UWORLD RENAL/GI Path Flashcards
ALDO vs ADH where do they work?
CORTICAL vs MEDULLARY collecting duct
Damage to the left 12th rib will injury what organ?
left Kidney
Part of kidney impermeable to water?
TAL
Urine PH, HCO3, and H2PO4 in DKA vs Normal?
low (excrete H ions), low (conserve bicarb), high (excrete titrable acids)
Where in the kidney is most of the H2O resorbed?
PCT
Pt given dose of this hormone that decreases fractional excretion of urea.
ADH - increases H2O and Urea absorption in Medullary Collecting Duct
Fuction of ALDO in cortical collecting duct?
Water and Salt IN
K and H out
Where in the kidney has the highest osmolarity? Lowest osmolarity?
Loop of henle (most concentrated)
DCT (least concentrated)
Artery that supplies upper ureter?
Renal artery
Vessels Lateral to ureters?
internal iliac
Hernia below inguinal ligament, and lateral to pubic tubercle?
Medial to this structure?
Femoral hernia. Medial to femooral vessels
Hernia in male infants? Older men? Female?
Indirect ingiunal, direct ingiunal, femoral
Woman with a hernia. Protrudes through?
Femoral hernia. Femoral ring
Hernia in old man. Caused by weakness of?
Direct inguinal. Due to weakness of transversalis fascia
Hernia in male infant. Due to?
failure of internal inguinal ring to close and persistent processus vaginalis
Persistant processes vaginalis causeswhat 2 pathologies?
Hydrocele and indirect inguinal hernia
to what lymph nodes?
Prostate
Bladder
internal iliac nodes
internal(superior part) AND external iliac (inferior part) nodes
Lactose intolerant pt given lactose. Changes to stool pH, Breath hydrogen, stool osmotic gap?
decreases (bacteria ferment lactose, increasing hydrogen),
increases (bacteria ferments lactose, increasing hydrogen),
increases (more stuff in stool, higher gap)
AIDS pt with small, vesicular ulceration in ESO. Microscopic findings?
HSV. Eosinophilic intranuclear inclusions (Cowdry type A)
AIDS pt wit linear ulcerations. Microscopic findings?
CMV. Intranuclear and cytoplasmic inclusions.
Pt with gets severe hypotension in abdominal aorta during surgery. Parts of colon affected most?
Watershed areas: splenic flexure and distal sigmoid colon.
Diffuse ESO spasms present like?
unstable angina
Pt who has painless hematuria might have had exposure to?
Bladder cancer (transitional cell cancer) Rubber, textiles, leather.
Clip renal artery. Cell that hypertrophy are of what type? Located?
JG cells (SMCs) hypertrophy to secrete renin. Located on AA.
Why Ca-Oxylate urinary stones in Crohn’s?
Normally, in bowl Ca binds oxylate and is excreted. In Crohn’s Ca binds unabsorbed lipids, oxylate is free to re-enter body and bind Ca, forming stones
H. Pylori. Where are the ulcers?
duodenum
Histo of ESO shows basal cell hypertrophy and intraepithelial eosinophils.
Reflex esophagitis
Pt with diarrhea with mucus. Mass in sigmoid colon and HypoK.
Can progress to?
Villous adenomas. Progresses to adenoCA.
Pt on NSAID. Type of renal injury?
Papillary necrosis or chronic interstitial nephritis.
Colon adencoCA mostly found where?
Rectosigmoid Colon
AIDs patient. Colonoscopy shows multiple ulcers and mucosal erosions. Bisopsy shows?
CMV. (inclusion bodies)
Pt with diarrhea. Colon biposy shows basophilic clusters on surface of interstinal mucosal cells.
Cryptosporidium
Colonoscopy shows discrete, flash-shaped ulcerative lesions with trophozoites?
Entamoeba histolytica
Colon biopsy shows crypt abcesses?
UC
IgA nephropathy vs Henoch-Schonlein purpura?
HS is IgA neuropathy + extrarenal symptoms (skin lesions, abdominal pain)
Uric acid crystal precipitate where?
Collecting duct because of increased acidity
Cresentic glomeruli with no immunoglobulin of complement deposits?
ANCA (wegners, microscopic polyangiitis)
Sign of right sided colon cancer?
Fatigue, weight loss, anemia (bleeding present but not grossly seen)
Pt with signet ring CA of stomach. Gross Appearance?
Linitis plastica (thick and leathery)
Pt with ballooning and vacuolar degeneration of proximal tubles. Anion gap metabolic acidosis. Presence of Ca-Oxylate crystals?
Ethylene glycol ingestion.
With with heart burn, fingertip ulceration and multiple telangiectasias. Mechanism of heart burn?
CREST. Fibrous replacement of muscularis
Deposits in Post-strep GN?
C3
Biliary tract infection - sequalae?
Brown stones
5 month old with failure to thrive. Bulky and greasy stool. Histo shows?
Abetalipoproteinemia. Histo will show abnormal accumulation of fat in enterocytes.
Ischemic ATN - what part of kidney affected?
PCT
Parenteral nutrition increases chance for?
Biliary stones from loos of enteral stimulation (stasis)
Hypertension - affect on kidney?
Arterial intimal fibroplasia and hyalinization
Teen who dies of overwhelming repiratory infection. Suffered multiple pulmonary infections. Diagnosed with steatorrhea. Abnormality of the pancreas?
Cystic fibrosis. Mucus plugs
Pt given ampicilin gets fever, maculopapular skin rash, and oliguria. Where in kidney affected?
Acute interstitial nephritis from drugs. (affects interstitium)
Recurrent nephrolithaisis in a young pt. What inborn error of metabolism?
Cystinuria. Defect in transporter of Cystine/Arginine/ornithine/lysine. Leads to Cysturia (Aminoaciduria) and cystine stones.
Overactivation of these enzymes makes one more susceptible to pro-carcinogens?
Microsomal monoxygenase (P450s) - convert pro-carcinogens to carcinogens
Likely outcome of HepB? hepC?
Complete resolution vs stable chronic hepatitis
Stones that precipitate in acid?
Base?
Acid - Uric acid, cystine, Ca-Oxylate
Base - struvite and ca-phosphate
BPH - changes to renal tissue?
hydronephrosis causes atrophy and scarring of renal tissue
External hemorrhoids - location?
Posterior to midline, distal to dentate line
Pt with elongation of lamina propria papillae, eosinophils and neutrophils on ESO biopsy
GERD
Acidophilic bodies in hepatocytes in hepatitis suggest?
Councilman bodies - apoptosis
crohn’s vs UC. helper T cells?
Th1 vs Th2
Systemic mastocytosis (lots of mast cells) - effect on gastric secretions?
Mast cells - more histamine - more secretions
Cresentic GN - crescents consist of?
monocytes, macrophages and fibrin
Diarrhea with leukocytes but mostly neurophils?
Salmonella
Diarrhea with leukocytes and eosinophils?
Parasites by NOT giardia or entameba
Site of lipid digestion vs absorption?
Ileum vs Jejunum
Ulcer in distal duodenum?
Zollinger-Elision syndrome. Grastrin secreting tumor
OTC drug that can decrease chance for Colon cancer?
Aspirin. COX-2 linked with colon cancer
Pt with mast cells in small bowl mucosa. Findings?
Mast cells = histamine = gastric hypersecretion
Newborn with imperforate anus. Other findings?
Vesiculocolic fistula (urinary tract infections)
Pancreatic pseudocyst - cause? consists of?
Actue pancreatistis. Granulation tissue and cirrhosis
Lesser omentum?
Hepatogastric and hepatoduodenal ligament
Location where ulcer is least likely to be malignant?
Duodenum
Secretory diarrhea caused by what type of growth?
Tubular or villous polyp
Absorbed in Ileum?
Bile/B12
Live Polio vaccine. How is it given? Benefit?
Applied to mucosal surface. More anti-IgA formation than injected virus
Pt with absense of segment of small bowel, with distal ileum winding around vascular stalk. Cause?
Vascular occlusion “apple peel”
Infections that Increase Brown stone formation? Through what enzyme?
E coli, Ascaris lumbricodies, Opisthorchis sinesis
Danger of hydatid cyst?
Echinococcus granulosus. Can cause anaphylaxis
microvesicular fatty change? Problem?
Mito dysfuntion so cannot break down fatty acids
Ballooning degeneration of hepatocytes seen in?
Viral hepatitis
Portal vein vs hepatic vein?
Into the liver vs out of the liver
IgG4 antibodies to Phospholipase A2 receptor?
Membranous nephropathy
