Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

00000 IM PLATINUM BOARD CORRELATES > NEPHRO > Flashcards

NEPHRO Flashcards

1
Q

Site of erythropoietin (EPO) production

A

Interstitial cells of the peritubular capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ADH actions on V1 vs V2 receptors

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

part of nephron that:
* Absorb Na* and H20 and secrete K* VS
* Absorb K* and secrete H*

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

main trigger in ADH secretion

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

differentiate ascending vs descending limb of loop of Henle in terms of permeability to solute and water

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

diuretics that can cause metabolic acidosis (1)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

diuretics that can cause metabolic alkalosis (2)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Test for measurement of albuminuria

A

Urinary albumin to creatinine ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most useful renal imaging study

A

Renal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Renal biopsy is not advised in a patient with bilaterally small kidneys because of 3 reasons

A
  • It is technically difficult and has a greater likelihood of causing bleeding and other adverse consequences
  • There is usually so much scarring that the underlying disease may not be apparent,
  • The window of opportunity to render disease-specific therapy has passed.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Imaging test for diagnosis of nephrolithiasis

A

Helical computed tomography (CT) scanning without radiocontrast enhancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common form of renal replacement therapy for AKI

A

Hemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Malnutrition is an indication for initiation of renal replacement therapy in patients with CKD

True or False

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Number of hours of hemodialysis in majority of ESRD patients

A

9-12hrs each weed
divided into 3 equal sessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Educational programs should be commenced at what stage of CKD

A

No later than stage 4 CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common therapeutic modality for end-stage renal disease (ESRD)

A

Hemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Leading cause of ESRD

A

Diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dialysis access with highest long-term patency rate

A

Fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Most important complication of arteriovenous grafts

A

Thrombosis of the graft and graft failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common acute complication ofhemodialysis, particularly among DM patients

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common additives to peritoneal dialysis solutions (3)

A
  • Heparin
  • Antibiotics
  • Insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most common organisms in PD-related peritonitis

A

Gram-positive cocci, including Staphylococcus (reflecting the origin from the skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Absolute indication for the urgent initiation of or intensification of dialysis prescription

A

Uremic pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Definition of AKI

A
  • A rise of creatinine of at least 0.3 mg/dL within 48 h or
  • Rise of creatinine 50% higher than baseline within 1 week; or
  • reduction in urine output to < 0.5 mL/kg/h for >6 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Definition of oliguria

A

<400 mL/24 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hallmark of AKI

A

elevated BUN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Light chain cast nephropathy is associated with what disease

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Most common form of AKI

A

Prerenal Azotemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Renal autoregulation usually fails once the systolic blood pressure falls below…

A

80mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Type of ATN with Extensive necrosis, PCT and DT affected, relatively longer lengths of tubules

A

Toxic-type ATN [e.g. in use of aminoglycosides, radiocontrast dyes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Most common clinical course of contrast nephropathy

A
  • A rise in SCr beginning 24-48h following exposure
  • Peak within 3-5 days
  • Resolution within 1 week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Most common protein in urine and produced in the thick ascending limb of the loop of Henle

A

Uromodulin/Tamm-Horsfall Protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

In the absence of a clinical diagnosis, the only recourse to establish an etiology in early-stagee CKD is

A

Kidney biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Definitive treatment of the hepatorenal syndrome

A

liver transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Continuous Renal Replacement Therapy is often preferred in patients with these 3 conditions ….

A
  • Severe hemodynamic instability
  • Cerebral edema
  • Significant volume overload
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

GFR of stage 5 CKD…

A

GFR <15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In early nephropathy, such as in diabetic nephropathy, microalbuminuria occurs… quanrtity of proteinuria in microalbuminuria ….. ____ mg/24 h

A

30-300mg/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Major side effect of calcium-based phosphate binders

A

hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Leading cause of morbidity and mortality in patients at every stage of CKD

A

cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Stage of CKD where normocytic, normochromic anemia appears

A
  • As early as Stage 3 CKD
  • Almost universal by Stage 4 CKD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Primary cause of anemia in CKD

A

Insufficient production of EPO by the diseased kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Target hemoglobin concentration in CKD

A

100-115 g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Stage of CKDwhere peripheral neuropathy usually becomes clinically evident

A

Stage 4 CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Protein excretion >____mg is an indication for therapy with ACEi/ARBs in CKD

A

> 300mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

mechanism behind Uremic fetor

A

Derives from the breakdown of urea to ammonia in saliva and is often associated with an unpleasant metallic taste (dysgeusia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most important initial diagnostic step in the evaluation of a patient presenting with elevated serum creatinine

A

To distinguish newly diagnosed CKD from acute or subacute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Classic lesion of secondary hyperparathyroidism; high bone turnover with increased PTH levels

A

Osteitis fibrosa cystica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Low bone turnover with low or normal PTH levels

A

Adynamic bone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Devastating condition seen almost exclusively in patients with advanced CKD

A

Calciphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Seen in patients with CKD who have been exposed to gadolinium

A

Nephrogenic fibrosing dermopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

type of cast seen in glomerulonephritis

A

RBC casts or dysmorphic RBCs seen in the sediment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Most common causes (2) of glomerulonephritis throughout the world (save for subacute bacterial endocarditis in the Western hemisnhere)

A

Malaria and schistosomiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Prototypical for acute endocapillary proliferative GN

A

Poststreptococcal GN (PSGN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

PSGN due to impetigo develops ____weeks after skin infection and ____weeks after streptococcal pharyngitis

A

PSGN due to impetigo
* develops 2-6 weeks after skin infection
* and 1-3 weeks after streptococcal pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Streptococcus pyogenes strains associated with
* impetigo vs
* pharyngitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

type of GN where kidneys have subcapsular hemorrhages with a “flea-bitten” appearance

A

Endocarditis-associated GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Primary treatment for endocarditis-associated GN

A

Eradication of the infection with 4-6 weeks of antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Immune-mediated glomerulonephritis characterized by thickening of the GBM with mesangioproliferative changes; 70% of patients have hypocomplementemia

A

Membranoproliferative GN (MPGN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what type of MPGN:

  • Presence of subendothelial deposits;
  • low C3
  • Has double contour sometimes called tram-tracking
A
59
Q

what type of MPGN:
* lntramembranous deposits, ribbon-like pattern, IgG autoantibody
* low C3
* dense deposit disease

A
60
Q

Most proliferative of the three types of MPGN

A

type I MPGN

60
Q

Pathologic changes of FSGS are most prominent in what part of the nephron

A

glomeruli located at the corticomedullary junction

61
Q

GN with highest reported incidences of renal vein thrombosis, pulmonary embolism, and deep vein thrombosis

A

membranous nephropathy (MGN)

62
Q

Pathologic change in the kidney that is a Sensitive indicator for the presence of diabetes but correlates poorly with the presence or absence of clinically significant nephropathy

A

thickening of the GBM

63
Q

Earliest manifestation in ~40% of patients with diabetes who develop diabetic nephropathy

A

Increase in albuminuria detected by sensitive radioimmunoassay

64
Q

Most renal amyloidosis is the result of

A
  • Fibrillar deposits ofimmunoglobulin light chains known as amyloid L (AL),
  • or secondary to fibrillar deposits of serum amyloid A (AA) protein fragments
65
Q

Lesion in HIV-associated nephropathy

A

FSGS

66
Q

GN caused by Hepatitis B

A
  • MGN: more common in children
  • MPGN: more common in adults
67
Q

Schistosoma species most commonly associated with clinical renal disease

A

Schistosoma mansoni
Note: Schistosoma haematobium causes bladder disease

68
Q

Signs and symptoms of nephrotic syndrome (4)

A
69
Q

Diseases presenting with nephrotic syndrome (5)
vs Diseases presenting with nephritic syndrome (5

A

NEPHROTHIC
* MCD
* MGN
* DM Nephropathy
* Renal Amyloidosis
* FSGS

NEPHRITIC
* PSGN
* Rapidly-Progressive GN (RPGN)
* Goodpasture syndrome
* Alport syndrome
* Lupus nephropathy

70
Q

Most common cause of nephrotic syndrome in Children VS elderly

A
  • children: MCD
  • elderly: MGN
71
Q

Signs and symptoms of nephritic syndrome (4)

A
72
Q

Nephrotic glomerular dse with the ff characteristics:
* Effacement of foot processes
* Highly*selective proteinuria
* good response to steroids,
* excellent prognosis

A
73
Q

Nephrotic glomerular dse with the ff characteristics:
* Idiopathic but may be caused by SLE, hepatitis B, syphilis, gold, penicillamine, malignancy
* Diffuse capillary and BM thickening, “spike & dome appearance” with subepithelial lgG and C3 deposits
* Non-selective proteinuria, poor response to steroids, indolent course

A
74
Q

Nephrotic glomerular dse with the ff characteristics:
* Microangiopathy leading to BM thickening
* Some patients also develop eosinophilic, PAS+ nodules called nodular glomerulosclerosis or Kimmelstiel-Wilson nodules

A
75
Q

Nephrotic glomerular dse with the ff characteristics:
* Deposition of hyaline masses (hyalinosis) leading to obliteration of capillary lumina

A
76
Q

Nephrotic glomerular dse with the ff characteristics:
* Subendothelialfmesangial amyloid deposits
* Apple-green birefringence on Congo red stain

A
77
Q

Nephritic glomerular dse with the ff characteristics:
* Most common pediatric cause of nephritic syndrome
* Hypercellular glomeruli, “lumpy-bumpy” deposits of lgG and C3, subepithelial electron microscopy
* Self-resolving

A
78
Q

Nephritic glomerular dse with the ff characteristics:
high ASO titer

A
79
Q

Nephritic glomerular dse with the ff characteristics:
* Poststreptococcal etiology in 50%
* Renal failure within weeks or months
* Rupture of the basement membrane seen in the EM

A
80
Q

3 types of RPGN and differentiate each type

A
81
Q

Nephritic glomerular dse with the ff characteristics:
* Anti-GBM antibodies and anti-alveolar BM antibodies
* Linear pattern of lgG on IF
* Hematuria and hemoptysis

A
82
Q

Nephritic glomerular dse with the ff characteristics:
* Appears before age 20
* Hereditary structural defect in collagen IV
* Leaky BM (BM splitting on electron microscope)
* Hematuria, hearing loss, blindness

A
83
Q

in Alport syndrome, disease appears before age ____

A

before age 20

84
Q

in Alport syndrome, there is hereditary structural defect in collagen ____

A

collagen IV

85
Q

serum marker that correlates best with the presence of renal disease in lupus nephritis

A

anti dsDNA

86
Q

The only reliable method of identifying the morphologic variants of lupus nephritis

A

renal biopsy

87
Q

class of LN which has Has the most varied course

A

Class III

88
Q

What class of LN:
Describes global, diffuse proliferative lesions involving the vast majority of glomeruli

A

Class IV

89
Q

What class of LN:
Most common and most severe type

A

Class IV

90
Q

What class of LN:
wire-loop lesions

A

Class IV

91
Q

in lupus nephritis, patients with THIS PATHO FINDING on biopsy has the worst renal prognosis without treatment

A

crescents

92
Q

Class of LN that is predisposed to renal-vein thrombosis and other thrombotic complications

A

Class V

93
Q

Henoch-Schonlein purpura is distinguished clinically from lgA nephropathy (4)

A
  • Prominent systemic symptoms
  • Younger age (<20 years old)
  • Preceding infection
  • Abdominal complaints
94
Q

Most common type of glomerulonephritis worldwide

A

lgA nephropathy

95
Q

IgA nephropathy is aka

A

Berger’s disease

95
Q

Two most common presentations of lgA nephropathy

A
  • Recurrent episodes of macroscopic hematuria often accompanied by proteinuria during or immediately following an upper respiratory infection, OR
  • Persistent asymptomatic microscopic hematuria
96
Q

Antibodies more common in
* granulomatosis with polyangiitis VS
* microscopic polyangiitis or Churg Strauss

A
97
Q

Triad of Wegener’s granulomatosis

A
  • Necrotizing granulomas of the respiratory tract
  • Necrotizing or granulomatous vasculitis
  • Focal necrotizing, or often crescentic glomerulonephritis
98
Q

Common cause of cholesterol emboli

A

Following an endovascular procedure with manipulation the aorta

99
Q

Classically present with fever, purulent rhinorrhea, nasal ulcers, sinus pain, polyarthralgias/arthritis, cough, hemoptysis, shortness of breath, microscopic hematuria, and 0.5-1 g proteinuria oer 24 h

A

Wegener’s granulomatosis

100
Q

Prototypes of Microangiopathic Hemolytic Anemia (MAHA) - (2)

A
  • Hemolytic Uremic Syndrome (HUS) and
  • Thrombotic Thrombocytopenic Purpura (TTP)
101
Q

Most common variant of HUS

A

Shiga toxin-producing Escherichia coli (STEC) HUS, which is also known as D+ (diarrhea-associated) HUS or enterohemorrhagic E.coli (EHEC) HUS

102
Q

Most common Shiga-toxigenic E. coli (STEC) strain

A

E.coli 0157:H7

103
Q

Most severe manifestation of scleroderma characterized accelerated hypertension, rapid decline in renal function, nephrotic proteinuria, and hematuria

A

scleroderma renal crisis (SRC)

104
Q

Autoantibody associated with development of scleroderma renal crisis

A

Anti RNA polymerase I and Ill

105
Q

autoantibody that may identify young patients scleroderma renal crisis

A

Anti-U3-RNP may identify young patients scleroderma renal crisis

106
Q

Renal lesion in Scleroderma renal crisis

A

onion-skinning

107
Q

First-line therapy in SRC unless contraindicated

A

ACE inhibitor

108
Q

Antiphospholipid antibodies (3)

A
108
Q

BP Goal in SRC

A

Reduce SBP by 20 mmHg and DBP by 10 mmHg every 24 hours until BP normalized

109
Q

HELLP SYNDROME(Hemolysis, Elevated Liver Enzymes, Low Platelets) commonly occurs at what trimester

A

third trimester

110
Q

HELLP SYNDROME stands for

A

Hemolysis, Elevated Liver Enzymes, Low Platelets

111
Q

Vein that is more commonly involved in renal vein thrombosis (RVT)

A

Left renal vein

112
Q

Most common renal abnormality in tuberous sclerosis

A

Angiomyolipomas

113
Q

Gitelman’s syndrome is distinguished from most forms of Bartter’s syndrome bv the presence of these 2 lab findings

A
  • Severe hypomagnesemia
  • Hypocalciuria
114
Q

Acute TIN most often presents with

A

Acute renal failure

115
Q

Predominant pathology in chronic TIN

A

Interstitial fibrosis

116
Q

Hallmark feature of TIN with uveitis

A

Painful anterior uveitis

117
Q

WHAT SYNDROME:
* Due to mutations affecting any of five ion transport proteins in the TAL
* Clinical syndrome mimics the effects of chronic ingestion of a loop diuretic

A
118
Q

WHAT SYNDROME:
* Due to mutations in the thiazide-sensitive Na-Cl co transporter (NCCT) in the DCT
* Mimics the effects of thiazide diuretics

A
119
Q

WHAT SYNDROME:
Mimics a state of aldosterone excess with early and severe hypertension, hypokalemia and metabolic alkalosis, but plasma aldosterone and renin levels are low

A
120
Q

Triad of heavy metal (lead) nephropathy

A
  • Saturnine gout
  • Hypertension
  • Renal insufficiency
121
Q

Renal biopsy findings of chronic TIN

A

Interstitial fibrosis & tubular atrophy out of proportion to the degree of glomerulosclerosis or vascular disease

122
Q

3 Normal points of narrowing in the urinary tract and common sites of stone obstruction:

A
  • Ureteropelvic and ureterovesical junctions
  • Bladder neck
  • Urethral meatus
123
Q

Most common type of urolithiasis

A

Calcium oxalate stones

124
Q

renal stones associated with Proteus mirabilis, forming staghorn calculi

A

Struvite stones (magnesium ammonium phosphate stones)

125
Q

Pathogenesis of struvite stone

A

Bacterial urease production

126
Q

Radiopaque stones on standard x-ray (3)

A

Calcium, cystine, and struvite stones

127
Q

Radiolucent stones on standard x-rays (1)

A

uric acid stones

128
Q

The two main risk factors for uric acid stones

A
  • Persistently low urine pH and
  • higher uric acid excretion
129
Q

Recommended target urine pH in uric acid stones

A

pH 6.5

130
Q

For all stone types, target urine volume/day

A

At least 2 L/day

131
Q

As part of cystine stone prevention…

Achieved by treatment with medication that covalently binds to cystine (____or ____) and a medication that raises urine pH.

A

tiopronin or
penicillamine

132
Q

Treatment for struvite stones

A

complete removal by urologist

133
Q

most common bacteria causing acute uncomplicated cystitis

A

E. coli (75-90%)

134
Q

Main feature distinguishing cystitis and pyelonephritis

A

Fever (fever of pyelonephritis exhibits a high, spiking, “picket fence” pattern & resolves over 72 h of treatment)

135
Q

fever of ____ exhibits a high, spiking, “picket fence” pattern & resolves over 72 h of treatment

A

fever of pyelonephritis exhibits a high, spiking, “picket fence” pattern & resolves over 72 h of treatment

136
Q

antibiotics considered relatively safe for UTI in early pregnancy (3)

A
  • Nitrofurantoin
  • Penicillin
  • Cephalosporins
137
Q

The standard of care for pregnant women with overt pyelonephritis

A

Parenteral beta-lactam with or without aminoglycosides

138
Q

Treatment of asymptomatic bacteriuria (ABU)does not decrease the frequency of symptomatic infections or complications, EXCEPT in these 3 populations…

A
  • Pregnant women
  • Persons undergoing urologic surgery
  • Neutropenic patients and renal transplant recipients
139
Q

Most common cause of bilateral hydronephrosis in boys

A

Posterior urethral valves

140
Q

Most common cause of urinary tract obstruction in adults

A

Acquired defects

141
Q

Pathognomonic of vesicoureteral reflux

A

Flank pain that occurs only with micturition

142
Q
A

00000 IM PLATINUM BOARD CORRELATES (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions