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Renal - FA, Pathoma Flashcards

1
Q

What is a malignant epithelial tumor arising from kidney tubules?

Presents how?

A

RCC

Hematuria, palpable mass, flank pain

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2
Q

IgA nephropathy follows what?

Deposition where on IF?

A

Mucosal infection

Mesangium

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3
Q

What part of the nephron is most susceptible to toxic agents?

What agents?

A

Prox tubule

Aminoglycosides, lead, myoglobinuria, ethylene glycol, radiocontrast dye, urate

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4
Q

Silver stain to view which disorders?

A

Membranous

MPGN

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5
Q

2nd MC cause of kidney stone?

Due to what?

Shape of stone?

Tx?

A

AMP (ammonium, magnesium, phosphate)

Proteus, Ureaplamsa, Klebsiella

Prism/coffin

Surgery

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6
Q

What RCC has the best prognosis, stains darkly and is least aggressive?

A

Chromophobe

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7
Q

MC cause of nephrotoxic ATN?

What do the crystals look like?

Tx?

A

Methicillin

Envelope shaped crystals w/low serum calcium

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8
Q

B/l renal agenesis is due to failure of what?

A

Urteric buds

NO Budweiser NO pee

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9
Q

Thyroidization of the kidney is pathognomonic for what?

A

Chronic pyelonephritis

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10
Q

What can cause prerenal azotemia?

BUN:Cr ratio?

[FENa]?

A

Decreased blood flow, Dec GFR

> 15

< 1%

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11
Q

DM affects the vasculature BM and causes what?

A

Hyaline arteriolosclerosis

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12
Q

Which schistosoma has spine on lateral side?

Presents how? Where?

A

Mansoni

Pipestem fibrosis of liver
Intestines and liver

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13
Q

MC cause of acute renal failure is what?

What sx?

Tx?

A

Acute tubular injury

Azotemia, metabolic acidosis, Hyperkalemia w/EKG changes

Furosemide, dialysis

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14
Q

What are the CFs of ATN?

A

Oliguria w/brown granular casts
Elevated BUN and Cr
Hyperkalemia w/metabolic acidosis

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15
Q

Long-standing obstruction causes what change in BUN:Cr?

FENa?

Urine osm?

A

< 15

> 2%

< 500, cannot [ ] urine

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16
Q

C3 nephritic factor causes what kidney problem?

A

MPGN type 2

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17
Q

MC kidney stone seen in kids is what?

Assoc w/what?

Stone looks how?

A

Cystine

Cystinuria, AR

Hexagonal crystals

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18
Q

What kidney stone is NOT visible on xray?

Seen in what?

A

Uric acid

Acidic pH, leukemia, myeloproliferative

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19
Q

Denys-drash sx?

Due to what?

A

Wilms, progressive renal disease, male pseudohermaphrodite

Mutation in WT1

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20
Q

WAGR sx?

Due to what?

A

Wilms, Aniridia, genitals fucked, retard

DELETION of WT1

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21
Q

What are the main CFs of nephritic syndrome?

A

Oliguria and azotemia
Edema, HTN
Rbc casts

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22
Q

Acute pyelonephritis MC cause?

How can a kid get it?

A

E.coli #1
Enterococcus
Klebsiella

Vesicoureteral reflux

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23
Q

Sterile pyuria in the presence of pyuria (- urine culture) suggests what?

Due to what?

A

Urethritis

C. Trachomatis or N. Gonorrhea

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24
Q

MPGN due to what?

Deposits where?

What proliferates?

A

C3 deficiency

Subendothelial type 1
Intramembranous - Dense deposits - type 2

Mesangial cells

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25
Q

Is ATN reversible?

A

YES

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26
Q

What RCC has bad prognosis and is resistant to chemo and radiation?

Tx?

A

Clear cell type

Surgery, immunotherapy

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27
Q

What MPGN is assoc. w/HepB and HepC?

Where are the deposits?

A

Type 1

Subendothelial

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28
Q

Scarring at the upper and lower poles of the kidney indicates what?

A

Vesicourteral reflux

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29
Q

Age demographic for RCC? M or F?

RFs?

If b/l then likely what?

A

50-70, Males

Smoking, analgesics, chronic renal failure

VHL mutation in clear cell type

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30
Q

Wilms tumor B9 or Mal?

Mutations?

MC cause?

A

Mal

WT1 on ch. 11
PAX6

Sporadic

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31
Q

What cells make EPO?

A

Renal peritubular interstitial cells

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32
Q

How is BUN:Cr affected in ATN?

FENa?

A

< 15

> 2%

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33
Q

Ethylene glycol causes what kind of stones?

A

Oxalate crystals

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34
Q

Urine showing pyuria and wbc casts mean what?

A

Acute pyelonephritis

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35
Q

Alport syndrome is a defect in what?

Inheritance?

Key CFs?

A

Type 4 collagen

X-linked

Hematuria, sensory hearing loss, ocular disturbance

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36
Q

Papillary urothelial tumor progression?

A

Low grade –> high grade –> invades

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37
Q

Where are the deposits located in Acute PSGN?

IF shows what?

A

Subepithleial –> “lumpy bumpy humps”

Granular deposits of IgG and complement

38
Q

What is the most common type of renal disease in SLE?

IF shows what?

Deposits are where?

A

Diffuse proliferative GN

Granular

Subendothelial

39
Q

What RCC is multifocal and b/l, cut surface is granular?

gene mutation?

A

Papillary RCC

MET, ch. 7 and 17

40
Q

What is kidney disorder is associated w/Hep B, HepC, solid tumors, SLE, or drugs?

What drugs?

A

Membranous nephropathy

NSAID, penicillamine

41
Q

Cystitis lab findings show what?

Culture shows what?

A

+ leukocyte esterase
Nitrites

Greater than 100,000 colony forming units

42
Q

MCD is associated with what other disease?

How is the damage mediated?

A

HL

Cytokines from T cells

43
Q

What produces brown/muddy dirty epithelial casts?

A

Acute tubular injury

44
Q

Presentation of ADPKD?

Associated with what?

A

HTN (INC renin), hematuria, worsening renal failure

Berry aneurysm, hepatic cysts, MVP

45
Q

What paraneoplastic syndromes does HCC make?

A 
PV
HTN
Cushing's
Hypercalcemia
Feminization/masculinization
46
Q

What kidney problem is associated w/HIV, heroin use, and sickle cell disease?

47
Q

Mutation of WT2 causes what? Due to what?

Sx?

A

Beckwith-Wiedemann, overexpressed IGF-2, pt has hypoglycemia

Macroglossia and hemi-hypertrophy

48
Q

How does renal papillary necrosis present?

Causes?

A

Hematuria and flank pain

Chronic ASA use, DM, Sickle cell, severe acute pyelonephritis

49
Q

What causes Acute interstitial nephritis?

A

NSAID
PCN
Diuretics

50
Q

How does dysplastic kidney arise?

Characterized by what?

A

Noninherited, congenital malformation

Cysts and abnormal tissue - CARTILAGE

51
Q

What presents w/parenchymal fibrosis and shrunken kidneys, leads to worsening renal failure

A

Medullary cystic kidney disease

52
Q

EM finding of FSGS?

Tx?

A

Effacement of foot process

Poor response to steroids, progresses to chronic renal failure

53
Q

MC cause of kidney stones?

Seen in what?

Tx?

A

Calcium oxalate

idiopathic hypercalciuria

HCTZ

54
Q

What is the most commonly involved organ in systemic amyloidosis?

Where are the deposits located?

A

Kidney

Mesangium

55
Q

Angiomyolipoma seen in what syndrome?

Color?

A

Tuberous sclerosis

Yellow

56
Q

PSGN can progress to what?

What else progresses to this?

A

RPGN (25%)

Goodpasture’s, Wegener’s, Churg-Strauss, microscopic polyangitis

57
Q

How to view Membranous GN?

Shows what?

A

Silver stain

Spike and dome

58
Q

Flat pathway of urothelial carcinoma progression?

Due to what?

A

High grade –> invasion

P53 mutation

59
Q

What can be used to slow progression of hyperfiltration induce-damage of DM?

What is affected most in this process?

A

ACE-I’s

Efferent arteriole –> high GF pressure

60
Q

Which schistosoma has a tail?

Lays eggs where?

A

Haemotobium

Bladder

61
Q

Medullary sponge kidney is good or bad prognosis?

Inc risk for what?

A

Good - spongeBOB will never hurt you

Uti and stones

62
Q

Crescents in Bowman space seen in what disease?

What are they made of?

A

RPGN

Fibrin, macrophages, podocytes

63
Q

What is abnormal in nephrotic syndrome?

A

Hypoalbuminemia
Hypogammaglobulinemia
Hypercoaguable state –> loss of ATIII
Hyperlipidemia and hypercholesterolemia

64
Q

Colicky pain w/Hematuria and u/l flank pain is what?

A

Nephrolithiasis

65
Q

What segments of the nephron are most susceptible to ischemia?

A

Prox tubule

Medullary segment of TAL

66
Q

Tubules that are dilated and filled with colloid indicate what?

A

Chronic pyelonephritis

67
Q

How does a RCC appear grossly?

Can cause what?

A

Solitary yellow areas of necrosis and hemorrhage

Left varicocele

68
Q

Presentation of AIN?

Pathognomonic finding?

Can progress to what?

A

Oliguria, fever, rash

Eosinophils in urine

Renal papillary necrosis

69
Q

Adenocarcinoma of the bladder due to what congenital defects?

What else can cause it?

A

Urachal remnant –> develops at dome of bladder
Exstrophy of bladder

Cystitis grandularis

70
Q

What causes postrenal azotemia?

GFR changes?
BUN:Cr?

A

Obstruction of urinary tract downstream from kidney

Dec
> 15

71
Q

What pts get pyelonephritis?

A 
Young women
Men with BPH
Kids w/reflux
Pregnant women
Diabetics
72
Q

Acute tubular necrosis affects the GFR how?

What is seen in the urine?

A

DEC

Brown, granular casts

73
Q

SCC of bladder RFs?

A

Chronic cystitis
Schistosoma haematobium
Nephrolithiasis

74
Q

What mediates damage in nephritic syndrome?

Due to what?

A

Neutrophils

Immune complex deposition which activates complement C5a

75
Q

What color are oncocytomas?

Have what inside?

B9 or Mal?

A

Brown/mahogany

Pink cytoplasm w/tons of mitochondria which have lots of IRON

B9

76
Q

Where does the horseshoe kidney get stuck as it ascends?

What spinal level?

A

IMA

L3 aka MEL Gibson 3

77
Q

ARPKD is associated with what?

A

Hepatic fibrosis and hepatic cysts

Signs and symptoms of portal HTN

78
Q

Oligohydramnios causes what?

A

Lung hypoplasia

Potter sequence

79
Q

Alport syndrome inheritance?

EM shows what?

A

Drinking a COLT45 on the runaway, tell it not to CROSS (X)

Basketweave appearance

80
Q

Membranous GN IF shows what?

EM?

What does Membranous GN look like?

A

Granules w/IgG and C3

Subepithelial deposits

Post-strep GN

81
Q

Afferent arteriole constriction: Describe the following: GFR

RPF

FF

A

Dec

Dec

Unchanged

82
Q

Efferent arteriole constriction: Describe the following: GFR

RPF

FF

A

INC

Dec

INC

83
Q

Inc plasma protein [ ]: Describe the following: GFR

RPF

FF

A

Dec

Unchanged

Dec

84
Q

Dec plasma protein [ ]: Describe the following: GFR

RPF

FF

A

Inc

Unchanged

Inc

85
Q

Constriction of ureter: Describe the following: GFR

RPF

FF

A

Dec

Unchanged

Dec

86
Q

Dehydration: Describe the following: GFR

RPF

FF

A

Dec

HUGE Dec

INC

87
Q

RTA type 1 urine pH? Defect is what? Assoc w/what?

Inc risk for what?

Cause?

A

> 5.5, a-intercalated cells cannot secrete H+, hypokalemia

Calcium kidney stones

Amphotericin B, obstruction

88
Q

RTA type 2 urine pH? Defect in what? Hypo/hyperkalemia?

Inc risk for what?

Causes?

A

< 5.5, defect in PCT HCO3 reabsorption, hypokalemia

HypoPO4 rickets

Fanconi syndrome, CAI’s

89
Q

RTA type 4 urine pH? Due to what? Hypo/hyperkalemia?

Causes?

A

> 5.5, hypoaldosteronism, hyperkalemia

ACEI, ARB, NASAID, heparin, K+ sparing diuretics, TMP/SMX

90
Q

Fatty casts in urine indicate what?

A

Nephrotic syndrome, Maltese cross sign

91
Q

Granular muddy brown casts indicate what?

A

Acute tubular necrosis

92
Q

Waxy casts indicate what?

A

ESRD/renal failure

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