MIDTERMS: Renal Disorders

Question 1

Sudden decline in kidney function, often classified as prerenal, intrinsic, or postrenal. Common causes include ischemia, nephrotoxins, and obstruction.

Answer 1

Acute Kidney Injury (AKI)

Question 2

Progressive loss of kidney function over months or years, often due to diabetes or hypertension. Staged based on eGFR.

Answer 2

Chronic Kidney Disease (CKD)

Question 2

Glomerular inflammation leading to hematuria, proteinuria, hypertension, and edema. Common causes include post-infectious glomerulonephritis and IgA nephropathy.

Answer 2

Nephritic Syndrome

Question 3

Intrinsic renal failure due to ischemia or nephrotoxins. Muddy brown casts are a hallmark finding on urinalysis.

Answer 3

Acute Tubular Necrosis (ATN)

Question 3

Characterized by massive proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, and edema. Common causes include minimal change disease and membranous nephropathy.

Answer 3

Nephrotic Syndrome

Question 3

Inflammatory response in the kidney interstitium, often drug-induced (NSAIDs, antibiotics). Features include fever, rash, eosinophilia.

Answer 3

Interstitial Nephritis

Question 4

Inflammation of the glomeruli, leading to hematuria and proteinuria. Causes include immune complex deposition (e.g., IgA nephropathy, post-streptococcal GN).

Answer 4

Glomerulonephritis

Question 5

Leading cause of CKD, characterized by nodular glomerulosclerosis (Kimmelstiel-Wilson lesions) and progressive proteinuria.

Answer 5

Diabetic Nephropathy

Question 6

Narrowing of renal arteries, often due to atherosclerosis or fibromuscular dysplasia. Presents with refractory hypertension and an audible abdominal bruit.

Answer 6

Renal Artery Stenosis

Question 6

Lower urinary tract infection, commonly caused by E. coli. Symptoms include dysuria, urgency, frequency, and suprapubic pain.

Answer 6

Acute Cystitis

Question 7

Presence of blood in urine; causes include urinary tract infections (UTIs), nephrolithiasis, trauma, and malignancies.

Answer 7

Hematuria

Question 8

Upper UTI with flank pain, fever, chills, and costovertebral angle tenderness (Murphy’s sign). Often due to ascending bacterial infection.

Answer 8

Acute Pyelonephritis

Question 9

Non-cancerous enlargement of the prostate, leading to urinary obstruction. Symptoms include nocturia, weak stream, and urgency.

Answer 9

Benign Prostatic Hyperplasia (BPH)

Question 10

Crystalline deposits in the renal system. Calcium oxalate is the most common type. Symptoms include flank pain, hematuria, nausea, and vomiting.

Answer 10

Nephrolithiasis (Kidney Stones)

Question 11

Most common kidney cancer in adults. Classic triad: flank pain, hematuria, and palpable abdominal mass.

Answer 11

Renal Cell Carcinoma (RCC)

Question 12

Most common pediatric renal malignancy. Often associated with WAGR syndrome (Wilms tumor, Aniridia, Genitourinary abnormalities, Retardation).

Answer 12

Wilms Tumor (Nephroblastoma)

Question 13

Due to phosphate retention and decreased vitamin D activation, leading to bone pain and osteitis fibrosa cystica.

Answer 13

Hyperparathyroidism in CKD

Question 14

Seen in CKD; leads to anemia, requiring erythropoietin-stimulating agents.

Answer 14

Erythropoietin Deficiency

Question 14

White, crystalline deposits of urea on the skin in end-stage renal disease (ESRD) due to high uremia levels.

Answer 14

Uremic Frost

Question 15

Exercise programs designed to improve functional capacity and quality of life in dialysis patients.

Answer 15

Renal Rehabilitation

Question 16

Symptoms: Oliguria, fluid overload, confusion, nausea, ECG changes (hyperkalemia).

Causes: Prerenal (hypovolemia), intrinsic (ATN, glomerulonephritis), postrenal (obstruction).

Key Findings: Increased creatinine, decreased urine output, metabolic acidosis.

Answer 16

Acute Kidney Injury (AKI)

Question 17

Symptoms: Fatigue, pruritus, edema, hypertension, uremic frost (in severe cases).

Causes: Diabetes, hypertension, glomerulonephritis.

Key Findings: Low eGFR (<60 mL/min), proteinuria, anemia, secondary hyperparathyroidism.

Answer 17

Chronic Kidney Disease (CKD)

Question 18

Symptoms: Massive edema (initially in lower extremities), foamy urine, dyspnea.

Causes: Minimal change disease, membranous nephropathy, diabetes.

Key Findings: Heavy proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, lipiduria.

Answer 18

Nephrotic Syndrome

Question 18

Symptoms: Fatigue, pruritus, edema, hypertension, uremic frost (in severe cases).

Causes: Diabetes, hypertension, glomerulonephritis.

Key Findings: Low eGFR (<60 mL/min), proteinuria, anemia, secondary hyperparathyroidism.

Answer 18

Nephritic Syndrome

Question 19

Symptoms: Fever, rash, eosinophilia, oliguria. Causes: Drug-induced (NSAIDs, antibiotics), infections, autoimmune diseases. Key Findings: WBC casts, eosinophiluria.

Answer 19

Interstitial Nephritis

Question 19

Symptoms: Oliguria, fluid overload, confusion, nausea. Causes: Ischemia (shock, sepsis), nephrotoxins (aminoglycosides, contrast dye). Key Findings: Muddy brown casts in urinalysis.

Answer 19

Acute Tubular Necrosis (ATN)

Question 20

Symptoms: Early stages asymptomatic, later proteinuria, hypertension, edema. Key Findings: Kimmelstiel-Wilson nodules on biopsy, progressive albuminuria.

Answer 20

Diabetic Nephropathy

Question 20

Symptoms: Dysuria, urgency, frequency, suprapubic pain. Causes: E. coli (most common), Staph saprophyticus. Key Findings: Positive leukocyte esterase, nitrites in urine.

Answer 20

Acute Cystitis (Bladder Infection)

Question 20

Symptoms: Fever, chills, flank pain, costovertebral angle tenderness (Murphy’s sign), dysuria. Causes: Ascending infection (E. coli, Proteus, Klebsiella). Key Findings: WBC casts in urinalysis.

Answer 20

Acute Pyelonephritis

Question 20

Symptoms: Refractory hypertension, flash pulmonary edema, audible abdominal bruit. Causes: Atherosclerosis (older males), fibromuscular dysplasia (younger females). Key Findings: Renal angiography (gold standard).

Answer 20

Renal Artery Stenosis

Question 20

Symptoms: Nocturia, weak urine stream, incomplete emptying, urgency. Key Findings: Smooth, firm, elastic prostate on DRE, increased PSA.

Answer 20

Benign Prostatic Hyperplasia (BPH)

Question 21

Symptoms: Blood in urine (gross or microscopic). Causes: UTI, nephrolithiasis, trauma, malignancy. Key Findings: RBCs in urine, possible casts.

Answer 21

Hematuria

Question 21

Symptoms: Bone pain, fractures, osteitis fibrosa cystica. Causes: Phosphate retention, vitamin D deficiency. Key Findings: Elevated PTH, calcium-phosphate imbalance.

Answer 21

Hyperparathyroidism in CKD

Question 21

Symptoms: Classic triad (flank pain, hematuria, palpable mass), weight loss. Risk Factors: Smoking, obesity, von Hippel-Lindau syndrome. Key Findings: Solid renal mass on imaging.

Answer 21

Renal Cell Carcinoma (RCC)

Question 21

Symptoms: White powdery urea deposits on skin in ESRD. Cause: Severe uremia due to CKD.

Answer 21

Uremic Frost

Question 21

Symptoms: Severe flank pain radiating to groin, hematuria, nausea, vomiting. Types: Calcium oxalate (most common), uric acid, struvite, cystine. Key Findings: CT scan (gold standard).

Answer 21

Nephrolithiasis (Kidney Stones)

Question 21

Symptoms: Abdominal mass in children, hypertension, hematuria. Key Findings: Associated with WAGR syndrome (Wilms, Aniridia, GU defects, Retardation).

Answer 21

Wilms Tumor (Nephroblastoma)