kidney anomalies-renovascular disease

Question 1

most common congenital renal anomaly

Answer 1

horseshoe kidney

Question 2

3 features of Potter sequence/cause

Answer 2

flat face/low set ears
lung hypoplasia
extremity defects
due to oligohydraminos

Question 3

unilateral renal agenesis is associated with:

Answer 3

hyperfiltration and risk of renal failure later in life

Question 4

how is cystic renal dysplasia differentiated from polycystic kidney disease? (3)

Answer 4

CRD is usually unilateral, cysts are in parenchyma, cysts contain abnormal tissue (cartilage)

Question 5

AR PCKD gene

Answer 5

PKHD1 (fibrocystin)

Question 6

appearance of cysts in AR PCKD

Answer 6

radial, span from capsule or cortex

Question 7

extra-renal abnormalities in AR PCKD (1)

Answer 7

hepatic fibrosis/cysts

Question 8

3 presenting symptoms of AD PCKD

Answer 8

hypertension, hematuria, progressive renal failure

Question 9

AD PCKD gene

Answer 9

APKD1

Question 10

extra-renal abnormalities associated with AD PCKD

Answer 10

berry aneurysm
mitral valve prolapse
hepatic cysts

Question 11

m/c location of ectopic kidney, m/c complication

Answer 11

pelvis/ureter obstruction

Question 12

Pre-renal ARF

cause, BUN:Cr, FENa, Urine Osm

Answer 12

decreased renal perfusion, ratio over 15, FENa under 1%, Urine Osm over 500

Question 13

Post-renal ARF

cause, BUN:Cr, FENa, Urine Osm

Answer 13

obstruction of urine outflow, late = ratio ~ 15, FENa over 2%, Urine Osm under 500

Question 14

m/c cause of intra-renal ARF

Answer 14

acute tubular necrosis

Question 15

ATN

cause, BUN:Cr, FENa, Urine Osm

Answer 15

ischemic or nephrotoxic cause, ratio ~ 15, FENa over 2%, urine osm under 500

Question 16

characteristic finding on urine micro in ATN

Answer 16

brown, granular casts

Question 17

most affected portion of nephron in ischemic ATN

Answer 17

PCT, TAL (require most ATP)

Question 18

most affected portion in nephrotoxic ATN

Answer 18

PCT (most exposure to agent)

Question 19

most common cause of nephrotoxic ATN

Answer 19

aminoglycosides

Question 20

acid-base abnormality associated with ATN

Answer 20

anion gap metabolic acidosis with hyperkalemia

Question 21

what is AIN?

Answer 21

drug-induced hypersensitivity reaction that damages the connective tissue between tubules

Question 22

prevention of AIN

Answer 22

fever, rash and oliguria after new med started

Question 23

characteristic finding in urine for AIN

Answer 23

eosinophils

Question 24

presentation of renal papillary necrosis

Answer 24

gross hematuria and flank pain

Question 25

predisposing to renal papillary necrosis (4)

Answer 25

analgesic abuse, DM, SCD, severe pyelo

Question 26

BP that predisposes to benign nephrosclerosis

Answer 26

SBP over 140 chronically

Question 27

typical finding in benign nephrosclerosis

Answer 27

small kidneys bilateral, hyaline arteriolosclerosis

Question 28

BP that predisposes to malignant nephrosclerosis

Answer 28

DBP over 130

Question 29

typical findings in malignant nephrosclerosis (3)

Answer 29

fibrinoid necrosis, onion skinning, flea bitten

Question 30

2 etiologies of renovascular hypertension

Answer 30

renal artery stenosis, fibromuscular dysplasia

Question 31

what is the typical patient with fibromuscular dysplasia?

Answer 31

young woman