Renal Path

Question 1

Light chain casts seen in

Answer 1

Multiple myeloma nephropathy

Question 2

Nephrotic vs nephrotic syndrome

Answer 2

Nephritic:
Inflamm
RBC casts

Nephrotic:
prOteinuria
Fatty casts

Question 3

MCC acute nephritis children

Answer 3

PSGN

Hx: strep infection

Question 4

Sub-epith humps on eMx

Answer 4

PSGN

Question 5

Granular deposits w/in mensagium n glom capillary wall

Answer 5

PSGN

• starry sky / lumpy bumpy app
• IgG, IgM + C3 dep along GBM and mesangium

Question 6

Acute kidney injury indications for dialysis

Answer 6

AEIOU

Acidosis
Electrolytes: inc K+
Intoxication (SLIME : Salicylates, lithium, isopropanol, methanol, ethylene glycol)
volume Overload
Uremia

Question 7

IF starry sky/ lumpy bumpy

Answer 7

Acute PSGN

IgG, IgM, C3

Question 8

Linear IF

Answer 8

Goodpasture

Question 9

Granular IF

Answer 9

1. PSGN
2. DPGN
3. Lupus nephritis - wire looping
4. MPGN - subendoth IC deposits (+ intramemb/ dense deposits) - TRAM TRACK APP

Question 10

Basket weave IF

Answer 10

Alport syndrome

• Type IV collagen mutation
• “can’t see, can’t pee, can’t hear a bee”

Question 11

EM - effacement ofnfoot processes

Answer 11

MCD + FSGN

Question 12

EM : Spike and dome subepith deposits

Answer 12

Membranous nephropathy

• PSGN (starry sky/ lumpy bumpy)

Question 13

Fibrocystin gene mutation seen in

Answer 13

ARPKD

PKHD1 gene

Question 14

MCC Prerenal azotemia

Answer 14

Ischemia - hypovolemia

Question 15

Epithelial / granular casts seen in

Answer 15

ATN

Muddy brown granular casts

Question 16

MCC postrenal azotemia

Answer 16

B/l outflow obstruction d/t

• stones
• BPH
• Cong anomalies or neoplasm

Question 17

MCC + location of ATN

Answer 17

1. Ischemia
2. Nephrotoxicity

PCT and ThAL

Question 18

MCC Renal papillary necrosis

Answer 18

Infection or immune trauma

Other causes:
» POSTCARDS «

Pyelonephritis 
Obstruction of urinary tract
SCA
Tb
Cirrhosis/ chronic alcohol
Analgesic abuse
Radiation / Renal transplant rejection 
Diabetes
Systemic vasculitis

Question 19

MCC CRF

Answer 19

Diabetic nephropathy

Question 20

MCC Diabetic nephropathy

Answer 20

Loss of heparan sulfate forming the -ve charged filtration barrier, causing inc filtration of -ve charged serum proteins into the urine, predominately albumin

Question 21

Abx to phospholipase A2 receptor seen in

Answer 21

Membranous nephropathy, Nephrotic

• spike and dome app on EMx

Question 22

MCC u/l flank mass in children

Answer 22

Wilms tumor

• loss of (f) mutation in WT1 or 2 gene on chrom 11
• WAGR complex
• Denys-Drash syndrome
• Beckwith-Wiedmann syndrome

Question 23

MCC u/l flank mass in children

Answer 23

Wilms tumor

• loss of (f) mutation in WT1 or 2 gene on chrom 11
• WAGR complex
• Denys-Drash syndrome
• Beckwith-Wiedmann syndrome

Question 24

HTN w Berry aneurysm and MVP seen w?

Answer 24

ADPKD

Question 25

#MCC b/l flank pain w hematuria, polyuria and nocturia

Answer 25

ADPKD - polycystin 1 gene mutation on chrom 16 (adults) - PKD2 mutation on chrom 4 (15% cases)

Question 26

#MCC recurrent kidney stones in kids

Answer 26

Hereditary cystinuria - hexagonal stones - defective AA reab in PCT - » COLA « wasting

Question 27

Sub endoth deposits seen in

Answer 27

DPGN “Wire lupus”

Question 28

Abx in mesangium on IF seen in?

Answer 28

Berger / IgA nephropathy - ass.w HSP #MCC vasculitis in children Hx URI Tx: steroids

Question 29

Hematuria w URI seen in?

Answer 29

IgA nephropathy vs PSGN : manifests 3-6 w after URI

Question 30

#MCC NAGMA

Answer 30

NAGMA / hyperchloremic acidosis 1. Inc NaCl infusion 2. RTA 3. Severe diarrhea

Question 31

#MCC EAGMA

Answer 31

1. DKA 2. RF 3. Poor tissue perfusion 4. Methanol, Ethanol tox

Question 32

#MCC MAlk

Answer 32

1. Diuretic OD 2. 1° hyperaldosteronism 3. Severe vomiting 4. NG suctioning 🔘 - vomiting : dec K - diarrhea : dec HCO3

Question 33

#MCC RAcidosis

Answer 33

Hypoventilation 1. Central resp depression (opioid OD) 2. OHS 3. NM weakness (Myasthenia gravis) 4. COPD

Question 34

#MCC RAlk

Answer 34

HYPERventilation 1. Acute V/Q mismatch (PE, pneumonia) 2. Anxiety 3. Inadequate pain control 4. High altitude 5. Pregnancy

Question 35

Nephritic syndrome

Answer 35

» Nephritic RAAPS « RPGN : crescents Anti GBM: linear IgG IgA nephropathy: hypercellular d/t IgA in mesangium Alport: lamellated GBM (?) PSGN : granular + sub epith humps

Question 36

Nephritic syndrome

Answer 36

» Nephritic RAAPS « RPGN : crescents Anti GBM: linear IgG IgA nephropathy: hypercellular d/t IgA in mesangium Alport: lamellated (basket weave app) GBM PSGN : granular + sub epith humps

Question 37

Urinary incontinence at the end of the day seen in?

Answer 37

Flaccid bladder - d/t LMN lesions (Cauda-equina) - large residual volume of urine

Question 38

#MC complication seen in MS after a few weeks

Answer 38

overactive/ spastic bladder