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Uworld Journal > Renal System > Flashcards

Renal System Flashcards

1
Q

MS patients have which type of urinary incontinence? What is the mechanism?

A

Urge incontinence.

Lesions above the sacral region of the spinal cord results in a loss of higher center control of micturition. Causes detrusor muscle hyperreflexia (“spastic bladder”)

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2
Q

What is Potter Sequence?

A 
P = pulmonary hypoplasia
O = oligohydramnios - stimulus
T = twisted skin (wrinkled)
T = twisted face (Potter facies/flat facies)
E = extremities defects (club foot)
R = renal agenesis, bilateral
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3
Q

Cause/inciting factor for Potter Sequence?

A

Renal anomalies -> oligohydramnios -> POTTER

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4
Q

Pipestem fibrosis (periportal fibrosis) + patient swam in a freshwater lake recently =

A

Hepatic schistosomiasis - S. japonicum, S. mansoni

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5
Q

Blood supply of proximal, middle and distal ureter

A 
Proximal = renal artery 
Middle = multiple anastamoses 
Distal = superior vesicle artery
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6
Q

Which type of urinary incontinence is common in type 1 DM patients? What is the mechanism?

A

Overflow incontinence

Diabetic autonomic neuropathy -> decreased innervation of the detrusor muscle results in impaired contraction

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7
Q

Chronic kidney hypoperfusion results in hyperplasia and hypertrophy of which cells?

A

Juxtaglomerular cells = modified smooth muscle cells that are part of the afferent arteriole

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8
Q

Non-lactose fermenting cause of UTI?

A

Pseudomonas aeruginosa

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9
Q

“Lumpy-bumpy” deposits + tea colored urine + periorbital edema =

A

Post-streptococcal glomerulonephritis

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10
Q

What are the Post-Streptococcal glomerulonephritis deposits made of and where are they located?

A

IgG, IgM, C3

subepithelial deposits

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11
Q

Kimmelsteil Wilson nodules =

Nephrotic vs Nephritic

A

Diabetic nephropathy

Nephrotic

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12
Q

What is the first thing you should think of if someone has been taking naproxen for 3+ month daily?

A

Chronic interstitial necrosis (drug-induced)

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13
Q

Dysuria definition

A

painful urination

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14
Q

Which structure blocks the ascent of the kidneys in a horseshoe malformation?

A

Inferior mesenteric artery (L3)

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15
Q

Clearance of which substance is used to calculate RBF and RPF?

A

PAH

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16
Q

Clearance of which substances is used to calculate GFR?

A
  • inulin

- creatine

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17
Q

Female + glomerulonephritis + photosensitive skin rash+ arthalgias + reproductive age =

A

Systemic Lupus Erythematosus

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18
Q

Female + arthralgias + african american + prolonged PTT + 2 spontaneous abortions + positive PRP test + negative Treponema pallidum immunoassay =

A

Antiphospholipid antibody syndrome

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19
Q

2 causes of sterile pyuria =

A
  • acute pyelonephritis - rare

- non-gonococcal urethritis + cystitis - Chlamydia or Ureaplasma

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20
Q

Toddler’s painless GI bleeding =

A

Meckel’s diverticulum = failure of obliteration of the vitelline/omphalomesenteric duct

21
Q

Failure of abdominal wall closure, viscera not covered with peritoneum =

A

Gastroschisis

22
Q

internal urethral sphincter

  • contraction
  • relaxation
A 
contraction = sympathetic
relaxation = parasympathetic
23
Q

Thyroidization of the kidney =

A

chronic pyelonephritis

24
Q

Crescent shaped proliferation within the glomerulus =

What are they made of?

A

Rapidly Progressive Glomerulonephritis

Crescents made of fibrin + plasma proteins (C3b)

25
Q

Wire looping of capillaries =

A

Diffuse Proliferative Glomerulonephritis

26
Q

Tramtracks on PAS stain + subendothelial deposits =

A

Membranoproliferative glomerulonephritis Type 1

27
Q

Pathology of Membranoproliferative glomerulonephritis Type 2 =

A

C3 convertase stabilization -> decreased levels of active C3 -> less inflammation

28
Q

Crescent glomeruli + sinusitis + lung involvement + negative IF stain =

A

Granulomatosis with polyangitis (Wegner’s) -> Rapidly progressive glomerulonephritis

29
Q

Negative IF stain + proteinuria = 5 + child =

A

Minimal Change Disease

30
Q

Which phase of ATN is this?

oliguric - hyperkalemia, metabolic acidosis, increased ECF volume, hyponatremia, hypocalcemia

A 
Maintenance phase
(2nd)
31
Q

Which phase of ATN is this?

polyuric - hypokalemia

A

Recovery phase

3rd

32
Q

How to differentiate between causes of metabolic alkalosis?

A
  • Urine Cl

- Volume status

33
Q

Obliteration of what neonatal structure leads to the adult medial umbilical ligament?

A

Umbilical artery

34
Q

Obliteration of the urachus leads to what adult structure?

A

Median umbilical ligament

35
Q

Stones that form in basic urine (high pH)

A
  • Calcium phosphate

- Ammonium magnesium phosphate (struvite)

36
Q

Stones that form in acidic urine (low pH)

A
  • Calcium oxalate
  • Uric acid
  • Cystine
37
Q

IL-2’s anti-tumor effects are due to the action of

A

IL-2 stimulates T cells and NK cells to mature and proliferate (also stimulates B cells and monocytes)

NK cells and T cells help fight off tumor cells (malignant melanoma and renal cell carcinoma)

38
Q

proximal tubular cell ballooning + vacuolar degeneration + flattening of tubular epithelial cells + FENa >2% (increased)

A

Acute Tubular Necrosis

39
Q

medullary cysts lined with cuboidal or urothelial epithelium + cystic dilation of collecting ducts

A

Medullary Sponge Kidney

40
Q

Deficiency of neutral AA transporters in the PCT and enterocytes

A

Hartnup disease (AR)

Can lead to a niacin deficiency (due to lack of tryptophan absorption) -> Pellagra

41
Q

Differences in presentation between post-streptococcal GN and Berger disease

A

Post-streptococcal GN = 2 weeks post-pharyngitis, mostly occurs in children

Berger disease = 5 days post-URI, recurrent

42
Q

Henoch-Schonlein purpura is what type of hypersensitivity?

A

Type III - IgA immune complex deposition in small vessels

43
Q

deaf + hematuria + progressive renal failure + Xlinked Recessive

A

Alport syndrome = mutation in type IV collagen

44
Q

Most common cause of nephropathy in HIV+ patients

A

Focal segmental glomerulosclerosis

-HIV patients have a collapsing variant

45
Q

Beckwith-Wiedmann Syndrome

A
  • Wilms tumor
  • Macroglossia
  • Organomegaly
  • Hemihypertrophy

mutation in WT2

46
Q

WAGR complex

A
  • Wilms tumor
  • Aniridia
  • Genitourinary malformations
  • mental Retardation

deletion of WT1

47
Q

Papillary necrosis causes (4)

A
  • Sickle cell disease or trait
  • Acute pyelonephritis
  • NSAIDs
  • Diabetes mellitus
48
Q

Cause of stress incontinence

A
  • urethral sphincter dysfunction

- loss of urethral support

Uworld Journal (12 decks)

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