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CDB PEARLS COPY > Nephro > Flashcards

Nephro Flashcards

1
Q

Most common cause of death in SLE

A

Lupus nephritis

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2
Q

SLE peak incidence

A

15-45

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3
Q

Male vs female: SLE

A

Female

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4
Q

Male vs female: Lupus nephritis

A

Equal

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5
Q

Children vs adults: Lupus nephritis is worse

A

Children

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6
Q

Male vs female : Lupus nephritis is worse

A

Male

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7
Q

Hallmark of lupus nephritis

A

Deposition of circulating immune complexes and in situ formation of others

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8
Q

Subendothelial vs subepthelial: Circulating immune complexes

A

Subendothelial (and mesangial)

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9
Q

Subendothelial vs subepthelial: Complexes formed in situ

A

Subepithelial

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10
Q

Subendothelial deposits in SLE nephritis form

A

Wireloops

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11
Q

Mgt of SLE: Induction/emergency

A

Methylprednisolone

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12
Q

Mgt of SLE: Maintenance

A

Prednisone

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13
Q

Most common drugs used in the mgt of SLE (4)

A

1) Steroids
2) Cyclophosphamide
3) Mycophenolate mofetil
4) Azathioprine

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14
Q

Drug for SLE that causes hemorrhagic cystitis

A

Cyclophosphamide

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15
Q

Pathognomonic lesion of DM nephropathy

A

Kimmelsteil-Wilson Lesion

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16
Q

% of Type 2 DM that already have nephropathy when diagnosed

A

20%

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17
Q

30-40% of Type 2 DM develop diabetic nephropathy within __years of diagnosis

A

10

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18
Q

When microalbuminuria is observed in 40% Type 1 DM patients

A

Next 5-10 years of disease

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19
Q

Normal urine protein

A

150 mg/day

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20
Q

Microalbuminuria

A

150-300 mg/day

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21
Q

Macroalbuminuria

A

> 300 mg/day

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22
Q

BP ctrl recommended for DM

A

Less than 130/80 mmHg

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23
Q

First line of therapy for all patients with diabetes and htn

A

ACEI

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24
Q

Alternative to ACEI in treatment of Htn in pxs with DM and Htn who also have asthma exacerbations

A

ARB

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25
Q

Most important and commone type of tubulointerstitial inflammation

A

Acute pyelonephritis

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26
Q

Most common organism obtained in urine culture of patients with pyelonephritis

A

E. coli

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27
Q

2 routes in the devt of pyelonephritis

A

1) Ascending

2) Hematogenous

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28
Q

Most common route in the devt of pyelonephritis

A

Ascending

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29
Q

Important morphologic hallmark of acute pyelonephritis (3)

A

1) Patchy interstitial suppurative inflamm
2) Intralobular aggregates of neutrophils
3) Tubular necrosis

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30
Q

Pyelonephritis: Caseous necrosis

A

Tuberculous

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31
Q

Pyelonephritis: Proteus mirabilis

A

Xanthogranulomatous pyelonephritis

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32
Q

Drug that can cause tubulointerstitial nephritis via interstitial immunologic reaction

A

Methicillin

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33
Q

Form of adult polycystic kidney disease associated with polycystic liver disese

A

Juvenile

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34
Q

Syndrome: 1) Hemangioblastoma or hemangioma of cerebellum, brain stem or retina

A

Von Hippel-Lindau

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35
Q

Internist’s tumor

A

Renal cell CA

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36
Q

90-95% of renal neoplasms arise from

A

Kidney

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37
Q

Response of renal cell CA to radio and chemotherapy

A

Resistant

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38
Q

4 hereditary syndromes associated with renal cell CA

A

1) VHL
2) HPRC
3) FRO
4) HRC

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39
Q

All (>50%) glomeruli involved

A

Diffuse

40
Q

Proportion (less than 50%) of glomeruli affected

A

Focal

41
Q

Entire glomerulus involved

A

Global

42
Q

Portion of glomerulus involved

A

Segmental

43
Q

Reduction of GFR to __% heralds progression to end stage renal failure

A

30-50%

44
Q

2 major histologic conditions in progressive glomerular disease

A

1) FSGS

2) Tubulointerstitial damage

45
Q

APGN: Prototypical exogenous pattern

A

PSGN

46
Q

APGN: Prototypical endogenous pattern

A

SLE

47
Q

Organism that causes rheumatic fever and PSGN

A

GABHS

48
Q

PSGN is most frequent in this age group

A

6-10 y/o

49
Q

Etiopathogenesis of PSGN

A

Deposition of ICs

50
Q

PSGN develops ____ days/weeks after strepthroat infection

A

5-21 days or ~10 days

51
Q

PSGN develops ____ days/weeks after impetigo

A

4-6 weeks

52
Q

Protein responsible for tropism to heart

A

M protein

53
Q

Histologic morphology of PSGN

A

Humps (electron dense deposits)

54
Q

__% of children with PSGN recover spontaneously

A

95

55
Q

RPGN types

A

I, II, III

56
Q

Type I RPGN causes

A

Goodpasture syndrome

57
Q

Type II RPGN causes

A

1) SLE
2) HSP
3) IgA nephropathy

58
Q

Type III RPGN causes

A

1) Wegener’s granulomatosis

2) Microscopic polyarteritis

59
Q

Earliest symptom of nephrotic syndrome in adults

A

Bipedal edema

60
Q

Earliest symptom of nephrotic syndrome in children

A

Periorbital edema

61
Q

Massive/ nephrotic range proteinuria

A

> 3.5 g/day

62
Q

Plasma albumin levels in nephrotic syndrome

A

Less than 3g/dL

63
Q

Normal albumin excretion

A

Less than 30 mg/day

64
Q

Primary vs secondary: Most cases of nephrotic syndrome in adults and children

A

Primary

65
Q

Most common primary glomerular disease causing nephrotic syndrome in adults

A

Membranous glomerulonephritis

66
Q

Most common primary glomerular disease causing nephrotic syndrome in children

A

MCD

67
Q

Most common primary glomerular disease causing nephrotic syndrome in all ages

A

FSGS

68
Q

Most common systemic diseases causing nephrotic syndrome (3)

A

1) DM
2) SLE
3) Amyloidosis

69
Q

Drugs that may cause membranous GN (2)

A

1) Penicillamine

2) Captopril

70
Q

Salts that may cause membranous GN (2)

A

1) Gold

2) Mercury

71
Q

Proteinuria in membranous GB is probably caused by

A

MAC (C5b-C9)

72
Q

Peak incidence of MCD

A

2-6 y/o

73
Q

Incidence of MCD is increased in patients with

A

Hodgkin’s disease

74
Q

Response of MCD to steroids

A

Dramatic

75
Q

Most common CA in children

A

Leukemia

76
Q

Most common leukemia in children

A

ALL

77
Q

Drugs that cause ischemic nephrotoxic nephropathy (3)

A

1) Aminoglycosides
2) Amphotericin B
3) Contrast agents

78
Q

Most common vasculitis in children

A

HSP

79
Q

2nd most common vasculitis in children

A

Kawasaki

80
Q

Common involvements in HSP

A

1) Purpuric skin lesions on extensor surfaces
2) Abdominal
3) Renal
4) Arthritis

81
Q

Hallmark of HSP

A

Palpable purpura on legs and buttocks

82
Q

Hallmark of FSGS

A

Epithelial damage

83
Q

__% of patients with FSGS progress to chronic GN

A

50-80%

84
Q

FSGS: Deposits seen on IF (2)

A

1) Ig

2) C3

85
Q

Histologic morphology of MPGN

A

Double contour or tram-track appearance caused by duplication of GBM with mesangial and monocyte interposition

86
Q

Most common type of GN worldwide

A

IgA nephropathy

87
Q

Common symptom of IgA nephropathy

A

Hematuria after a respiratory infection

88
Q

IgA nephropathy is also known as

A

Berger’s disease

89
Q

Hereditary form of GB associated with nerve deafness

A

Alport’s syndrome

90
Q

Defect in Alport’s syndrome

A

a5 chain of collagen type IV

91
Q

Where Type I collagen is typically found

A

Bone

92
Q

Where Type II collagen is typically found

A

Cartilage

93
Q

Where Type III collagen is typically found

A

Reticular fibers of blood vessels

94
Q

Where Type IV collagen is typically found

A

Basement membrane

95
Q

Disease where Type V collagen is typically defective

A

Ehler’s Danlos

96
Q

Drug associated with feral renal agenesis

A

ACEI

CDB PEARLS COPY (27 decks)

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