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STEP1 > Renal path 1 > Flashcards

Renal path 1 Flashcards

1
Q

T/F You don’t see casts w/ cystitis, bladder cancer, or kidney stones.

A

True. B/c they form in the kidney calyx.

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2
Q

Which type of cast is normal?

A

hyaline

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3
Q

What do the following indicate?
Fatty cast
granular (muddy brown) cast
waxy cast

A

fatty-nephrotic syndrome
muddy brown cast-acute tubular necrosis
waxy-end stage renal disease, low urine output

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4
Q

What is the most common type of kidney stone? What is its shape, X-ray findings, and pH?

A 
Calcium stones!
Calcium phosphate increases pH
Calcium oxalate decreases pH
Radiopaque on xray
envelope or dumbbell shaped
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5
Q

What are some causes of calcium oxalate stones?

A

Vit C abuse
ethylene glycol (antifreeze)
malabsorption-Crohn’s

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6
Q

What is the most common kidney stone presentation and treatment?

A

calcium oxalate stone in pt w/ hypercalciuria from high PTH or something and normocalcemia

Treatment: thiazide diuretic (retain calcium in blood), hydration, citrate

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7
Q

Describe the pH, X-ray findings and shape of ammonium magnesium phosphate stones?

A

aka struvite stones, can form stag horn calculi
increase pH
radioopaque
coffin lid

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8
Q

How do ammonium magnesium phosphate stones form?

A

urea–>ammonia via urease
can happen w/ urease + bugs (proteus mirabilis, staph saprophytic us, klebsiella, pseudomonas)
ammonium binds up magnesium or phosphate

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9
Q

What’s the deal w/ uric acid kidney stones?

A

decrease pH
radiolucent
rhomboid or rosette shape
**visible on CT and ultrasound, but not X-ray

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10
Q

What is the treatment for uric acid stones?

A

alkalization of the urine

allopurinol

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11
Q

What’s the deal with cystine stones?

A

seen in children
decrease pH
hexagonal shape (sixtine has six sides)
can also form stag horn calculi

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12
Q

What can cause cystine stones and what can treat them?

A

aut recessive loss of fcn of PCT transporter of cystine reabsorption

sodium cyanide nitroprusside test +

treat w/ alkalization of the urine

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13
Q

What is the most common primary renal malignancy? Patients that usu get it?

A

Renal cell carcinoma

men in 50-70s who are obese and smoke

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14
Q

Which cell type does RCC originate from ?

A

polygonal clear cells of renal tubular cells (PCT)

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15
Q

What is the usual presentation of RCC?

A

can be silent and catch w/ metastasis to lung or bone

or can present w/ hematuria, palpable mass, secondary polycythemia from EPO release, flank pain, weight loss, fever.

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16
Q

Aside from EPO release, what else can be released w/ RCC?

A

ACTH, PTHrP, Prolactin

17
Q

What is the genetic association w/ RCC?

A

Von Hippel Lindau Dx

Chromosome 3

18
Q

What can happen once you get RCC?

A

invade renal vein and IVC and spread via blood to bone or lung

19
Q

What is the most common renal malignancy in children? What is its genetic association?

A

Wilms tumor

WT1 or WT2 on Chromosome 11. loss of fcn mutation on tumor suppressor genes.

20
Q

How does Wilms tumor present?

A

large palpable mass unilateral

hematuria

21
Q

What are 2 conditions that Wilms tumor may be a part of?

A
  1. Beckwith Widemann Syndrome

2. WAGR complex

22
Q

What are the features of beck with wiedemann syndrome?

A

Wilms tumor
macroglossia
organomegaly
hemihypertrophy

23
Q

What are the features of WAGR complex?

A

wilms tumor
aniridia (congenital absence of the iris)
genitourinary malformation
retardation (ID)

24
Q

What is the most common tumor of the urinary tract system? How does it present?

A

Transitional Cell Carcinoma
painless hematuria
**can occur from renal calyx to the bladder

25
Q

Which substances predispose to transitional cell carcinoma?

A 
Pee SAC
Phenacetin
Smoking
Aniline Dyes
Cyclophosphamide (can also cause hemorrhagic cystitis)
26
Q

Aut Dom Polycystic Kidney Dx presents how?

A

bilateral enlarged kidneys

flank pain, hematuria

27
Q

What is the genetic association of ADPKD?

A

PKD1 (chromosome 16)

PKD2 (chromosome 4)

28
Q

Which possibly fatal associations are there w/ ADPKD?

A

berry aneurysms
mitral valve prolapse
benign hepatic cysts

29
Q

What’s the deal with aut recessive polycystic kidney dx?

A

seen in infants
Potter sequence: oligohydramnios. See absent or small bladder.

sonogram: bilaterally enlarged hypoechoic kidneys

**associated w/ congenital hepatic fibrosis

30
Q

What is the dx that is inherited, shows tubulointerstitial fibrosis, progressive renal insufficiency, and shrunken kidneys on US?

A

Medullary cystic dx

31
Q

Which types of cysts do you remove for fear of progression to renal cell carcinoma?

A

complex cysts

32
Q

Where are simple cysts usu found?

A

outer cortex of the kidney

STEP1 (54 decks)

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