Renal and Male GU pp1

Question 1

Azotemia

Answer 1

biochemical manifestation of acute or chronic kidney injury; characterized by elevated blood urea nitrogen (BUN) or by an elevated serum creatinine; reflects a reduction in GFR

Question 2

nephrotic syndrome

Answer 2

glomerular disease characterized by

1) severe proteinuria (more than 3.5g/day)
2) severe edema (periorbital)
3) hyperlipidemia
4) hypoalbuminemia

Question 3

nephritic syndrome

Answer 3

glomerular disease characterized

1) grossly visible hematuria
2) azotemia with oliguria
3) HTN
4) sub-nephrotic proteinuria

Question 4

most common/second most common cause of CRF/ESRD

Answer 4

1) Diabetes

2) HTN

Question 5

prerenal azotemia

Answer 5

due to hypoperfusion of the kidneys

Question 6

postrenal azotemia

Answer 6

seen when urine outflow is obstructed distal to the kidney, removal of obstruction corrects the azotemia

Question 7

uremia

Answer 7

when azotemia becomes associated with a constellation of clinical signs and symptoms and biochemical abnormalities

Question 8

rapidly progressive glomerulonephritis

Answer 8

characterized as a nephritic syndrome with a rapid decline in GFR (days to weeks). Implies severe glomerular injury

Question 9

how does nephrotic syndrome cause edema?

Answer 9

decreased plasma oncotic pressure

Question 10

How does DM contribute to glomerular pathologies?

Answer 10

persistent hyperglycemia causes glucotoxicity

Question 11

normal GFR

Answer 11

90-120 ml/min

Question 12

who has lower GFR?

Answer 12

older people; GFR decreases with age

Question 13

acute kidney injury

Answer 13

1) rapid decline in GFR
2) more severe: oliguria or anuria
3) may be from glomerular, interstitial, vascular or acute tubular injury
4) reversible or can progress to CKD

Question 14

How is mild chronic kidney disease seen clinically?

Answer 14

it can be clinically silent

Question 15

How is severe chronic kidney disease seen clinically?

Answer 15

uremia

Question 16

Definition chronic kidney disease

Answer 16

1) diminished GFR <60 ml/min/1.73m2 for at least 3 months

2) persistent albuminuria

Question 17

Prognosis CKD

Answer 17

generally irreversible (requires dialysis)

Question 18

end stage renal disease

Answer 18

• GFR <5% of normal

- end stage of uremia

Question 19

fluid and electrolyte manifestations of uremia

Answer 19

dehydration
edema
hyperkalemia
metabolic acidosis

Question 20

calcium phosphate and bone manifestations of uremia

Answer 20

hyperphosphatemia
hypocalcemia
secondary hyperparathyroidism
renal osteodystrophy

Question 21

hematologic manifestations of uremia

Answer 21

anemia

bleeding diathesis

Question 22

cardiopulmonary manifestations of uremia

Answer 22

HTN
CHF
cardiomyopathy
pulmonary edema
uremic pericarditis

Question 23

gastrointestinal manifestations of uremia

Answer 23

nausea and vomiting
bleeding
esophagitis, gastritis, colitis

Question 24

neuromuscular manifestations of uremia

Answer 24

myopathy
peripheral neuropathy
encephalopathy

Question 25

dermatologic manifestations of uremia

Answer 25

sallow color pruritus dermatitis

Question 26

glomerulus definition

Answer 26

vascular epithelial organ designed for the ultrafiltration of plasma

Question 27

what does the macula densa produce

Answer 27

renin | erythropoetin

Question 28

What happens with injury to podocytes?

Answer 28

proteinuria

Question 29

Chronic glomerular responses to injury

Answer 29

1) basement membrane thickening 2) hyalinosis 3) sclerosis

Question 30

What is seen with acute, severe glomerular injury?

Answer 30

crescents

Question 31

diffuse glomerular disease

Answer 31

involves all glomeruli in kidney

Question 32

focal glomerular disease

Answer 32

involves only a subset of glomeruli in kidney

Question 33

segmental glomerular disease

Answer 33

of affected glomeruli, only portions are involved

Question 34

global glomerular disease

Answer 34

involves the entire glomerulur

Question 35

crescentic glomerulonephritis

Answer 35

- histo finding associated with RPGN - collapsed, compacted glomerular tuft - due to proliferating visceral and parietal epithelial cells - infiltration of macrophages and leukocytes

Question 36

HLA subtype associated with RPGN

Answer 36

HLA-DRB1

Question 37

most common cause of nephrotic syndrome in children

Answer 37

primary kidney disease

Question 38

Is a primary or secondary nephrotic syndrome more common in adults?

Answer 38

secondary

Question 39

chronic glomerulonephritis

Answer 39

end stage glomerular disease fed by several streams of antecedent glomerulonephritis; a percentage of cases are idiopathic