Question | Answer |
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 |