renal path

Question 1

elevation of the blood urea nitrogen (BUN) and creatinine levels, due to decreased filtration of blood through the glomeruli (decreased glomerular filtration rate)

Answer 1

azotemia

Question 2

association of azotemia with clinical signs and symptoms, including gastroenteritis, peripheral neuropathy, pericarditis, dermatitis, hyperkalemia, and metabolic acidosis

Answer 2

uremia

Question 3

most common feature of acute nephritic syndrome

Answer 3

acute onset of hematuria

Question 4

most common feature of nephrotic syndrome

Answer 4

heavy proteinuria (> 3.5 g per day)

Question 5

most common feature of acute renal failure

Answer 5

oliguria (or anuria)

Question 6

AD (adult) polycystic kidney disease is characterized by _____ in both kidneys

Answer 6

multiple expanding cysts

Question 7

defective gene for adult polycystic kidney disease is _____ located on chromosome 16; the gene encodes for _____

Answer 7

PKD1; polycystin-1

Question 8

AR (childhood) polycystic kidney disease is due to mutations in the _____; defective protein is _____

Answer 8

PKHD1; fibrocystin

Question 9

nephrotic syndrome is caused by increased _____ to plasma proteins

Answer 9

glomerular capillary permeability

Question 10

4 major causes of nephrotic syndrome

Answer 10

1. minimal change disease
2. focal and segmental glomerulosclerosis
3. membranous nephropathy (glomerulonephritis)
4. glomerular disease in diabetes mellitus

Question 11

nephritic syndrome characterized by acute onset of:

Answer 11

1. hematuria
2. oliguria and azotemia
3. hypertension

Question 12

causes of nephritic syndrome

Answer 12

1. acute postinfectious (poststreptococcal) glomerulonephritis
2. IgA nephropathy

Question 13

renal disease affecting tubules, interstitium, and pelvis and is most often secondary to bacterial infection; includes suppurative inflammation of the kidney and renal pelvis

Answer 13

acute pyelonephritis or tubulointerstitial nephritis

Question 14

acute pyelonephritis is characterized by sudden onset with pain at ______ and systemic evidence of infection; often there is accompanying ______

Answer 14

costovertebral angle; dysuria, frequency, and urgency

Question 15

clinical and pathologic condition where renal function declines rapidly with evidence of tubular epithelial damage/necrosis

Answer 15

acute tubular necrosis

Question 16

acute tubular necrosis causes acute kidney injury that leads to ______

Answer 16

decreased GFR, oliguria (low urine output), and electrolyte abnormalities

Question 17

causes of acute tubular necrosis

Answer 17

severe trauma, ischemia (shock)/DIC , septicemia, and toxins

Question 18

kidneys are symmetrically atrophic, with moderate reduction in size; kidney surface has an even fine granularity and the cortex is thin

Answer 18

arterionephrosclerosis

Question 19

_____ and _____ are contributing factors to arterionephroscerosis

Answer 19

hypertension; diabetes

Question 20

in arterionephrosclerosis, there is narrowing of the lumens or arterioles and arteries caused by _____ and ______

Answer 20

hyaline type of arteriolosclerosis; fibroelastic hyperplasia of muscular arteries

Question 21

relatively rapid onset of renal failure with increased intracranial pressure leading to headache, nausea, vomiting, and visual impairment

Answer 21

arterionephrosclerosis assoc with malignant hypertension

Question 22

in arterionephrosclerosis assoc with malignant hypertension, arterioles show ______, reducing blood flow and causing necrosis of glomeruli

Answer 22

hyperplastic arteriolosclerosis

Question 23

acquired defect in ADAMTS 13, a plasma protease that degrades vWF multimers

Answer 23

thrombotic thrombocytopenia purpura (TTP)

Question 24

endothelial cell injury which, in most cases, is due to a Shiga-toxin from E.coli; injury leads to platelet activation

Answer 24

hemolytic-uremic syndrome (HUS)

Question 25

TTP and HUS are both types of _____

Answer 25

thrombotic microangiopathies

Question 26

one of the more common cancers in children ages 2-5; characterized by abdominal mass; risk is greatly increased in some inherited syndromes

Answer 26

Wilm’s tumor

Question 27

major clinical renal syndromes

Answer 27

acute nephritic syndrome, nephrotic syndrome, acute renal failure

Question 28

acute nephritic syndrome characterized by:

Answer 28

proteinuria (mild/moderate), HEMATURIA, and hypertension

Question 29

nephrotic syndrome characterized by:

Answer 29

SEVERE PROTEINURIA (> 3.5 g/day), low serum albumin, anasarca, high serum lipid, lipiduria

Question 30

acute renal failure characterized by:

Answer 30

sudden onset of azotemia with OLIGURIA/ANURIA

Question 31

congenital cystic renal diseases

Answer 31

autosomal dominant (adult) polycystic kidney disease
autosomal recessive (childhood) polycystic kidney disease

Question 32

most obvious clinical sign of nephrotic syndrome

Answer 32

severe edema

Question 33

most common cause of nephrotic syndrome in children (2/3 of all cases)

Answer 33

minimal change disease

Question 34

_____ can be seen in EM with minimal change disease

Answer 34

effacement of epithelial cell foot processes

Question 35

usually occurs in children and young adults; hematuria is noted 1-2 days after non-specific upper respiratory tract viral infection

Answer 35

IgA nephropathy (cause of nephritic syndrome)

Question 36

acute clinical syndrome; progressive loss of renal function; lab finding consistent with nephritic syndrome; severe oliguria

Answer 36

crescentic or rapidly progressive glomerulonephritis

Question 37

interstitial infiltration of mononuclear inflammatory cells, often with neutrophils and many eosinophils

Answer 37

drug-induced interstitial nephritis