Term
Clear Cell Renal Cell Carcinoma
- signs and symptoms
- associated genetic disorder and signs |
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Definition
| Smoker, flank pain, hematuria, polycyhtemia (EPO), HTN (renin). Von Hippel Lindau diagnosis if present with multi organ system tumors/angiomas/hemangiomas etc) |
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Term
| Cancer caused by alflatoxin exposure |
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Definition
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Term
| Leukemia and chemotherapy cause what type of kidney stones? |
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Definition
| Uric acid (due to high cell destruction and chemo) |
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Term
| Struvite stones are composed of what, and are a sign of kidney infection by what bacteria? |
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Definition
| Magnesium ammonium phosphate, Proteus species (Mg ammonium phosphate can progress to staghorn calculi) |
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Term
| This organism splits what? |
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Definition
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Term
| PAINLESS hematuria is most likely what? |
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Definition
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Term
| Exposure to what toxin is associated with this cancer? |
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Definition
| Naphthylamine (in cigarette smoke) |
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Term
Alport syndrome
- 3 resulting disorders
- type of collagen defect |
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Definition
- ears (deafness), eyes (ocular), nerves
- type 4 collagen |
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Term
Amyloidosis
- sign on renal biopsy
- associated diseases (2) |
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Definition
-Apple green birefringence
- Multiple myeloma and rheumatic arthritis |
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Term
| IgA renal deposition with arthritis, abdominal pain and rash. Diagnosis? |
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Definition
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Term
| Most common renal disease in HIV patients? |
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Definition
| Focal segmental glomerulosclerosis (begins focal then spreads segmental) |
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Term
| Goodpasture's syndrome, Wegener's granulomatosis, and microscopic polyarteritis can all lead to what? |
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Definition
| RPG = rapidly progressive glomerulosclerosis |
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Term
Subarachnoid hemorrhage/berry aneurysm is associated with what renal diagnosis?
-Name the most common artery involved |
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Definition
-Renal Cell Carcinoma
- anterior communicating artery of circle of Willis |
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Term
Name the blood supply for
- epidural hematoma
- subdural hematoma
-subarachnoid hemorrhage |
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Definition
Epidural hematoma - middle meningeal artery (branch of maxillary artery. Between the dura and skull, so between = middle
Subdural - Bridging veins (slow developing hematoma over time
Subarachnoid - (berry aneurysm), anterior communicating artery |
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Term
| What disease starts with hemoptysis and ends in renal failure, crescentric RPG, c-ANCA and p-ANCA negative? |
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Definition
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Term
| c-ANCA and p-ANCA results for Goodpasture's, microscopic polyarteritis, and Wegener's granulomatosis |
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Definition
All can lead to RPG
Goodpasture's - negative for both
Microscopic poly is p-ANCA positive
Wegener's is c-ANCA positive |
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Term
1. Only radiolucent renal stone (can't be seen on radiographic imagine)
2. Most common renal stone
3. Stone associated with recurrent UTI's |
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Definition
1. Uric acid stones
2. Calcium oxalate stone
3. magnesium ammonium phosphate (struvite stones) - proteus mirabilis or Klebsiella |
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Term
Cystinuria
- inheritance
- symptoms
- renal presentation |
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Definition
- homozygous recessive (both parents must have cystinuria to pass onto child)
- flank pain, dark urine
- cystine stones (rarest kind of nephrolithiasis) due to inability of the kidney to handle cystine |
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Term
| paraneoplastic syndrome associated with small cell carcinoma |
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Definition
| SIADH (ADH secreting cancer. High urine sodium, low serum sodium) |
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Term
Small cell lung cancer secretes ____ and should be treated with what drug, and what MOA?.
Squamous cell lung cancer secretes ____. |
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Definition
ADH ---> high urine sodium, low serum sodium. Treat SIADH with Demeclocycline. MOA is inhibition of vasopressin receptors (V2) on the kidney/collecting duct.
PTH-like peptide --> hypercalcemia and hypophosphatemia |
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Term
| Succinylcholine and inhalation anesthetics for general anesthesia may cause ______(rare) and should be treated with ____. |
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Definition
| Malignant hyperthermia - treat with Dantroline. |
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Term
| Drug of choice for central diabetes insipidus |
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Definition
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Term
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Definition
| 5-HT3 antagonist. Anti-emetic for post op or chemo patients |
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Term
| How does hyperkalemia present on an EKG? |
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Definition
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Term
| Patient on AXB's, sudden BUN:Cr < 15, hyperkalemia, Urine osmolality is low (cannot concentrate urine), brown tubular casts in urine. Diagnosis? |
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Definition
| Acute tubular necrosis (ATN) - i.e intrinsic renal failure. Urea is normally reabsorbed while Cr is not. Tubular necrosis prevents reabsorbing urea, therefore ratio decreases. |
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Term
Name the signs and symptoms and etiology of each
1. Urge incontinence
2. Overflow incontinence
3. Outflow obstruction
4. Stress incontinence |
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Definition
1. Urge: detrusor hyper-reflexia regardless of bladder urine volume. Complains of frequency, urge, nocturia, repeated incontinence throughout the day.
2. Overflow: hypotonic bladder/weak contractions. Bladder distension, retention without complains of bladder fullness. Medications inhibiting AcH, fecal impaction.
3. Patient with history of recurrent UTI's causing urethral scaring
4. Stress: increased intra-abdominal pressure from coughing, laughing, exercise, resulting in incontinence. Cause is a hypermobile bladder with exertion. |
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Term
Sodium escape phenomenon in chronic Conn's (primary hyperaldosteronism) syndrome.
-Early vs. chronic disease |
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Definition
Early = serum Na+ elevated
Chronic= chronic HTN from elevated Na+ increases ANP from right atrium resulting in Na+ excretion and this serum Na+ normalization occurs. |
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Term
| MOA of statin drugs and possible side effects on the kidney. |
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Definition
MOA: inhibits HMG-CoA reductase in the liver (decreasing cholesterol synthesis).
Side effects: rhabdomyolysis. *patient with red colored urine but NO RBC's present = red is myoglobin from skeletal muscle breakdown and not hemoglobin.
- Rhabdo can lead to ATN, seen by granular casts and renal tubular cells in urine. |
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Term
| Name the category of drug that masks hypoglycemic events in diabetics, can exacerbate asthma, cause an AV block, and therefore you should prescribe with caution. |
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Definition
Beta blockers such as propranolol for HTN (since it also decreases glucose synethesis and by lowering BP it increases HR, just like a hypoglycemic event).
- beta blockers may exacerbate asthma too |
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Term
Name the diagnosis
1. Tram-tacking and mesangial cell splitting/proliferation on electron microscopy
2. Spike and dome appearance of LM |
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Definition
1. Membranoproliferative glomerulonephritis
2. Membranous glomerulonephritis |
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Term
| Chronic renal failure results in decreased vitamin D and secondary hyperparathyroidism in an attempt to increase serum calcium levels. What necrotic skin lesion may result from this accumulation of calcium and phosphate? |
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Definition
| Calciphylaxis (calcium phosphate crystals in the vasculature) |
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Term
Name the defective protein in each disease
1. Duchenne and Becker muscular dystrophy
2. Marfan's syndrome
3. Ehler's Danlos syndrome
4. Alport syndrome (hematuria, hearing loss, visual defects, nerves) |
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Definition
1. dystrophin
2. fibrillin
3. Type III collagen
4. Type IV collagen |
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Term
| What is the most common cause of nephrotic syndrome in children, and what finding will there be on light microscopy? |
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Definition
- minimal change disease
- light microscopy will show normal glomeruli (minimal change = normal appearing glomeruli) |
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Term
| Positive serum anti-ribosomal P protein antibodies (highly specific towards ___ but not towards any organ in particular) and wire looping on immunofluorescence of a renal glomerulus is indicative of what systemic disease and what resulting renal disease? |
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Definition
| Systemic lupus erythematosus (SLE)resulting in diffuse proliferative glomerulonephritis |
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Term
| Hep B, hep C, and cryoglobinemia is associated with what renal disease? |
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Definition
| Membranoproliferative glomerulonephritis type I/MPGN I(dense deposit disease) |
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Term
| MPGN II is associated the presence of what factor, which is an autoantibody for what? |
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Definition
| C3 nephritic factor which is an autoantibody for C3b complement protein, so MPGN II is associated with low C3 levels. |
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Term
| Name the components of Meltzer's Triad and what group of diseases it is associated with |
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Definition
| Triad: purpura, arthalgia, myalgia. Associated with polyclonal cryoglobulins in essential, viral, or connective tissue disease-associated cryoglobulins. |
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Term
| Male with painless gross hematuria and suprapubic/lower abdominal pain is most likely what? |
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Definition
| Bladder cancer (transitional cell carcinoma) |
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Term
These are risk factors for what?
- Travel/contact with unsanitary water conditions in Middle East and East Afria
- smoking
- aniline
- petroleum byproducts |
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Definition
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Term
| Treatment of choice for Schistosomiasis and MOA. |
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Definition
Praziquantel.
MOA - makes trematode/fluke worm permeable to Ca++ ions-->paralysis the fluke and exposes to bodies immune system |
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Term
Identify prerenal, postrenal, or intrinsic/renal failure with the following.
1. BUN:Cr >20, Uosm > 500, urine Na+ < 20 and FeNa < 1%
2. BUN:Cr <15, Uosm < 350, urine Na+ >40, FeNa > 2%
3. BUN:Cr >15, Uosm < 350, urine Na+ > 40, FeNa > 2% |
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Definition
1. prerenal (hypoperfusion of kidney/ decreased GFR)
2. intrinsic/renal
3. postrenal |
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Term
Name the cast present
1. prerenal ARF
2. ATN |
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Definition
1. hyaline casts (hyaline casts in hypoperfusion states)
2. granular casts |
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Term
| nephrotic syndrome, hypercalcemia, S3 gallop (restrictive cardiomyopathy). Diagnosis? |
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Definition
| Amyloidosis secondary to multiple myeloma or B cell lymphoma secreting amyloid light chains and depositing into organs. |
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Term
Autoantibodies in organic Lupus =
Autoantibodies in drug induced lupus = |
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Definition
1. Antinuclear antibodies (ANA)
2. anti-histone antibodies |
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Term
Chlorthalidone is a ___ diuretic acting where?
Triamterene is a ___ diuretic, like (___ and ____) acting where? |
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Definition
1. Chlorthalidone is a thiazide diuretic (only one not ending in thiazide)acting on the PCT.
2. Triamterene is a potassium sparing diuretic just like Amiloride and Spironolactone, that acts on the collecting tubules. **The K+ STAys (spironolactone, triamterene, amiloride) |
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Term
Fanconi syndrome
- hereditary
- how may it be acquired?
- which renal tubule effected?
- signs and symptoms |
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Definition
May be acquired through tetracycline byproducts
Effects PCT
Polyuria, polydypsia, dehydration |
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Term
| 4 year old with rash on the buttocks and extensor surface of legs with renal involvement. |
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Definition
| HS purpura (IgA nephropathy) |
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Term
| What is the most common cause of acute glomerulonephritis in the US that present with painless microscopic hematuria, swelling around the eyes (sodium retention) and lower extremities, all following 1-2 days after an URTI? |
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Definition
| Berger's Disease (IgA nephropathy) |
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Term
MCC of SUDDEN ONSET nephrotic syndrome in kids is?
MCC of nephrotic syndrome in adults is ___ and associated with what disease? |
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Definition
Minimal change disease in kids
FSGS in adults (HIV and heroin): HIV = African American patient |
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