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Flashcards in Quiz 2 Deck (103)
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1
Q

What is the tern used to describe the condition in which the kidneys are fused at either the upper or lower pole>

A

horseshoe kidney

2
Q

What is the most common site of fusion for horseshoe kidney? Which direction does the hila face with this abnormality?

A

lower pole

anteriorly

3
Q

What is the term used to describe an abnormal location of one or both kidneys?

A

ectopic kidney

4
Q

What is the most common location of an ectopic kidney?

A

lower abdomen or pelvis

5
Q

In what condition do cysts affect the medullary and papillary regions of the kidney but spare the cortex?

A

Medullary sponge kidney

6
Q

Which form of PKD is autosomal recessive?

A

Childhood PKD

7
Q

Which form of PKD is autosomal dominant?

A

Adult PKD

8
Q

What condition is histologically characterized by large cysts lined by flattened cuboidal epithelium and an intervening parenchyma that is fibrotic with island of bluish cartilage?

A

Childhood PKD

9
Q

Which form of PKD is more commonly associated with concurrent liver cysts?

A

adult PKD

10
Q

What are dialysis patients with renal cysts at an increased risk for?

A

renal cell carcinoma

11
Q

A kidney shows a large irregular tan mass with large cysts arranged around the mass. What are you looking at?

A

renal cell carcinoma

12
Q

What disease has a proliferation of mesangial, endothelial and epithelial cells in addition to a thickening of the basement membrane?

A

Glomerular disease

13
Q

What specific antibodies are found in glomerular disease? What other disease might produce these antibodies?

A

anti-GBM antibodies (GBM=glomerular basement membrane)

SLE

14
Q
How do these four diseases present? 
lipoid nephrosis
membranous glomerulopathy
focal-segmental glomerulosclerosis 
nodular and diffuse glomerulosclerosis
A

as nephrotic sydrome

15
Q

What disease presents as proteinuria, decreased serum proteins, increased serum lipid levels, generalized edema?

A

nephrotic syndrome

16
Q

What is the most common cause of nephrotic syndrome in children?

A

lipoid nephrosis aka minimal change disease/nil disease

17
Q

What disease is known to present with selective protein, in that albumin in generally the only protein commonly lost in the urine?

A

lipoid nephrosis/minimal change disease/nil disease

18
Q

What do the glomeruli look like in lipoid nephrosis?

A

little to no change

hence, the name minimal change disease/nil disease

19
Q

What disease reveals flattening of the foot processes with electron microscopy?

A

lipoid nephrosis/minimal change disease/nil disease

20
Q

t/f. lipoid nephrosis involves no immune complexes

A

true

21
Q

What is the most common cause of adult nephrotic syndrome?

A

membranous glomerulopathy

22
Q

This disease is known to follow infections (HBV, HCV, syphilis, etc), drugs (gold therapy, captopril) and tumors (lung, colon, melanoma, lymphomas)?

A

membranous glomerulopathy

23
Q

In which disease are the capillary loops usually thickened and prominent while the epithelial cellularity and mesangial cellularity do not increase?

A

membranous glomerulopathy

24
Q

In which condition is the basement membrane diffusely thickened with a “spiked” appearance?

A

membranous glomerulopahy

25
Q

What is the most common cause of nephrotic syndrome in African American?

A

Focal segmental glomerulosclerosis (FSG) aka focal sclerosis

26
Q

This kidney disease is commonly seen in aids patients.

A

FSG

27
Q

NSAIDs, lithium and interferon have been said to cause this kidney disease.

A

FSG

28
Q

Which disease is known to present with non-selective proteinuria, hematuria, progress to chronic renal failure and poor response to corticosteroid therapy?

A

FSG

29
Q

This disease is notably hypercellular and the capillary loops are poorly defined.

A

post-infectious glomerulonephritis

30
Q

In this disease, the immune deposits are predominantly sub-epithelial, termed “humps”. The capillary lumen is filled with a leukocyte demonstrating cytoplastic granules

A

post-infectious glomerulonephritis

31
Q

In this disease, deposits of protein collect in the basement membrane and appear in a diffuse granular pattern by immunofluorescence.

A

Membranous glomerulonephritis

32
Q

This disease is characterized by crescents composed of proliferating epithelial cells as seen under a microscope.

A

rapidly progressive glomerulonephritis

33
Q

What illness is characterized by “wire loop” (capillary loops) lesions?

A

lupus nephritis

34
Q

This form of GN shows up as a crescent, due to leakage of fibrinogen into Bowman’s space, on immunofluorescence.

A

rapidly progressive glomerulonephritis

35
Q

What is the most common cause of chronic renal failure in the US?

A

DM

36
Q

Those with diabetic nephropathy common have this histologic change.

A

What is Glomerulosclerosis :)

37
Q

What do we call nodular glomerulosclerosis related to diabetes?

A

Kimmelstiel-Wilson Disease

38
Q

What is the first laboratory abnormality in diabetic nephropathy?

A

microalbuminuria

39
Q

This condition is characterized by amyloid deposition in one or multiple organs.

A

amyloidosis

40
Q

Under a microscope, this substance looks homogenous, highly refractive and has a high affinity for congo red dye/

A

amyloid

41
Q

What might be present within amyloid depositions in amyloidosis?

A

fibrils

42
Q

What condition may present with orbital ecchymosis?

A

amyloidosis

43
Q

What condition is characterized by the presence of gross hematuria with red bloody casts ?

A

nephritic syndrome

also, proteinuria, HTN, azotemia, oliguria

44
Q

What are the two classic diagnoses of nephritic syndrome?

A

post-streptococcal glomerulonephritis

crescentic glomerulonephritis

45
Q

What is the most common cause of glomerulonephritis worldwide?

A

IgA nephropathy

46
Q

What other renal pathology is most likely in presence of celiac disease?

A

IgA nephropathy

47
Q

Besides IgA nephropathy, what is another condition of IgA oversecretion that may present like amyloidosis but the purpura shows up in the lower extremities?

A

Henoch-Schonlein purpura

48
Q

If mesangial IgA deposits are noted, what two conditions are likely?

A

IgA nephropathy

Henoch-Schonlein purpura

49
Q

If mesangial IgG deposits are noted, what condition is likely?

A

lupus nephritis

50
Q

This form of glomerulonephritis is characterized by low numbers of cells in the glomeruli.

A

non-proliferative GN

51
Q

Do non-proliferative GN patients present with nephrotic syndrome or nephritic syndrome?

A

nephrotic syn

52
Q

This form of GN is characterized by an increased number of cells in the glomerulus.

A

proliferative GN

53
Q

What is the most common cause of acute nephritic syndrome?

A

post-streptococcal GN (PSGN)

54
Q

PSGN follows a strep infection with a nephrogenic strain of group ___ ____-hemolytic strep.

A

A, beta

55
Q

Electron microscopy shows a “lumpy “appearance with diagnostic findings of sub-endothelial “clumps of humps”. What the dx?

A

PSGN

56
Q

What is the prognosis for children and adults with PSGN?

A

children: most likely total recovery
adults: 50% progress to renal failure/latent dz

57
Q

What is another name for Rapidly Progressive GN (RPGN)? Why is it called that?

A

crescentic GM

crescents of epithelial cells form around glomerular capillaries

58
Q

What condition might present with RPGN?

A

Goodpasture’s Syndrome (affects kidneys and lungs)

59
Q

This disease is characterized by circulating anti-basement membrane antibodies

A

Goodpasture’s Syndrome

60
Q

This disease shows a linear pattern of IgG immunofluorescence

A

Goodpasture’s Syndrome

61
Q

This condition is a type of vasculitis, all of which present with antineutrophil cytoplasmic antibodies (serum is positive for C-ANCA)

A

Wegener’s granulomatosis

62
Q

What condition, besides Wegener’s, might present with similar symptoms but is sero-positive for P-ANCA?

A

Polyarteritis nodosum (PAN)

63
Q

What disease is characterized by proximal tubular epithelium necrosis and how is this dz classified?

A

acute tubular necrosis (ATN)

toxic or ischemic

64
Q

What disease is characterized by absence of nuclei and a homogenous cytoplasm which stains intensely eosinophilic yet preserves it normal shape?

A

toxic ATN

65
Q

What is one of the most common causes of acute renal failure?

A

toxic ATN

66
Q

What condition does Dr. Miller want you to know might reveal intra-tubular cast formation under the microscope?

A

toxic ATN

67
Q

What disease specifically causes skip lesions through the tubules?

A

ischemic ATN

68
Q

What disease is most commonly caused by an allergic reaction to drugs and presents with eosinophila?

A

acute interstitial nephritis

69
Q

In which condition is the interstitial area expanded by fibrosis with distortion of the tubules and periglomerular fibrosis without pathological changes to the glomeruli?

A

chronic interstitial nephritis

70
Q

This is a disease of the proximal renal tubules in which glucose, AAs, uric acid, phosphate and bicarb and passed in the urine instead of being reabsorbed.

A

Fanconi’s Syndrome

71
Q

Large amounts of aspirin and acetaminophen consumption over a long period of time is most likely to cause this kidney disease.

A

analgesic nephropathy

72
Q

What is the term used to describe antherosclerotic changes in the renal blood vessels?

A

benign nephrosclerosis

73
Q

The surface of the kidney appears granular (looks like grain leather). What’s up?

A

benign nephrosclerosis

74
Q

What condition is characterized by the small renal arteries and arterioles becoming hyperplastic, taking on an “onion ring” appearance?

A

malignant nephrosclerosis

75
Q

What is one of the most common causes of secondary HTN?

A

renal artery stenosis

76
Q

HUS and TTP often result in this renal condition

A

Thrombotic microangiopathy

77
Q

What condition has this presentation triad: acute renal failure, microangiopathy hemolytic anemia, thrombocytopenia

A

HUS

78
Q

Shig-like toxin is clearly linked to this renal pathology

A

HUS

79
Q

Verocytotoxin is related to what pathology?

A

classic childhood HUS

80
Q

In this condition, capillary lumen are often occluded by necrotic debris and thrombi. This will appear with diffuse thickening of capillary walls and swelling of endothelial cells. Fibrin thrombi and packed red blood cells are visible in the lumina.

A

HUS

81
Q

Most renal artery emboli come from what source?

A

cardiac

82
Q

A look through the microscope reveals cleft-like spaces where crystals were located prior to preparation of the slide. What is the pathology?

A

embolic disease

83
Q

What does it mean when there is poor uptake of “vital” stains by tissues?

A

likely renal tissue ischemia

84
Q

Grossly, there is a classic wedge shaped abnormal appearance to the kidney tissue when this has occurred.

A

renal infarction

85
Q

What part of the kidney are stones most likely to develop?

A

the pelvis

86
Q

What is the 2 most common type of kidney stones?

A

calcium oxalate 75%

triple phosphate stones 15%

87
Q

These stones are most associated with abnormal renal absorption of calcium.

A

Calcium oxalate stones. Hypercalemia is relatively rare (5%) with these times of stones.

88
Q

These stones are most commonly associated with urinary tract infections by bacteria which are urea splitting and increased urine pH.

A

Magnesium ammonium (triple phosphate) stones

89
Q

Another name for magnesium ammonium stones

A

staghorn calculi

90
Q

These stones are associated with a urine pH of 5.5 of less

A

uric acid crystals

91
Q

This type of stone is known for causing nephropathy due to accumulation within the kidney parenchyma

A

uric acid crystals

92
Q

These stones are the most common stones found in pediatric patients AND often present with multiple stones

A

cystine stones

93
Q

These stones is most readily precipitated out of acidic urin

A

cystine stones

94
Q

What type of adenoma is known for uniform large polygonal cells and numerous prominent mitochondria in a “stacked” appearance under electron microscopy?

A

oncocytoma

95
Q

What is the most common renal malignancy?

A

renal cell carcinoma

96
Q

What type of cell is usually involved with renal cell carcinoma?

A

clear cell

97
Q

This tumor is the most common primary renal tumor in children?

A

Wilm’s Tumor

98
Q

This tumor looks like nests of primitive appearing cells (from nephrogenic zone of fetal kidney) under the microscope

A

Wilm’s Tumor

99
Q

What are the most common sites of metastasis for RCCA?

A

lung, lymph nodes, bone, liver,

100
Q

T/F. Those with polycystic kidney disease have an equal risk of developing renal cell carcinoma as those with renal cysts.

A

false

101
Q

This population of people have a high risk of developing acquired cystic disease

A

chronic dialysis patients

102
Q

What is the most common primary malignancy of the urinary tract?

A

TCC

103
Q

When in the kidney, this malignancy is known to be found in the renal pelvis.

A

TCC