Rx_2.11 (Renal)

Question 1

Post-leukemia tx w/chemo + lower back pain ==> dx?

Answer 1

• uric acid stones (seen on ultrasound)

Question 2

Causes of caclium-based stones

Answer 2

• hypecalcemia ==> hypercalcuria
  
  • hyperparathyroidism
  • destructive bone disease
  • increased vitamin D levels
  • milk alkali syndrome
• calcium-oxalate stones
  
  • ethylene glycol (antifreeze)
  • vitamin C abuse
  • Chron disease

Question 3

Dehdration impacts on afferent/efferent arteriole and GFR and RPF

Answer 3

• PGE ==> vasodilation @ afferent
• ATII ==> contriction @ efferent
• increased GFR
• decreased RPF

Question 4

Consequence of chronic schistosoma hematobium

Answer 4

• S. hematobium = parasitic flatworm spread via snails ==> urinary bladder ==>
  
  • asymptomatic vs. chronic inlfammation vs. persistent hematuria
• Chronic bladder wall schistosomiasis ==> squamous cell carcinoma of the bladder
  
  • areas of infection in bladder wall seen as focal calcification during cystography

Question 5

Tx for schistosomiasis infection

Answer 5

praziquantel

Question 6

Dracunculus medinensis characteristics/presentation

Answer 6

• “Guinea worm”
• parasitic worm found in Africa
• resides @ subcutaneous tissue
  
  • ==> cutaneous nodules/ulcerations
  • no systemic illness
• female tail protrudes from ulcer @ lower limb in order to release offspring after contact with water

Question 7

Necator americanus characteristics/presentation

Answer 7

• hookworm
• found in Americas, sub-saharan Africa, SE Asia
• ==> chronic hookworm infection @ children ==> malnutrion, mental disability, abdominal pain, diarrhea

Question 8

Schistosoma mansoni characteristics/presentation

Answer 8

• flatworm w/similar characteristics to S. hematobium
• @ Sub-saharan Africa, South America
• associations
  
  • intestinal schistosomiasis
  • intestinal cancer
  • liver infection
  • Katayama fever

Question 9

Schistosoma mansoniTaenia solium

Answer 9

• “pork tapeworm” = flatwom that infects pigs and humans in Asia, Africa, Americas
• morphology
  
  • long, slender, flat bodies w/subunits (“proglottids”) and single head
  • numerous hooks/suckers ==> attach to intestinal wall
• chronic infection ==> intestinal sx
• may migrate to brain ==> neurocysticercosis

Question 10

Conn syndrome characteristics + tx

Answer 10

• primary hyperaldosteronism
• tx = spironolactone
  
  • competitive aldosterone receptor antagonist
  • steroid molecule

Question 11

UA in pyelonephritis

Answer 11

• pyuria
• WBC casts

Question 12

Granular casts ==> ?

Answer 12

acute tubular necrosis

Question 13

Common embryologic process failure in Potter syndrome

Answer 13

• failure of development of ureteric buds ==> bilateral renal agenesis