Buzz Words- Renal Word Scramble
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question | Answer |
complement levels in IgA nephropathy? | NORMAL C3 and C4 key to DDx from Post-infectious GN in which complement levels are LOW (also IgA occurs <b>days<b/> post infection; Post Infectious GN occurs weeks later) |
oval fat bodies may be sign of? associated with what type of syndrome? | hyperlipidemia; nephrotic syndrome |
classic presentation: proteinuria (foamy urine), hypoalbuminemia, edema, hyperlipidemia | nephrotic syndrome |
likely to present in children with acute onset; associated with lymphomas*; caused by effacement of podocytes | minimal change disease |
most common cause of nephrotic syndrome in african americans? | FSGS |
nephrotic syndrome most commonly associated with HIV/AIDS | FSGS |
which nephrotic syndrome is an exception in that it is due to an antibody/antigen complex? | membranous glomerulonephropathy |
which syndrome is it crucial to perform age appropriate cancer screening? | membranous GN |
kimmel steil- wilson nodules | diabetic glomerulosclerosis or as Bri says... Jimmy Kimmel has diabetes (but he doesn't?) |
classic presentation: hematuria, oliguria, HTN (+ RBC casts and low protein) | nephritic syndrome |
crescentic lesions (general) | nephritic syndrome |
#1 cause of GN worldwide | IgA nephropathy |
associated with Henoch Schonlein Purpura | IgA nephropathy |
IgA nephropathy is associated to occur after which two broad kind of infections? | URI and GI infections |
Post-infectious is associated to occur after what kind of infection usually? | Strep Pharyngitis |
which nephritic syndrome presents with low C3 and low C4? | Post infectious GN |
which nephritic syndrome presents with low C3 and normal C4? | Membranoproliferative GN |
which nephritic syndrome presents with normal C3 and normal C4? | IgA nephropathy |
dry mouth, dry eyes; positive anti-ro and anti-la antibodies | Sjogrens disease (commonly associated with membranoproliferative GN) |
Anti-GBM only kidney involvement- more likely in? | older women |
Anti-GBM- goodpasture (with kidney and lung involvement)-- more likely in? | young men with history of smoking (may present with hemoptysis |
nephritic syndrome with lung, kidney AND SINUS involvement | Wegener's granulomatosis (a type of small vessel vasculitis); sinus involvement may include- epistaxis or recurrent sinusitis must Ddx from Goodpastures (kidney and lung only) |
c-ANCA (+) AND anti-PR3 | Wegener's |
hansel stain (eosinophilia) | acute interstitial nephritis |
sterile pyuria and HTN | chronic interstitial nephritis |
brown muddy casts | acute tubular necrosis |
tubulointerstitial disease associated with fanconi's syndrome | renal tubular acidosis (type II) |
acquired fanconi's syndrome | multiple myeloma |
tamm-horsfall mucoprotein | cast nephropathy assoc. with multiple myeloma |
congo red stain with beta pleats | amyloid assoc. with multiple myeloma |
Benz-jones proteins | multiple myeloma |
onion skin lesions (hyperplastic arteriolitis) | malignant HTN |
fibrotic intimal thickening (luminal narrowing) | HTN nephrosclerosis (benign) |
high levels of renin in elevated renal vein | renal artery stenosis |
string of beads on angiogram | fibromuscular dysplasia |
schistocyes in peripheral blood smear | microangiopathic thrombotic disease (also seen in pentad of symptoms with TTP) |
classic presentation: pentad-- fever, neurologic symptoms, microangio hem. anemia, thrombocytopenia, ARF | TTP |
ADAMTS13 and vWF | TTP |
WAGR syndrome + WT1/WT2 mutations | nephroblastoma (wilm's) |
most common renal tumor of infancy | congential mesoblastic nephroma |
most common renal tubular epithelium neoplasm | renal papillary adenoma |
mahogany brown; stellate central scar | renal oncocytomas |
LM: mix of adipose, smooth muscle, blood vessels | angiomyolipoma (duh look at the word.. angio-- vessel, myo-- muscle, lipo--fat) |
VHL gene mutation leading to high levels of VEGF | RCC (more specfically in clear cell) mutation occurs in over 90%!!! |
triad of sym: flank pain, palpable mass, hematuria | RCC |
most common RCC | clear cell- conventional |
C-met gene | Papillary RCC (also assoc. with RF/ "dialysis kidney") |
renal tumor assoc. with sickle cell (african am and mediterranean) | renal medullary carcinoma very rare, very aggressive |
urothelial invasion of the bladder | collecting duct carcinoma (worst prognosis of typical RCC subtypes) |
known to invade the renal vein and IVC | RCC |
dilation of renal pelvis and calyces & atrophy | obstructive uropathy |
neoplasm associated with urachal cysts | adenocarcinoma |
soft tan broad mucosal plaques | malacoplakia |
foamy macrophage, multinucleated cells with granular PAS positive | malacoplakia (note: amyloid is PAS negative) |
michaelis gutmann bodies | malacoplakia |
developmental anomoly associated with Trisomy 18 | horseshoe kidney |
oligohydraminos and Potter's sequence (fatal condition) | bilateral renal agenesis **TOL said to know** (potters- flat nose, low set ears, recessed chin) |
cobblestone gross appearance kidney | ADPKD |
development path associated with berry aneurysms | ADPKD |
develpment path associated with hepatic fibrosis | ARPKD |
clinical triad: abnormal abdominal musculature, UT anomalies, bilateral cryptorchidism | prune belly syndrome |
cobra head appearance on IVU | ureterocele |
hallmark of costovertebral angle tenderness | ureteral calcuil |
WBC casts in UA | pyelonephritis |
Balanitis is commonly associated with? | Phimosis |
hallmark of perineal discomfort and fever | bacterial prostatitis |
bladder pain relieved by voiding | interstitial cystitis |
glomerulations-- submucosal hemorrhage | interstitial cystitis |
christmass tree bladder | bladder diverticuli (neurogenic) |
tender, enlarged epididymis AND assoc with arthritis | epididymitis |
clinical triad: mass, hematuria, pain | RCC (kidney) |
requires Lasix for Dx | UPJ obstruction |
one exception of nephrotic diseases in which renal biopsy is NOT indicated | MCD in children |
No finding on LM and IF; podocyte effacement on EM | Minimal change disease note: FSGS may also show similar findings if focal segment is missed on biopsy (IF will also show collapse of capillaries and increase in ECM) |
the only nephrotic with immune complex deposits | membranous glomerulopathy (this is a repeat but was mentioned with both thomas and leonard) |
LM: thick capillary walls with silver stain spikes IF: granular stainging EM: subepithelial immune deposits* | membranous glomerulopathy (remember only nephrotic with immune complexes) |
FSGS must be DDx with? | MCD |
leading cause of ESRD; often presents with small vessel disease and microalbumin | Diabetic GS |
LM: thickening of BM region AND proliferation/expansion of mesangium | Diabetic GS (DDx with FSGS- this occurs only in the glomerular capillary) |
hallmark of back pain with lytic lesions on xray | multiple myeloma (associated with Amyloid nephropathy) |
congo red stain and apple green bifringement with polarized light | amyloid nephropathy (remember it is PAS negative! unlike Diabetic GS) |
LM: proliferative GN IF: "lumpy-bumpy" deposits EM: subepithelial "humps" | Acute post infectious GN |
EM: immune complex deposits subendothelium and mesangial hypercellularity | Type I MPGN |
"tram tracking" of GBM on silverstain | Type I MPGN |
deposit of complement and ribbon like increase in GBM density | Type II MPGN |
associated with C3 nephritic factor (IgG autoAb) | Type II MPGN |
common presentation in female african americans with SLE | Lupus nephritis (think malar rash with nephritic symptoms) |
Morphologic: thick capillary loops--"wire loops" | Lupus nephritis |
ANA (+) with anti-dsDNA antibodies | Lupus nephritis Dx |
associated with autoantibody against IV collagen | anti-GBM GN |
IF: smooth diffuse "linear" IgG staining | Anti-GBM GN (as opposed to "lumpy" with acute post infectious and "granular" with membranous glomerulopathy) |
prominent hyaline sclerosis in renal arterioles | diabetic GS (FSGS also shows sclerotic changes but only in the GC not the arterioles) |
most common cause of nephrotic syndrome in kiddos | minimal change disease |
most common cause of nephrotic syndrome in US caucasian/asian adults? african american? | membranous glomerulopathy; FSGS |
glomerular disease with favorable prognosis with corticosteroid Tx | Minimal change disease |
classic triphasic histopath of nephroblasomta | blastema (primitive tubules), epthielium (abortive tubules), stroma (spindle cells) |
three syndromes assoc with nephroblasomta | beckwith-Wiedeman, *WAGR syndrome*, denys drash WAGR- genital anomaly retardation |
tumor characterized by spindled cells resembling immature tissue; metastases rare | congential mesoblastic nephroma (Ddx: wilms tumor-- commonly metastases to lung) |
most common renal tubular epithelium neoplasm | renal papillary adenoma |
renal papillary adenoma commonly associated with what? | acquired cystic renal disease |
rank in order of worst prognosis to best clear cell RCC, Papillary RCC, Chomophobe RCC, collecting duct RCC | collecting duct (worst)-->clear cell--> papillary-->Chomophobe (Best) |
carcinoma associated with "carcinogenic field effect" and presence of mulifocal neoplasms | renal urothelial carcinomas |
commonly associated with hepatic fibrosis and portal hypertension | ARPKD |
primary genetic abnormality PKD1 or PKD2; what do these encode? | ADPKD; encode polycystin |
primary genetic abnormality PKHD1; what does this encode? | ARPKD; encodes fibrocystin (think ARPKD-- hepatic FIBROSIS (hard liver=H in PK*H*D1) |
acquired condition which may be hemorrhagic and confused with cystic RCC** | simple renal cyst*** must do microscopic evaluation to Dx -- will see thin walled uniloculated in simple renal cysts |
degenerative kidney, bumpy shrunken gross appearance leading to ESRD and dialysis | acquired renal cystic disease |
Abx induced acute interstitial nephritis clinical triad: | fever, rash, eosinophilia |
high urine glucose and normal serum glucose | chronic interstitial nephritis |
characterized by clinical presentation of acidosis and hyperkalemia from prolonged hypotension (septic shock) | acute tubular necrosis (think brown muddy casts) |
renal tubular acidosis with hyperkalemia, hyperchloremic met. acidosis | type 4 - high serum K (distal) |
renal tubular acidosis with hypokalemia and acidosis | type 1- low serum k often presents in kids as failure to thrive and renal stones |
low back pain, male age>50, african american hepatosplenomegaly, cardiomyopathy | multiple myeloma |
most common cause of Multiple myeloma | cast nephropathy (*tamm-horsfall mucoprotein) |
DDX between RTA and Multiple myeloma | Anion gap RTA (normal AG) Multiple myeloma (low AG) |
which disease is assoc with acquired fanconis ? which is caused by fancois synd? | acquired-- multiple myeloma caused by fanconis syndrome-- type II renal tubular acidosis (also pharm plug-- tetracyclines that have expired are linked with acquired fanconis) |
potassium disorder; hypertensive, low renin, low aldosterone | Liddles-- hypokalemic |
K disorder; normotensive, HIGH urine Ca | Bartters-- hypokalmeic |
K disorder; normotensive, NORMAL urine Ca and low serum Mg | Gitelmans-- hypokalemic |
K disorder; HTN, low renin activity hyperK withOUT renal failure | Gordans (pseduohyopaldosteronism) aldosterone resistant-- impaired renal excretion |
EKG: ST depression, decreased amplitude, U WAVE* | hypokalemia |
EKG: Tinted T waves, no P wave, wide QRS | hyperkalemia |
if urine Osm > serum Osm Dx likely? | SIADH |
what is the lethal dose of ASA? | 500 mg/dl |
toxic dose of ASA? | 150 mg/kg or >40 mg/dL |
3 Tx options of ASA OD | charcoal, sodium bicarb, hemodiaylsis (if neurologic symptoms) |
acid base disturbances seen with ASA OD | resp alkalosis and metabolic acidosis (SEPERATE and INDEPENDENT) |
SSRIs (sertraline, fluoxitine, citalopram) lead to what common disorder in older people? | hyponatremia |
most common cause of staghorn calculi | UPJ obstruction |
Created by:
caldwekl
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