Renal Review

Question 1

male stillborn, born premature

oligohydramnios, absence of a urethral opening

dx is \_\_\_\_\_
complications
P\_\_\_
Twisted \_\_/\_\_\_
E
R

Answer 1

potter sequence

pulm hypoplasia
skin/face
extremity defects
renal failure

Question 2

young boy, recurrent UTI

creatinine is elevated indicating renal failure

dx is \_\_\_\_\_
labs
Calcium \_\_
Phos \_\_\_\_
1, 25 OH VD3 \_\_\_

Answer 2

secondary hyperPTH

dec
inc
dec

Question 3

AD PCKD

cysts in __/___
kidneys are ___

Sx: F/H/H

mutation in __/___ on chromosome ___/___

assc w B/M

tx w ___/___

Answer 3

renal cortex/medulla
enlarged

flank pain, hematuria, HTN

PKD1/PKD2, 16/4

berry aneurysm, MVP

acei/arb

Question 4

MA man, dx w nephrolithiasis

calcium is primary component, inc Ca excretion

pharm therapy w ___
inhibit ___/__ symporter

Answer 4

Thiazide diuretic

Na/Cl

Question 5

elderly woman ,dx of lung cancer

seizure
labs show low serum Na
high urine Na
high urine osmolarity

dx is ____

Answer 5

SIADH

Question 6

pt w head trauma, excreting large amounts of urine

serum Na is very high, urine osmolality is extremely low

dx is ____
dec production of ____, which acts on ___

ADH acts on ___ for serum osmolarity and __ for BP

aids insertion of aquaporins in ___ of collecting duct

Answer 6

Diabetes Insipidus
ADH, collecting duct

V2 receptor, v1 receptor

principal cells

Question 7

MA woman, urinary freq and burning sensation w urination

normal temp/BP/HR

urinalysis shows + nitrites/LE

causal organism is ___

Answer 7

e coli

Question 8

elderly man, hx of hypertension

HBP, inc K, low HCO3
creatinine is elevated

dx is ___

Answer 8

hyperaldosteronism

Question 9

MA man, history of bipolar disorder

history of polyruia
labs normal
urinalysis has very low specific gravity

dx is _____
dec responsiveness to ___

Answer 9

nephrogenic diabetes insipidus

ADH/vasopressin

Question 10

elderly man, no urine in 10hrs

BP inc, HR inc
suprapubic fullness/tenderness

prostate is normal
BUN is very high, creatinine is high

next step in management

Answer 10

bladder catheter

Question 11

MA woman, hx of T1DM and diabetic nephropathy, CKD

labs show high creatinine, low Hb and normal MCV

needs tx w ____

Answer 11

EPO

Question 12

MA man, hx of T1DM

fundoscopic exam shows microaneurysm/hemorrhage, diabetic nephropathy

Protein/creatinine is high

tx w ___ to slow renal disease
mechanism is to constrict ___

Answer 12

ACEI

efferent arteriole

Question 13

MA woman, worsening cough/hemoptysis

rhonchi
inc creatinine, urine protein/blood/RBC

dx is ___
test w ____

Answer 13

goodpastures dz

anti-GBM antibody

Question 14

MA woman, inc BP

high renin and aldosterone

most likely cause of findings is __

Answer 14

obstruction of renal arteriole flow

Question 15

elderly man, dx of COPD

serum bicarb is high, pH is normalized, high pCO2

dx is ___ via COPD
kidney is responding by reabsorbing ___ in ___

Answer 15

CO2 retenion

Bicarb, proximal tubule

Question 16

teenager, gross hematuria

post URI, high blood/RBC in urine

dx is ____
mechanism: __ deposition in ___

Answer 16

IgA nephropathy

IgA, mesangium

Question 17

ma woman, history of nausea/fatigue

previous cellulitis, prescribed an antibiotic

creatine is inc, WBC high, few RBC

dx is ___

Answer 17

acute interstitial nephritis

Question 18

MA man, gross hematuria

long hx of smoking
thick walled, hyperechoic cyst in kidney

dx is ___
pathology will show ____

Answer 18

RCC

clear cell carcinoma

Question 19

Elderly woman, worsening leakage of urine

needs to urinate, does so before she can find a bathroom

previous hx of vaginal delivery

dx is ____
etioogy: _____

Answer 19

urge incontinence

involuntary detrusor muscle contraction