Robbins 8th ed - Chapter 20 - Kidney (1)

Question 1

What are the clinical features of nephritic syndrome?

Answer 1

Haematuria, variable proteinuria, oliguria, raised creatinine.

Question 2

What are the clinical features of nephrotic syndrome?

Answer 2

Proteinuria is >3.5g/day.
Hypoalbuminaemia.
Hyperlipidaemia.
Lipiduria.

Question 3

What type of kidney disease is Goodpasture syndrome classed as? What do the antibodies target?

Answer 3

Glomerulonephritis . Anti-GBM antibodies (basement membrane).

Question 4

Name 3 primary glomerular diseases that commonly present with nephrotic syndrome.

Answer 4

Membranous glomerulonephropathy
Minimal change disease
Focal segmental glomerulosclerosis

Question 5

Epidemiology of renal calculi:

• Lifetime risk?
• Gender?
• Age

Answer 5

• 5-10% lifetime risk
• men > women
• Peak incidence is age 20-30

Question 6

Composition of renal calculi:

70% are made of _______? What are some features of the patient population?

Answer 6

Calcium. Composed of calcium oxalate and/or calcium phosphate. Many of these patients have hypercalcaemia. They also may have a higher dietary intake of oxalate (found in vegetables and nuts).

Question 7

Composition of renal calculi:

20% of stones are made of ______? What are some features of the patient population?

Answer 7

Triple phosphate, or struvite, stones composed of magnesium ammonium phosphate. These occur more commonly in patients with renal tract infection (with bacteria that metabolise urea), or with gout.

Question 8

How can renal tract infections precipitate renal calculi? Which type of calculi?

Answer 8

Bacterial infections, such as Proteus, alkalinize the urine by converting urea to ammonia. This precipitates formation of struvite stones, including staghorn stones.

Question 9

Composition of renal calculi:

5-10% of stones are made of ______? What is an underlying cause?

Answer 9

Uric acid. If the urine is very acidic, this can precipitate uric acid.

Question 10

What is a morphologic feature of focal segmental glomerulosclerosis?

Answer 10

Loss of foot processes.

Question 11

What is the Mendelian inheritance of Adult Polycystic Kidney Disease?

Answer 11

Autosomal Dominant.

Question 12

What is the Mendelian inheritance of Childhood Polycystic Kidney Disease?

Answer 12

Autosomal Recessive.

Question 13

List the electrolyte abnormalities that occur in Chronic Renal Failure.

Answer 13

Hypocalcaemia (due to Vit D deficiency)
Hyperphosphataemia (due to renal retention of phosphatE)
Hyperkalaemia
Uraemia
Metabolic acidosis