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Pathology: Renal

What is the likely origin of the glomerular disorder when the following are seen with Immunofluorescence stain: 1. linear pattern 2. granular pattern 1. antibodies formed against basement membrane (i.e. Goodpastures) 2. immunocomplex deposition in glomerulus (type III hypersensitivity)
What is the cause of edema in: 1. Nephritic syndrome 2. Nephrotic syndrome 1. Na+ retention 2. hypoalbuminemia
How much protein loss distinguishes nephrotic from nephritic? nephrotic is > 3.5g/day
What is the underlying cause of glomerular injury: 1. Nephritic syndrome 2. Nephrotic syndrome 1. neutrophils 2. cytokines
Diagnosis? 1. WBC cast on U/A 2. RBC cast on U/A 3. Granular "muddy brown" cast on U/A 1. acute pyelonephritis 2. glomerulonephritis 3. Acute tubular necrosis
Most common cause of Acute Tubular Necrosis prerenal azotemia due to hypovolemia
How does chronic aspirin use lead to tubulointerstitial nephritis? aspirin inhibits PGE2, the vasodilator of the afferent arteriole. Afferent arteries constrict and ATII unopposed to constrict the efferent arteriole. Lose blood supply to renal medulla → necrosis
1. Which finding on electron microscopy indicates nephrotic syndrome? 2. Which cells make the glomerular basement membrane? 3. What molecule gives the basement membrane a negative charge? 1. fusion of podocytes 2. visceral podocytes 3. heparan sulfate
1. Most common glomerulonephritis? 2. When does it occur? 1. IgA glomerulonephritis (Berger's disease) 2. a few days after a GI, upper respiratory or urinary infection in children
Most common cause of nephrotic syndrome: 1. in children 2. in adults 1. minimal change disease 2. focal segmental glomerulonephritis
Renal adenocarinoma is known to ectopically secrete: 1. EPO leads to polycythemia 2. PTH like peptide leads to hypercalcemia
Huge, palpable flank mass and hematuria in a child Wilm's tumor
1. initial laboratory finding of diabetic glomerulopathy? 2. Which tests allows this detection? 1. microalbuminuria 2. microalbuminuria dipstick
What is edema due to in: 1. Nephritic syndrome 2. Nephrotic syndrome 1. Na+ retention 2. hypoalbuminemia
Most common subtype of glomerular disease in systemic lupus erythematosus Diffuse proliferative glomerulonephritis
1. Glomerular disease associated with "tram track" appearance 2. Glomerular disease associated with C3 nephritic factor 1. Type I MPGN 2. Type II MPGN
How do you determine if respiratory adequate compensation has occurred in response to metabolic acidosis? Winter's formula Pco2 = 1.5(HCO3-) + 8 +/- 2
1. How does acidosis effect K+ concentration? 2. How does hyperkalemia effect H+ concentration? 1. Acidosis → K+ release from cells (hyperkalemia) 2. Hyperkalemia → H+ release from cells (acidosis)
What acid/base abnormalities do the following cause: 1. hyperaldosteronism 2. diuretics 3. uremia 4. methanol 5. diarrhea 5. renal tubule acidosis 1. metabolic alkalosis 2. metabolic alkalosis 3. ↑ anion gap metabolic acidosis 4. ↑ anion gap metabolic acidosis 5. normal anion gap metabolic acidosis 6. normal anion gap metabolic acidosis
1. Congo red stain with apple-green birefringence 2. common cause of ammonium magnesium phosphate kidney stones 3. how does hyperaldosteronism contribute to acid/base pathology? 1. amyloidosis 2. infection with urease positive bugs 3. aldosterone → ↑K+ & H+ secretion → metabolic alkalosis
What is the inheritance pattern of polycystic kidney disease in: 1. adults 2. children 1. autosomal dominant 2. autosomal recessive
Cause of Renal osteodystrophy 1. osteoporosis: chronic metabolic acidosis → loss of bone mass to buffer acids 2. osteomalacia: hypovitaminosis D → ↓mineralization of bone
1. child with aniridia, abdominal mass. 2. What is hypertension due to in polycystic kidney disease 1. Wilm's tumor 2. ↑ renin production
1. Subepithelial immunocomplex deposits with granular IF staining. 2. Mesangial immunocomplex deposits with granular IF staining 3. Subendothlial immunocomplex deposits with granular IF staining and "wire looping" of capillaries. 1. Post-streptococcal GN 2. IgA glomerulopathy 3. Diffuse proliferative GN; caused by SLE
1. Hepatitis B virus, silver stains show "spike and dome" pattern. 2. Most common causes (2) of acute tubular necrosis? 1. Diffuse membranous glomerulopathy 2. ischemic injury and toxic injury
1. Fibrinoid necrosis. 2. Nodular glomerulosclerosis. 3. Hyperplastic arteriosclerosis. 4. Hyaline arteriosclerosis. 1. Malignant hypertension 2. Diabetes 3. Malignant hypertension 4. Benign, long-standing hypertension
Treatment for: 1. Goodpastures syndrome? 2. Diffuse proliferative GN 3. Minimal change disease 4. IgA glomerulonephropathy 1. plasmaphoresis 2. corticosteroids + cyclophosphamide 3. corticosteroids 4. corticosteroids
1. Unilateral enlarged, cystic kidney. 2. Hemoptysis, hematuria, sinusitis 1. Renal dysplasia 2. Wegener's (affects both upper & lower respiratory tract; Goodpastures only effects lower)
Where in the kidney tubule do cysts appear in: 1. Autosomal dominant Polycystic Kidney Disease 2. Autosomal recessive Polycystic Kidney Disease 1. proximal convoluted tubule 2. collecting duct
ADPKD is associated with a defect on chromosome __. chromosoome 16
1. Male with bilateral hydronephrosis. DDx? 2. With which disorder is it common to see eosinophils in the urine? 1. BPH 2. interstitial nephritis (usually drug induced)
1. Associated with squamous cell bladder cancer in the Middle East 2. Only two glomerulonephritis disorders associated with subendothelial deposits 1. Schistosomiasis 2. MPGN, Diffuse proliferative
What is the defect in Alport syndrome? type IV collagen (basement membrane) defect
Rapidly progressive glomerulonephritis with: 1. p-ANCA 2. c-ANCA 1. Microscopic polyangiitis 2. Wegener's granulomatosis
Most common nephrotic syndrome in HIV patient Focal segmental glomerulosclerosis
What is the plasma calcium level of most individuals with kidney stones? normocalcemia; kidney stones are usually idiopathic
Staghorn calculi in adult Ammonium magnesium phosphate from urease-positive bug (proteus, Klebsiella)
Which kidney stone is radiolucent (not seen on X-ray)? Uric acid
Which renal pathology are the following associated with: 1. penicillin 2. aminoglycosides 3. acetaminophen 4. sulfonamides 5. shock 6. sickle cell disease 1. interstitial nephritis (drug acts as hapten) 2. acute tubular necrosis 3. renal papillary necrosis 4. interstitial nephritis 5. acute tubular necrosis 6. renal papillary necrosis
Created by: amichael87