Renal Pathophys Part 2 Schoeny Exam 3

Question 1

The most common cause of asymptomatic hematuria is

Answer 1

IgA nephropathy - caused by immune complex formation and also Most common primary cause of glomerulonephritis

Question 2

What other 2 diseases is IgA nephropathy associated with?

Answer 2

celiac disease and Henoch-Schonlein purpura

Question 3

What are the pathological findings in IgA nephropathy?
light microscopy?
immunofluorescence?
electron microscopy?

Answer 3

-Light microscopy:
Focal segmental glomerulosclerosis of crescentic glomerulonephritis
-Immunofluorescence:
Granular pattern with IgA and complement
-Electron microscopy:
IgA immune complexes present

Question 4

7-year-old boy is brought into your clinic with a rash he has developed over his legs and buttocks. You note palpable, non-blancheable purpura on BIL legs that are bright red. MOC reports the child also has symptoms of GI bleeding, hematuria, abdominal pain and arthralgia. Of note, he had a URI 2 weeks ago. You tell the mom that his condition is?

a. IgE mediated allergic reaction
b. IgA mediated vasculitis
c. Tubulointerstitial Disease

Answer 4

b. IgA mediated vasculitis. Yep, he has Henoch Schonlein purpura

Question 5

Acute tubulointerstitial disease can be due to a drug reaction from PCNs, rifampin, sulfonamides, or ciprofloxacin. What symptoms would be associated with this condition?

Answer 5

rash, fever, eosinophilia and elevated IgE present

Question 6

Which 2 immune disorders are associated with acute tubulointerstitial disease?

Answer 6

SLE (of course) and Sjogren’s

Question 7

Microscopic findings of acute tubulointerstitial disease ?

Answer 7

edema of cells, neutrophils, and focal necrotizing infiltrates

Question 8

Acute Interstitial Nephritis (AIN) is usually drug induced most commonly caused by which 2 classes of medications?

Answer 8

PCNs and sulfonamides

AIN is a P(penicillins)AIN in the asS(sulfonamides)
I’m reaching here but just go with it people

Question 9

microscopic findings of AIN?

Answer 9

Interstitial lymphocytes and macrophages, eosinophils. Sometimes giant cells and granulomas

Question 10

symptoms of AIN?

Answer 10

hematuria, acute renal failure, rash, eosinophilia, proteinuria

Question 11

renal insufficiency, hypertension, anemia and non-nephrotic proteinuria occurring over years describes?

Answer 11

chronic tubulointerstitial disease

Question 12

Chronic tubulointerstitial disease caused by long term use of NSAIDS is also referred to as?

Answer 12

analgesic nephropathy

Question 13

microscopic findings of chronic tubulointerstitial disease?

Answer 13

cellular infiltrate composed of lymphocytes and macrophages. Interstitial fibrosis present

Question 14

Besides muddy brown casts, which other kind of casts can you see in Acute Tubular Necrosis (ATN) ?

Answer 14

Tamm Horsfall protein

(ATN (attention!) your Horse fell) lol

Question 15

what is the most common cause of acute renal failure?

Answer 15

ATN

Question 16

Name some nephro toxic causes of ATN.

Answer 16

aminoglycosides
IV contrast
mercury
ethylene-glycol poisoning
hyperuricemia (high cell turnover with malignancies)

Question 17

What are the other two causes of ATN? You should remember this…hopefully

Answer 17

Yes! Ischemia and sepsis ;)

Question 18

Which stage of ATN is characterized by oliguria (renal flow slows to <400 mls of urine, starts within 24 hrs of initiating event) ?

a. initiating
b. maintenance
c. recovery

Answer 18

maintenance

Question 19

which stage of ATN is characterized by increased urine output, up to 3 L?

Answer 19

recovery stage. Beware, electrolyte disturbances can lead to increased risk of death

Question 20

Diabetic nephropathy can cause what kind of renal disorder?

Answer 20

nephrotic syndrome due to porous capillary walls

Question 21

what are the 3 most common bacteria to cause acute pyelonephritis?

Answer 21

e.coli, Proteus, Enterobacter

Question 22

Diabetics gas production within the renal parenchyma due to e.coli can cause what type of pyelonephritis complication?

Answer 22

emphysematous pyelonephritis

Question 23

Struvite-staghorn calculi are kidney stones associated with what 3 types of infectious organisms?

Answer 23

Proteus, Providencia and Pseudomonas

Question 24

What is the classic triad of renal cell carcinoma?

Answer 24

hematuria, flank pain and a palpable mass

Question 25

Production of erythropoietin in renal cell carcinoma results in?

Answer 25

polycythemia