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(Pharm) 01 > USMLE Renal > Flashcards

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
Q

What kind of nephrotic and nephritic syndromes do SLE patients present with?

A

Membranous nephropathy, Diffuse proliferative glomerulonephritis

26
Q

Granular immunofluorescence points towards what kind of nephropathy?

A

Membranous nephropathy b/c it signifies immune complex deposition

27
Q

What does tram track appearance on PAS stain point towards?

A

Membranoproliferative glomerulonephritis

28
Q

What is Type I membranoproliferative glomerulonephritis associated with?

A

HCV
HBV
Tram track

29
Q

What is Type II membranoproliferative glomerulonephritis associated with?

A

C3 nephritic factor, which stabilizes C3 convertase, decreases C3 levels

30
Q

What is the first change in the kidneys in diabetes?

A

Non enzymatic glycosylation of the GBM

31
Q

What feature in the kidneys is pathognomonic for diabetes?

A

Kimmelstiel Wilson lesions

32
Q

What defines nephritogenic strains of group A strep?

A

M protein virulence factor

33
Q

Subepithelial hump in EM. Dx?

A

Poststrep GN

34
Q

Periorbital edema, cola-coloured urine, HTN. Dx?

A

Poststrep GN

35
Q

In RPGN, what are the crescents on biopsy made up of?

A

Fibrin and macrophages

36
Q

Patient presents with hematuria, hemoptysis, and have RPGN with sinusitis. Dx?

A

Wegener’s granulomatosis (w/ +ve c-ANCA)

37
Q

Patient presents with hematuria, hemoptysis, and have RPGN. Dx?

A

Goodpasture’s Syndrome

38
Q

Patient presents with isolated hematuria, sensory hearing loss and eye problems with positive fam hx. Dx?

A

Alport syndrome.

39
Q

What kind of stone typically develops from an ammonium Mg phosphate stone?

A

Staghorn calculi

40
Q

What is important to exclude with hypercalciuria?

A

Hypercalcemia

41
Q

What does being on dialysis in end stage renal failure increase the risk of?

A

RCC

42
Q

What are angiomyolipomas associated with?

A

Tuberous sclerosis

43
Q

What is the triad associated with RCC?

A

Hematuria
Palpable mass
Flank pain

44
Q

What paraneoplastic syndromes are associated with RCC?

A

ACTH (Cushing’s)
Epo (2ndary polycythemia)
PTHrP
Renin (HTN)

45
Q

What do you think of if you see a left-sided varicocele?

A

RCC

46
Q

Pathogenesis of RCC involves loss of what gene?

A

VHL on chromosome 3

47
Q

What is the key component of Wilms tumour?

A

Blastema

48
Q

What are the risk factors for urothelial carcinoma?

A

Smoking (Naphthylamine and polycyclic aromatic HCs)
Azo dyes
Long term cyclophosphamide and phenacetin

49
Q

Flat urothelial carcinomas are associated with…

A

Early p53 mutations

50
Q

Middle Eastern male presents with painless hematuria. Dx?

A

Squamous cell carcinoma of the bladder secondary to schistosoma infection

51
Q

What kind of cancer with urachal remnants?

A

Bladder adenocarcinoma on the dome of the bladder

52
Q

Patients with angiomyolipomas also have what findings?

A

Brain hamartomas and ash-leaf skin patches as a result of tuberous sclerosis

53
Q

Calcium kidney stones typically lead to what Ca levels in blood and urine?

A

Normocalcemia, hypercalciuria

54
Q

What are important factors to check in the differential of metabolic alkalosis?

A

Volume status and urine chloride

55
Q

What drug should you check for before giving ACEi and why?

A

Thiaizide or loop diuretics b/c of potential first dose hTN

56
Q

How do you calculate net filtration pressure?

A

(Hydrostatic of Glomerulus - Hydrostatic of Bowman) - (Oncotic of Glomerulus - Oncotic of Bowman)

57
Q

A man treated for sinusitis with ampicillin later presents with oliguria, rash, fever. What does he have?

A

AIN

58
Q

What cells are Epo released from?

A

Interstitial cells of peritubular capillary bed

59
Q

Why does the BUN rise in prerenal AKI?

A

Because kidneys reabsorb H2O, Na, and BUN to raise volume

60
Q

How do you prevent Ca stones from precipitating?

A

By adding citrate

61
Q

What does ANCA stand for?

A

Anti neutrophil cytoplasmic antibodies

62
Q

What kidney disease is MPLAR-2 associated with?

A

Membranous nephropathy

(Pharm) 01 (23 decks)

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