Rub/Rob Kidney

Question 1

Rub 4: Most ectopic kidneys are located along

Answer 1

the pathway of renal migration during fetal development and are caudal to their normal lumbar position; think remaining in the pelvis

Question 2

Rub 8: Neoplastic plasma cells secrete a

Answer 2

homogenous immunoglobulin chain which can be detected in serum or urine by electrophoresis. Amyloid nephropathy caused by deposition of secreted lambda or kappa light chains in the glomerular BMs and mesangial matrix

Question 3

Rub 9: Amyloidosis is a well-known complication of chronic inflamm disorders, like

Answer 3

chronic suppurative bronchiectasis, RA, or osteomyelitis; these conditions stimulate the production of amyloid from the serum amyloid A protein

Question 4

Rub 23: Focal proliferative glomerulonephritis typically presents with

Answer 4

pathologic changes in some glomeruli, whereas others remain normal. This group of diseases includes lupus nephritis, nephritis that accompanies several vasculitides, H-S purpura, and several other disorders. Also includes Berger disease (has mesangial deposits of IgA and mesangial cell prolif)!!!

Question 5

Rub 24: Acute postinfectious glomerulonephritis features

Answer 5

1. Main features are subepi dense deposits shaped like “humps”
2. Also could have mesangial and subendo deposits

Question 6

Rub 30: Crescentic glomerulonephritis the morphologic equivalent of

Answer 6

ARF, which could develop in rapidly progressive glomerulonephritis of Goodpasture syndrome

Question 7

Rub 38: Glucosuria of diabetes predisposes to

Answer 7

acute pyelonephritis by providing a rich medium for bacterial growth; NECROSIS of the PAPILLARY tips could occur in severe cases

Question 8

Rub 42: Bilateral renal cortical necrosis is a syndrome characterized by

Answer 8

massive tubular necrosis involving large portions of the cortex of both kidneys; massive bilateral renal cortical necrosis typically occurs in the setting of hypovolemia and endotoxic shock

Question 9

Rub 45: Hypertensive nephroscelrosis (benign nephrosclerosis) leads to

Answer 9

obliteration of glomeruli and could lead to end-stage kidney disease

Question 10

Rub 49: HUS features

Answer 10

microangiopathic hemolytic anemia and acute renal failure with little or no evidence for significant vascular disease outside the kidneys; think Shiga toxin-producing E coli

Question 11

Rub 51: RCC is the most

Answer 11

common cancer of the kidney; spreads most frequently to the lung and bones

Question 12

Rub 54: Neuroblastoma can present as

Answer 12

an abdo mass in children that SECRETES catecholamines and causes elevation of vanillylmandelic acid in the urine

Question 13

Rub 55: RCC’s originate from

Answer 13

renal tubules or ductal epi cells; tumor composed of cuboidal cells that form either tubules or solid nests

Question 14

Rob 3: Multiple myeloma has the following symptoms:

Answer 14

1. Large amount of serum globulin
2. back pain from lytic lesions
3. Immunosuppression with recurrent infections
4. amyloid deposition enlarging the kidneys

Question 15

Rob 5: Carcinoma of the urethra is

Answer 15

uncommon, and tends to occur in older women and is locally aggressive

Question 16

Rob 7: IgA nephropathy can explain the presence of

Answer 16

recurrent hematuria in a young adult; nephrotic syndrome is NOT present, and mesangial IgA deposition is characteristic; think upper respiratory infection and celiac

Question 17

Rob 10: RCC can potentially secrete

Answer 17

EPO, giving rise to polycythemia

Question 18

Rob 12: Drug-induced interstitial nephritis can be caused by

Answer 18

sulfonamides, penicillins, cephalosporins, fluoroquinolone antibiotics ciprofloxacin and norfloxacin, and antiTB drugs isoniazid and rifampin; maybe thiazides and loop diuretics, cimetidine, ranitidine, omeprazole, NSAIDs

Question 19

Rob 18: Ischemic acute tubular necrosis often accompanied by

Answer 19

rupture of the basement membrane (tubulorrhexis)

Question 20

Rob 19: Painless hematuria in an older adult suggests

Answer 20

renal neoplasm, and presence of constitutional symptoms like fever and weakness should raise the suspicion of RCC

Question 21

Rob 23: AR PKD most often occurs in

Answer 21

children and could involve the liver; think mutations in PKHD1 gene encoding for fibrocystin expressed in kidney, liver, and pancreas

Question 22

Rob 25: In this case, drug-induced interstitial nephritis caused by

Answer 22

ampicillin (immunological rxn caused by drug acting as a hapten)

Question 23

Rob 28: Embryologic urachus may not become obliterated, leaving a

Answer 23

fistulous tract or a cyst b/w the bladder and abdo wall at the umbilicus

Question 24

Rob 29: Minimal change disease most likely caused by

Answer 24

primary injury to visceral epi cells caused by T cell-derived cytokines that leads to foot process fusion

Question 25

Rob 31: Medullary sponge kidney shows

Answer 25

cystic dilation of 1-5 mm in the inner medullary and papillary collecting ducts; could see calculi in dilated collecting ducts

Question 26

Rob 42: Most common cause of nongonococcal urethritis in men is

Answer 26

C trachomatis (think STD!!!)

Question 27

Rob 44: An anlgesic nephropathy can

Answer 27

damage the renal interstitium and give rise to papillary necrosis; unlikely to get hydronephrosis with no urinary tract obstruction

Question 28

Rob 52: A patient with nephrocalcinosis due to hypercalcemia could have

Answer 28

metatstatic disease; have chronic tubulointerstitial disease of the kidneys that’s initially manifested by loss of concentrating ability and progressive loss of renal function

Question 29

Rob 57: Patient with malignant HTN can have

Answer 29

necrotizing arteriolitis and hyperplastic arteriolosclerosis