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USMLE Renal Flashcards

1
Q

What HF drug will result in gynecomastia?

A

Spironolactone - similar structure to steroid

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2
Q

What drug can be added onto a HF regimen to improve survival?

A

Spironolactone

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3
Q

How does IL-2 suppress tumours?

A

Enhancing T cell and NK cell activity

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4
Q

What part of the kidney reabsorbs the most water?

A

Proximal tubule

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5
Q

People with upper motor neuron lesions have what kind of bladder?

A

Hypertonic bladder

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6
Q

Where does uric acid precipitate in the renal tubules and why?

A

Collecting ducts, b/c of low urine pH

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7
Q

How are particles filtered in the glomeruli?

A

By size (fenestrated capillaries) and by charge (heparan sulfate in the BM)

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8
Q

How do you calculate renal clearance?

A

Cx = Ux*V/Px

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9
Q

How do you calculate filtered load?

A

Filtered load = GFR x Px

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10
Q

How do you calculate excreted load?

A

Excreted load = Ux * V

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11
Q

What is the Potter Sequence?

A 
Pulmonary hypoplasia
Oligohydramnios
Twisted face
Twisted skin
Extremity defects
Renal failure in utero
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12
Q

If one baby has a dysplastic kidney, what’s the risk of subsequent children having one as well?

A

Relatively low, not inherited.

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13
Q

If a newborn has the Potter sequence, what condition do you suspect?

A

ARPKD

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14
Q

If a newborn has signs and sx of portal HTN, what condition do you think of?

A

ARPKD

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15
Q

If patient presents with fam hx of renal failure and death from brain hemorrhage/renal failure, what condition do you think of?

A

ADPKD

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16
Q

How do you differentiate prerenal from renal acute kidney injury?

A

BUN:creatinine ratio goes up in prerenal, down in renal.

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17
Q

How does the BUN:creatinine ratio change in early and late postrenal kidney injury?

A

Rises then falls as tubules get damaged.

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18
Q

If a patient with AKI has oxalate crystals in their urine, what do you think of?

A

Ethylene glycol poisoning leading to nephrotoxic (vs ischemic) ATN

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19
Q

Patient with fever, rash, hematuria, and eosinophils on urine. Dx?

A

Acute Interstitial Nephritis

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20
Q

Minimal change disease is associated with what other disease?

A

Hodgkin’s Lymphoma

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21
Q

What are the risk factors for FSGS?

A

Heroin use, sickle cell disease, HIV infxn

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22
Q

FSGS is the most common cause of nephrotic syndrome in what kinds of people?

A

Black and Hispanic

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23
Q

Membranous is the most common cause of nephrotic syndrome in what kinds of people?

A

Caucasian adults

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24
Q

Minimal change disease is the most common cause of nephrotic syndrome in what kinds of people?

A

Children

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25
What kind of nephrotic and nephritic syndromes do SLE patients present with?
Membranous nephropathy, Diffuse proliferative glomerulonephritis
26
Granular immunofluorescence points towards what kind of nephropathy?
Membranous nephropathy b/c it signifies immune complex deposition
27
What does tram track appearance on PAS stain point towards?
Membranoproliferative glomerulonephritis
28
What is Type I membranoproliferative glomerulonephritis associated with?
HCV HBV Tram track
29
What is Type II membranoproliferative glomerulonephritis associated with?
C3 nephritic factor, which stabilizes C3 convertase, decreases C3 levels
30
What is the first change in the kidneys in diabetes?
Non enzymatic glycosylation of the GBM
31
What feature in the kidneys is pathognomonic for diabetes?
Kimmelstiel Wilson lesions
32
What defines nephritogenic strains of group A strep?
M protein virulence factor
33
Subepithelial hump in EM. Dx?
Poststrep GN
34
Periorbital edema, cola-coloured urine, HTN. Dx?
Poststrep GN
35
In RPGN, what are the crescents on biopsy made up of?
Fibrin and macrophages
36
Patient presents with hematuria, hemoptysis, and have RPGN with sinusitis. Dx?
Wegener's granulomatosis (w/ +ve c-ANCA)
37
Patient presents with hematuria, hemoptysis, and have RPGN. Dx?
Goodpasture's Syndrome
38
Patient presents with isolated hematuria, sensory hearing loss and eye problems with positive fam hx. Dx?
Alport syndrome.
39
What kind of stone typically develops from an ammonium Mg phosphate stone?
Staghorn calculi
40
What is important to exclude with hypercalciuria?
Hypercalcemia
41
What does being on dialysis in end stage renal failure increase the risk of?
RCC
42
What are angiomyolipomas associated with?
Tuberous sclerosis
43
What is the triad associated with RCC?
Hematuria Palpable mass Flank pain
44
What paraneoplastic syndromes are associated with RCC?
ACTH (Cushing's) Epo (2ndary polycythemia) PTHrP Renin (HTN)
45
What do you think of if you see a left-sided varicocele?
RCC
46
Pathogenesis of RCC involves loss of what gene?
VHL on chromosome 3
47
What is the key component of Wilms tumour?
Blastema
48
What are the risk factors for urothelial carcinoma?
Smoking (Naphthylamine and polycyclic aromatic HCs) Azo dyes Long term cyclophosphamide and phenacetin
49
Flat urothelial carcinomas are associated with...
Early p53 mutations
50
Middle Eastern male presents with painless hematuria. Dx?
Squamous cell carcinoma of the bladder secondary to schistosoma infection
51
What kind of cancer with urachal remnants?
Bladder adenocarcinoma on the dome of the bladder
52
Patients with angiomyolipomas also have what findings?
Brain hamartomas and ash-leaf skin patches as a result of tuberous sclerosis
53
Calcium kidney stones typically lead to what Ca levels in blood and urine?
Normocalcemia, hypercalciuria
54
What are important factors to check in the differential of metabolic alkalosis?
Volume status and urine chloride
55
What drug should you check for before giving ACEi and why?
Thiaizide or loop diuretics b/c of potential first dose hTN
56
How do you calculate net filtration pressure?
(Hydrostatic of Glomerulus - Hydrostatic of Bowman) - (Oncotic of Glomerulus - Oncotic of Bowman)
57
A man treated for sinusitis with ampicillin later presents with oliguria, rash, fever. What does he have?
AIN
58
What cells are Epo released from?
Interstitial cells of peritubular capillary bed
59
Why does the BUN rise in prerenal AKI?
Because kidneys reabsorb H2O, Na, and BUN to raise volume
60
How do you prevent Ca stones from precipitating?
By adding citrate
61
What does ANCA stand for?
Anti neutrophil cytoplasmic antibodies
62
What kidney disease is MPLAR-2 associated with?
Membranous nephropathy

USMLE (23 decks)

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