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Med School: Semester 2 > Renal Quiz 1b > Flashcards

Renal Quiz 1b Flashcards

1
Q

What does the presence of casts suggest?

A

That the hematuria/pyuria is of renal (as opposed to bladder) origin.

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2
Q

What can cause RBC casts?

A

a. glomerulonephritis
b. malignant HTN
c. renal ischemia
d. vasculitis

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3
Q

What can cause WBC casts?

A

a. tubulointerstitial inflammation
b. acute pyelonephritis
c. transplant rejection

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4
Q

What can cause “muddy brown” casts?

A

acute tubular necrosis

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5
Q

What can cause waxy/fatty casts?

A

nephrotic syndrome

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6
Q

What can cause hyaline casts?

A

non-specific, can be a normal finding

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7
Q

What causes the straight line in immunoflorescence?

A

IgG… common with Goodpastures.

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8
Q

What causes big clumps on immunoflorescence?

A

IgA. Common in Berger’s.

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9
Q

What are the 3 types of renal cell carcinomas?

A

a. Clear-cell carcinoma: defect in VHL (von Hippel-Lindau)
b. Papillary renal cell carcinoma: defect in MET
c. Chromophobe renal carcinoma: lost chromosome (!)

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10
Q

What is the classic triad of symptoms for renal cell carcinoma?

A

a. painless hematuria
b. palpable flank mass
c. flank pain

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11
Q

What is the most common demographic for renal cell carcinoma?

A

60-70 y/o male.

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12
Q

Where do transitional tumors usually occur? What is an indication?

A

Urinary tract outside of kidney, common in the bladder.

Risk factors (age of 50-70, smoking, etc.) + painless hematuria = suspicion

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13
Q

What is the Wilms tumor pneumonic?

A

W: Wilms tumor
A: Aniridia (no iris)
G: Genitourinary malformation
R: Retardation (mental-motor)

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14
Q

Who does Wilms Tumor (Nephroblastoma) usually hit? What is the genetic indication?

A

Children 2-5 y/o.

Loss of WT1, a tumor supressor gene on chromosome 11.

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15
Q

What type of junction are the slit barriers at the level of the foot processes of the podocytes?

A

modified tight junctions.

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16
Q

How do the podocytes communicate with endothelial cells?

A

VEGF

17
Q

What is the charge of the charge barrier, and what is believed to hold the charge?

A

The glycocalyx is believed to have a negative charge.

18
Q

What catches low MW proteins that get thru the glomerulus, and what happens to these proteins?

A
  • Take up in PCT by megalin, cubilin and amnionless

- processed in lysosomes and AAs are scavenged and reabsorbed

19
Q

What is the dominant site of resistance to flow in the kidney?

A

afferent arteriole

20
Q

What is the principle signal for efferent arteriole resistance?

A

Angiotensin

21
Q

How does high Na+ affect the afferent arteriole? How does it affect the efferent arteriole?

A

Reabsorption of Na+ goes thru the basolateral side of the cell using a Na/Cl ATPase transporter. The resulting ADP causes the mesangial cells to contract the afferent arterioles, and reduce flow.

High Na+ also decreases AngII which widens the efferent arteriole.

22
Q

What hormone is released when volume is too high, and it decreases Na+ reabsorption?

A

Dopamine

23
Q

What effect does AngII have on the PCT?

A

It increases Na+ reabsorption.

24
Q

What causes release of ANF and what does it do?

A

Stretch of atria releases, and it decreases Na+ reabsorption.

25
Q

What is the diluting limb? Why is it called that?

A

Thick ascending. It reabsorbs 2Cl-, Na+ and K+, but does not reabsorb H2O.

26
Q

Does an increase in sympathetics make renin?

A

yes

27
Q

What causes periorbital edema?

A

Post-strep

28
Q

What are the two presentations of IgG in IF?

A

a. ribbon-like: Goodpastures

b. lumpy-bumpy: post-strep

29
Q

What do calcium stones look like?

A

a. dumbbell

b. pretty earrings

30
Q

What shape are ammonium magnesium phosphate stones?

A

coffin-lid

31
Q

What shape are cystine crystals?

A

cystine = six sides (very uncommon)

32
Q

What shape are uric crystals?

A

rhomboid or rosette

Med School: Semester 2 (37 decks)

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