2PO4

HCO3

66
Q

loop diuretic act by inhibiting _______ cotransporter in the medullary and cortical _____ of the loop of Henle, increasing Na, Cl, and H2O excretion. Used as a first line therapy for rapid relief of symptoms in patients with acute decompensated HF

A

Na-K-2Cl

Thick ascending limb

67
Q

postoperative urinary retention, with incomplete bladder emptying treated using ________, a muscarinic agonist and alpha 1 blocking drug

A

bethanechol

68
Q

PAH is primarily ________ into the nephron by the ______ and is not reabsorbed. Therefore, concentration of PAH is lowest in Bowman’s space

A

secreted

PT

69
Q

the _____ run in close proximity to the pelvic lymph nodes and the uterine artery in the female pelvis,, which predisposes them to injury during pelvic surgery

A

ureters

70
Q

________ ingestion leads to toxic ___________ with vacuolar degeneration and abllooning of the PT cells. Findings include high anion gap metabolic acidosis, increased osmolar gap, and calcium oxalate crystals in urine

A

ethylene glycol

acute tubular necrosis

71
Q

metabolic acidosis is characterized by a decrease in serum______ and serum ______. PaCO2 will also _____ as a result of respiratory compensation

A

pH

HCO3

decrease

72
Q

treatment of choice for DKA is __________, which will increase serum HCO3, Na, and ________ serum glucose, osmolality and potassium

A

IV normal saline and insulin

decrease

73
Q

thiazide diuretics are more likely to cause ______ and _______, while loop diuretics cause ______

A

hyponatremia

hypercalcemia

hypocalcemia

74
Q

renal artery stenosis causing significant renal hypoperfusion will result in ______ GFR and activation of ______ system. Chronically, this can lead to hyperplasia of modified smooth muscle cells of the afferent arterioles, known as ______ cells

A

decreased

RAA

JG

75
Q

crescent formation on light microscopy is diagnostic for _____________. These crescents consist of glomerular parietal cells, monocytes, macrophages, as well as abundant _____. crescents eventually become ________

A

rapidly progressive glomerulonephritis

fibrin

sclerotic

76
Q

__________ classically presents with gross hematuria, acute flank pain, and passage of tissue fragments in urine. It is most commonly seen in patients with ______, DM, analgesic nephropathy, or severe obstructive pyelonephritis

A

renal papillary necrosis

sickle cell disease or trait

77
Q

the filtration fraction = ___________ and is usually equal to ______ in healthy individuals

A

GFR/RPF

20%

78
Q

Eosinophils play a role in host defense during ______ infection. They destroy the parasite via ________ . another function of eosinophils is the regulation of ______ hypersensitivity reactions

A

parasite

antibody dependent cell mediated cytotoxicity

Type I

79
Q

___________ is an oxidase positive, non lactose fermenting, gram (-) organism and is a common cause of urinary tract infections in patients with ________

A

pseudomonas aeruginosa

indwelling bladder catheters

80
Q

DKA is characteried by polydipsia, polyuria, and a fruity odor to the _______. Shows a ____pH, _____ HCO3, and _____ PaCO2

A

breath/urine

low
low
low

81
Q

PSGN: immunofluorescence microscopy shows granular deposits of ___, ____, and ____ in the mesangium and basement membranes

A

IgG

IgM

C3

82
Q

_____ associated chronic renal injury is morphologically characterized by __________ and papillary necrosis with shrunken and irregular kidneys and papillary calcifcations

A

NSAID

Chronic interstitial nephritis

83
Q

_______ is the most common pathogen causing cystitis and acute pyelonephritis.

______ is the second most common cause of UTI in sexually active women

A

E coli

Staphylcoccus saprophyticus

84
Q

______ disease presents with neuropathic pain, angiokeratomas, telangiectasia, glomerular disease (proteinuria), and cerebral and cardiovascular disease. It is an ____ linked recessive lipid storage disorder charcterized by ________ deficiency, which is responsible for the breakdown of glotriaosylceramide (Gb3), which accumulates in the body

A

Fabry

X linked

alpha galactosidase A

85
Q

the serum threshold at which glycosuria begins, called the threshold of glucose, is approximately ____mg/dL, while the transport maximum of glucose is _____mg/dL

A

200

375

86
Q

crescent formation on LM is diagnostic of ______

frequently occurs as a manifestation of ______ associated vasculitides with the absence of ________

A

rapidly progressive (crescenteric) glomerulonephritis

ANA

Ig or complement deposits

87
Q

Acute organ rejection occurs at

due to sensitization of ____ against donor _____

A

<6months

host T cell

donor MHC

88
Q

fever, chills, hypotension, dyspnea, chest/back pain, hemoglobinuria after transfusion =

hypersensivity type ____ which is _____ mediated

leads to ______ mediated cell lysis

A

acute hemolytic transfusion reaction

II, antibody

complement

89
Q

patients with evidence of atherosclerosis may have _______. The use of _______ and ARBs such as ______ or losartan cause efferent arteriolar vasodilation that causes the GFR to fall and may lead to _______

A

bilateral renal artery stenosis

ACEI

ramipril

acute renal failure

90
Q

the compound papillae in the upper and lower poles of the kidney are most susceptible to _____ induced damage in _____________, which appears as dilated calyces with overlying renal cortical scarring and atrophy. Patients present with secondary HTN

A

reflux

vesicoureteral reflux

91
Q

metabolic alkalosis is characterized by a high aterial blood ____, _____, ______. determining the patients _________ concentration can help to identify the cause of metabolic alkalosis

A

pH, HCO3, pCO2

urinary chloride

92
Q

loop diuretics also stimulate ______ release to inc renal blood flow. The concurrent use of _____ can result in a decreased diuretic response

A

prostaglandin

NSAIDs

93
Q

diabetic autonomic neuropathy is common in T1DM and can cause ___________ due to the inability to sense a full bladder along with ________. PVR testing with ultrasound or catheter can confirm inadequate

A

overflow incontinence

incomplete emptying

bladder emptying

94
Q

ADH causes V2 receptor mediated increase in ____ and ______ permeabiliity at theinner medullary collecting duct, which results in maximally concentrated urine

A

water

urea

95
Q

IL2 is produced by ____ and stimulates the growth of CD4, CD8, and B cells. It also activates _____ and monocytes. The activation of _____ cell is responsible for IL2s anticancer effect on metastatic melanoma and ____

A

Th2

Natural Killer

NK

RCC

96
Q

inhibition of glucose reabsorbtion would cause glucose clearance to approach the value of GFR which is typically estimated by calculating the clearance of

A

inulin

97
Q

stress incontinence (cough or laugh) is due to loss of pelvic floor support and incompetence of the __________

A

urethral sphincter

98
Q

_________ induced DI is the result of the drugs antagonizing effect on the action of vasopressin on principal cells within the collecting duct system.

patients?

A

lithium

bipolar

99
Q

the ureters pass posterior to the _______ vessels within the retroperitoneum and ______ to the common/external iliac arteries to reach the true pelvis

A

gonadal

anterior

100
Q

frothy or foamy urine may be caused by _______. If heavy, like in nephrotic syndrome, can cause regional or generalized interstitial edema because the decrease in serum albumin and total protein lowers the _____ pressure

A

proteinuria

plasma oncotic pressure

101
Q

ACEIs _____ renin, _____ ATI, ______ ATII, _____ aldosterone, _______ bradykinin

A

increase

increase

decrease

decrease

increase

102
Q

hypovolemia results in ______ RPF, ______ GFR, _____ FF

A

big decrease

decrease

increase

103
Q

discharge of urine from the umbilicus in an infant = failure of____________, which is a remnant of the ______

A

urachus to obliterate

allantois

104
Q

_________ is used as an antiviral for ganciclovir resistant CMV infections, and can result in renal wasting, _____, and _______

A

Foscarnet

hypocalcemia

hypomagnesemia

105
Q

urge incontinence or overactive bladder is caused by ________. Pharmacologic therapy with a ___________ targeting ______ can help improve symptoms

A

detrustor instability

antimuscarinic drug

M3

106
Q

36 yrold man with hemoptysis, hypertension, hematuria, + cANCA =

cause of

deposits on IF?

A

Granulomatosis with polyangiitis (Wegener’s)

cresenteric (rapidly progressive) glomerulonephritis type 3 (pauci)

no

107
Q

In the kidney, AngII preferentially constrict the ____ arteriole, while ACEI promote ______ arteriole dilation

A

Efferent

Efferent

108
Q

HSP generally affects young children and is classically preceded by ______. This _____ mediated hypersensitivity vasculitis commonly causes colicky abdominal pain, ______, lower extremity palpable purpura, and hematuria

A

URTI

IgA

joint pain

109
Q

thiazide diuretics such as ________ decrease intravascular fluid volume, which stimulates aldosterone secretion and leads to increased excretion of _____ and _____ ions in the urine, resulting in _____ and metabolic alkalosis

A

chlorthalidone

potassium

hydrogen

hypokalemia

110
Q

acute ureteral constriction or obstruction _________ GFR and FF

A

decreases

111
Q

BPH leads to intermittent bladder outlet obstruction and overflow incontinence. Urinary retention results in inc. pressure in the urinary tract and resultant reflux nephropathy, which lead to

A

interstitial atrophy and scarring

112
Q

the risk factors for nephrolithiasis include
primary hyperparathyroidism, which leads to
Crohn disease, which leads to
distal renal tubular acidosis, which leads to
gout, which leads to

also
low fluid, low calcium intake, high oxalate intake, high protein intake, high sodium intake, high fructose intake

A

hypercalciuria
hyperoxaluria
hypocitraturia
hyperuricosuria

113
Q

diuretic that causes hypercalcemia

A

thiazide

114
Q

CKD can result in hypocalcemia and ___________

A

secondary hyperparathyroidism

115
Q

________ manifest in patients 40-50 years old with enlarged kidneys, HTN, and renal failure

gene

extrarenal manifestations

A

Autosomal dominant polycystic kidney disease

PKD-1, 2

liver cysts and cerebral aneurysms

116
Q

fever, neuro symptoms, renal failure, anemia, thrombocytopenia in setting of GI illness is =

results in (to the kidneys)

A

TTP-HUS

platelet rich thrombi in glomeruli and arterioles

117
Q

_______ stones are yellow/brown and diamond shaped crystals. Patients with chronic diarrhea develop metabolic acidosis and excrete ____ ions to compensate, increasing the conversion of soluble urate salts into insoluble

A

uric acid

hydrogen ions

uric acid stones

118
Q

diffusion speed increased with

decreases with

A

high concentration gradient, large SA, and increased solubility

membrane thickness, small pore size, high molecular weight, low temp

119
Q

___________ results in hexagonal shaped crystals on urinalysis due to an AR disorder causing elevated urinary cysteine levels (______). The sodium cyanide nitroprusside test is a screen, and it is treated with urinary alkalinization

A

cystinuria

aminoaciduria

120
Q

patients with MS commonly develop _____ due to loss of CNS inhibition of detrusor contraction in the bladder

A

urge incontinence

121
Q

medication most likely to prevent recurrent calcium oxalate stone formation =

A

hydrochlorothiazide

122
Q

homogenous deposition of eosinophilic hyaline material of the intima and media of small arteries and arterioles characterize _______________ from untreated HTN or ___________

A

hyaline arteriolosclerosis

diabetes

123
Q

constriction of the efferent arteriole will ____ RPF and _________ filtration fraction

A

decrease

increase

124
Q

RBF =

A

PAH clearance/(1-hematocrit)

125
Q

PSGN has a poorer prognosis and a higher risk of chronic HTN and renal insufficiency if the patient is

A

an adult

126
Q

______________ presents as gross hematuria in an elderly man with a history of smoking or occupational exposure to rubber, plastics, aromatic amine containing dyes, textiles, or leather

A

transitional cell carcinoma of the bladder

127
Q

grapefruit juice inhibits

increases nephrotoxicty of

A

CYP3A4

cyclosporine

128
Q

spironolactone has significant __________ and can cause gynecomastia

A

antiandrogenic effects

129
Q

medical therapy for Conn syndrome

A

spironolactone or eplerenone

130
Q

the most common renal malignancy is RCC, and those clear cells are generally those with a high _____

A

glycogen or lipid content

131
Q

flulike symptoms, fever, anew systolic murmur suggest

can be complicated by

causes

A

infective endocarditis

deposition of circulating immune complexes

glomerulonephritis

132
Q

blue toe, livedo reticularis following an invasive vascular procedure =-

may involve the kidneys and will show

A

atheroembolic disease

needle shaped cholesterol clefts within the atheromatous thrombus

133
Q

serum antibodies to PLAR2 with circulating IgG4 antibodies is associated with

A

idiopathic membranous nephropathy

134
Q

secondary to malignant tumor, infections, certain meds; thickening of the GMN on LM w/o increase in cellularity; spike and dome appearance on methenamine silver stain =

A

membranous glomerulopathy (nephrotic)

135
Q

CKD with mineral bone disease usually presents w/ ____ phosphate, _______ parathyroid, and _______ calcitriol

weakness, bone pain, fractures

A

increased

increased

decreased

136
Q

the risk for UTI can be reduced by avoiding unnecessary catheterization and ____________

A

removing the catheter as soon as possible

137
Q

pyuria and bacteriuria are found in both upper and lower UTI. ___________ only form in the renal tubules and are pathognomonic for acute pyelonephritis

A

white blood cell casts

138
Q

recurring painless hematuria in a older child or young adult within a week of an URTI =

biopsy shows

A

IgA nephropathy

mesangial hypercellularity and mesangial IgA deposits

139
Q

_______ binds to the immunophilin FK-506 binding protein in the cytoplasm and inhibits mTOR, effectively blocking ____ signal transduction and prevents cell cycle progression and lymphocyte proliferation

A

Sirolimus

IL2

140
Q

linear IgG and C3 deposits =

lumpy bumpy granular deposits of IgG and C3

A

Goodpastures

PSGN

141
Q

in horsehoe kidney, the kidneys are fused at the poles. The isthmus of the kidney usually lies anterior to the _____ and posterior to the _______ (which limits the ascent of the horeshoe kidney)

A

aorta

IMA

142
Q

C3 level in PSGN =

A

decreased

143
Q

___________ can be caused by decreased renal perfusion due to severe hypovolemia, shock, surgery. The ______ and the Thick ascending loop of Henle are most commonly affected. ________casts are pathognomonic

A

acute tubular necrosis

proximal tubule

muddy brown casts

144
Q

moderately increased ________is the earliest manifestation of diabetic nephropathy

A

albuminuria

145
Q

beta blockers inhibit ____ release, resulting in a reduction in angI, II, aldosterone

A

renin

146
Q

liver will ______ lipoprotein synthesis in secondary response to PSGN

A

increase

147
Q

________ is a common cause of ARF in children. triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury following diarrheal illness caused by

A

HUS

E coli O157:H7 or Shigella dysenteriae

148
Q

everytime GFR halves, serum creatinine

A

doubles

149
Q

_______ is the most common cause of nephrotic syndrome in children. Systemic T cell dysfunction leads to the production of glomerular permeability factor, which leads to a loss of negative charge and _________

A

minimal change disease

selective albuminuria

150
Q

FF =

RPF =

A

GFR/RPF

RBF x (1 - hematocrit)

Step 2 CK: UWorld Questions (20 decks)

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