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RENAL II Exam 2 > Robbins Ch. 20 - The Kidney III > Flashcards

Robbins Ch. 20 - The Kidney III Flashcards

1
Q

affect on calyces

A

only chronic PN and analgesic nephropathy

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2
Q

xanthogranulomatous pyelonephritis

A

accumulation of foamy macrophages

-proteus infection (weil felix)

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3
Q

drug-induced interstitial nephritis

A

fever, eosinophilia, rash

-PCN, MCN, rifampin, thiazides, NSAIDs

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4
Q

prep for colonoscopy

A

acute phosphate nephropathy

-precipitate of calcium P

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5
Q

bence jones

A

myeloma kidney

-pink blue cast

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6
Q

tophus

A

mononuclear response with giant cells

-chronic urate nephropathy

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7
Q

medial/intimal thickening, hyalinzation of artery walls

A

nephrosclerosis

granular kidney, shrinkage

elderly, blacks, DM - increased

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8
Q

malignant nephrosclerosis

A

BP > 200/120
papilledema, retinal hemorrhage, confusion

hyperplastic ateriosclerosis (onion skinning)

elevated renin levels

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9
Q

renal artery stenosis

A

curable with surgery
-70% caused by atheromatous plaque

  • increased renin - leads to ischemic kidney
  • causes HTN

-also - fibromuscular dysplasia (string of beads)

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10
Q

string of beads

A

fibromuscular dysplasia

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11
Q

bruit on kidney, renin, response to ACE (-)

A

renal artery stenosis

Tx - 70-80% cured with surgery

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12
Q

E. coli 0157/H7

A

typical HUS

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13
Q

mutation in factor H

A

atypical HUS

also factor I and CD46

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14
Q

Tx typical HUS

A

dialysis - recover in weeks

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15
Q

antiphospholipid syndrome

A

atypical HUS

also pregnancy, systemic sclerosis, chemo, radiation

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16
Q

ADAMTS13

A

TTP

-inhibitory autoantibodies

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17
Q

Tx for TTP

A

plasmapharesis

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18
Q

subendo deposits of fibrion and mesangiolysis

A

TTP

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19
Q

reduced NO and prostaglandins

A

prothrombotic

-in TTP/HUS

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20
Q

generalized ischemia to kidney

A

diffuse cortical necrosis

  • during obstetric emergency
  • coagulative necrosis of glomeruli and tubules
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21
Q

mural thrombi embolizes

A

renal infarct - 25% CO

-white infarct- wedege shaped

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22
Q

sickle cell nephropathy

A

hematuria/hyposthenuria (can’t concentrate urine)

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23
Q

if biopsy kidney or do nephrectomy?

A

check for U/L kidney

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24
Q

hypoplasia

A

more commonly U/L

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25
Q

ectopic kidney

A

typically in pelvis

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26
Q

horseshoe kidney

A

fusion of lower poles

27
Q

APKD gene

28
Q

bilateral cysts

A

APKD always is bilateral

29
Q

PKD1

A

ADPKD

  • chromosme 16
  • cell-cell matrix interactions
  • worse prognosis - 70% ESRD by 60yo
  • majority of cases
30
Q

PKD2

A 
ADPKD
-chromosome 4
-Ca channel
-better prognosis - 15% ESRD by 60yo
-
31
Q

ADPKD clinical

A

flank pain, stones, UTI, HTN

faster in blacks

also liver cysts, mitral valve prolapse, colon diverticula

32
Q

berry aneurysms

A

increased in ADPKD

33
Q

prognosis of ADPKD

A

40% die of coronary or HTN heart disease

34
Q

perinatal ARPKD

A

90% cystic collecting ducts
-survive few hours after birth

MOST COMMON

35
Q

neonatal ARPKD

A

60% cystic collecting ducts

-survive few months after birth

36
Q

infantile ARPKD

A

20% cystic collecting ducts

-survive until childhood

37
Q

juvenile ARPKD

A

10% cystic collecting ducts

-survive to adolescence

38
Q

PKGD

A

fibrocystin - mutation in ARPKD

-chromosome 6

39
Q

ARPKD

A

CD dilation

  • cysts in cortex and medulla (cuboidal)
  • dilated channels at right angles

also - portal fibrosis of liver occurs

40
Q

cysts at corticomedullary junction

A

nephronophthisis and adult onset medullary cystic disease

41
Q

most common genetic cause of ESRD in children and young adults

A

nephronophthisis

-polydipsia and polyuria

42
Q

MCKD1 and 2

A

mutated in adult onset medullary cystic diseases

-autosomal dominant

43
Q

mutations in nephronophthisis

A

NPHP1-11

JBTS2, 3, 9, 11

44
Q

NPHP2

A

inversin

  • modulates right/left patterning
  • mutated in nephronophthisis
45
Q

islands of undifferentiated mesenchyme, cartilage, immature CDs

A

multicystic renal dysplasia

U/L - excellent prognosis after removal of affected kidney
B/L - ESRD may occur

46
Q

simple cysts

A

single/multiple

  • typically in cortex
  • incidental finding
  • not clinically significant
47
Q

proteus infection

A

magnesium ammonium phosphate

  • struvite stones
  • staghorn calculi
48
Q

small stones

A

more hazardous - can enter ureter

49
Q

subtotal intermittent obstruction

A

hydronephrosis

50
Q

<1cm mass

A

renal papillary adenoma - benign

51
Q

> 1cm mass

A

low-grade renal cell carcinoma

52
Q

tuberous sclerosis

A

angiomyolypoma - benign

lesions of cerebral cortex, retardation, epilepsy, skin changes, heart tumors

53
Q

TSC1 , 2

A

mutations in tuberous sclerosis

54
Q

worry with angiomyolypoma

A

may hemorrhage significantly

55
Q

epithelial cell with increased mitochondria

A

oncocyte

-in oncocytoma

56
Q

oncocytoma

A

epithelial neoplasm

  • large eosinophilic cells, from intercalated cells and CD
  • mahogany with central scar

benign

57
Q

wilms tumor

A

age 2-5yo
asian
large abdominal mass
pain, hematuria, HTN

58
Q

WAGR

A

wilms tumor
aniridia
genital
retardation

59
Q

denys drash

A

with wilms tumor

60
Q

beckwith wiedeman

A

with wilms tumor

61
Q

nephrogenic rests

A

precursor lesions in wilms tumor

62
Q

diffuse anaplasia

A

bad prognosis for wilms tumor

63
Q

older with wilms

A

better prognosis

64
Q

p53, 11q, 16q deletion with wilms

A

bad prognosis

RENAL II Exam 2 (10 decks)

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