Renal patho 2

Question 1

Stress incontinence is due to

Answer 1

Outlet incompetence

Question 2

Overflow incontinence diagnostic test

Answer 2

↑ post-void residual

Question 3

Sympathetic input to bladder
Receptors:
Function:

Answer 3

Hypogastric nerve
Receptors: α1 (internal urethral sphincter), ß3 (body)
Function: ↑ urinary retention

Question 4

Somatic input to bladder
Receptors:
Function:

Answer 4

Pudendal nerve
Receptor: Nicotinic (external urethral sphincter)
Function: voluntary control

Question 5

Parasympathetic input to bladder
Receptors:
Function:

Answer 5

Sacral prexus
Receptors: M3 (Detrusor muscles and internal urethral sphincter)
Function: ↑detrusor muscle tone, ↓IUS tone

Question 6

RCC most common metastasis to

Answer 6

1. lung
2. bone
3. liver

Question 7

Renal oncocytoma originates from:

Gross and Histology:

Answer 7

Benign epithelial cell tumor arising from collecting ducts (well circumscribed mass with central scar).

Large eosinophilic cells with abundant mitochondria without perinuclear clearing

Question 8

Most common tumor of urinary tract system

Answer 8

Transition cell carcinoma

Question 9

Transition cell carcinoma is associated with

Answer 9

Pee SAC

Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide

Question 10

Tumor at dome of bladder is due to ________

type of cancer

Answer 10

Urachal remnant

Adenocarcinoma

Question 11

Transition cell carcinoma: test of choice

Answer 11

cystoscopy and biopsy

Question 12

Acute cystitis treatment:

Answer 12

antibiotics (eg, TMP-SMX, nitrofurantoin).

Question 13

Acute pyelonephritis CT would show

Answer 13

striated parenchymal enhancement

Question 14

Xanthogranulomatous pyelonephritis
►Gross
►kidney damage due to
►Associated with

Answer 14

►grossly orange nodules that can mimic tumor nodules
►widespread kidney damage due to granulomatous tissue containing foamy macrophages.
►Associated with Proteus infection

Question 15

Chronic pyelonephritis

►Gross

Answer 15

Coarse, asymmetric corticomedullary scarring, blunted calyx

Question 16

Decline in renal function can be beasured by

Answer 16

1. ↑Cr and ↑BUN

2. Oliguria/anuria

Question 17

Test of choice in postrenal azotemia is

Answer 17

Renal USG

Question 18

Acute interstitial nephritis

Type of hypersensitivity

Answer 18

cell mediated type 4

Question 19

D/Ds of Acute interstitial nephritis

Answer 19

►Acute tubular necrosis from NSAIDs
no rash or eosinophils
►Renal atheroemboli
also presents with eosinophiluria, eosinophilia, and skin rash
rash is typically livedo reticularis with digital infarcts and not maculopapular

Question 20

NSAIDs cause ATN due to

Answer 20

Ischemia (afferent vasoconstriction)

Question 21

Ischemic ATN ________ highly susceptible to injury

Answer 21

(PCT and thick ascending limb are highly susceptible to injury).

Question 22

Diffuse cortical necrosis

Answer 22

Acute generalized cortical infarction of both kidneys. Likely due to a combination of vasospasm and DIC.

Question 23

Part of renal artery stenosed in
►atherosclerosis
►fibromuscular dysplasia

Answer 23

►proximal 1/3

►distal 2/3 or segmental branches

Question 24

In bilateral renal artery stenosis, kidney is dependent on ____ for perfusion

Answer 24

Angiotensin II
Angiotensin II → systemic vasoconstriction → ↑BP to maintain renal blood flow
also Angiotensin II causes efferent vasoconstriction to maintain GFR

Question 25

Risk of renal failure in patients treated with ACE inhibitor can be lowered by

Answer 25

discontinuing diuretics as volume depletion increases dependence on efferent vasoconstriction to maintain GFR

Question 26

Autosomal recessive polycystic kidney disease | Cystic dilation of

Answer 26

collecting ducts

Question 27

Autosomal dominant tubulointerstitial kidney disease Also called ______. It causes _____________. USG findings

Answer 27

medullary cystic kidney disease tubulointerstitial fibrosis and progressive renal insufficiency with inability to concentrate urine Medullary cysts usually not visualized; smaller kidneys on ultrasound

Question 28

ADPKD is associated with

Answer 28

berry aneurysms, mitral valve prolapse, benign hepatic cysts, diverticulosis.

Question 29

Cystic fibrosis: metabolic defect? | Why?

Answer 29

Metabolic alkalosis | ► 1. Diarrhea 2. Cl- loss in sweat