Renal 1

Question 1

HLA found and expressed?

ABO found and expressed?

Answer 1

HLA - WBC on chromosome 6

ABO - RBC on chromosome 9

Question 2

Risk of ESKD in young people after donating kidneys

Answer 2

High risk even without relevant risk factors

Elderly - doesn’t matter -similar risk as general population

Question 3

Commonest graft issue?

Answer 3

Graft loss ( graft not functioning) due to cardiovascular

Question 4

CMV prophylaxis 6 months if?

Answer 4

Donor +ve, recipient negative

All other scenarios - just 3 months unless both donor and recipient negative

Question 5

Infection related mortality in Australia after transplant usually due to?

Answer 5

Pulmonary bacteremia

Question 6

Where is macula densa located?

Answer 6

between glomerulus and distal convoluted tubules

Question 7

Complications of AV fistula

Answer 7

Steal syndrome (distal hypoperfusion - ischemia syndrome)

Question 8

What imaging parameters exclude PCKD?

Answer 8

US - no cysts by 40 years old

MRI - < 5 cysts

Question 9

PCKD imaging criteria

Answer 9

With family history - 2 cysts or more = each kidney

Without family history - 10 cysts or more + bilateral hydronephrosis

Question 10

Mutation of aquaporin causes?

Answer 10

Nephrogenic DI

Question 11

ATN - what you see in urinalysis?

Answer 11

Muddy brown casts

Question 12

Best prevention of ESKD?

Best diet to reduce risk of ESKD?

Answer 12

Blood pressure management

Sodium diet < 2g
Protein < 1g/kg/day

Question 13

EPO produced where?

Answer 13

Renal interstitial fibroblast

Question 14

secondary/tertiary HyperPTH treatment?

Answer 14

1st line = Calcitriol (vit D)
2nd line = PO4 binders
3rd line = calcimimetics ( reduce PTH)

Question 15

Nucleated cells contain?

APC cells contain?

Answer 15

HLA I = A,B,C

HLA II = DR,DP,DQ

Question 16

Vascular rejection needs?

Answer 16

Steroids and aggressive immunosuppressants

Question 17

ATG causes what?

Answer 17

T cell lysis

Question 18

Mtori causes less what?

Answer 18

Melanoma and Viral infection/reactivation (CMV/VZV)

Question 19

Chronic allograft nephropathy types?

What do you see in them?

Answer 19

1. Antibody mediated rejection
   - chronic interstitial nephritis + fibrosis, vascular narrowing
2. Immunosuppressant effect
   - Arteriolar hyalinosis + Tubular atrophy

Question 20

Post infectious GN a/w infection?

Answer 20

Streptococcus

Question 21

Autosomal recessive PCKD mutation?

Answer 21

Chromosome 6 - fibrocystin protein

Question 22

Histology of Alport syndrome and FSGS is the same - what do you see?

Answer 22

Basket weave pattern - thinning and thickening of BM

Question 23

Renal artery;
proximal/ostial part affected - what disease?
Middle to end - what disease?
Distal end - what disease?

Answer 23

Proximal/ostial - Renal artery stenosis

Middle to end - FMD

Distal end arteries - PAN

Question 24

Tuberous sclerosis mutation where?

Answer 24

Chromosome 9 - inhibit Growth hormone and mTOR signaling pathways

Question 25

What monoclonal antibody can trigger Alport syndrome?

Answer 25

Alemtuzumab CD52

Question 26

Complications of Alport syndrome?

Pathogenesis of Alport syndrome?

Answer 26

Alport can become Good pasture disease
(anti-GBM targets collagen IV)

Pathogenesis = mutation of Alpha 5 chain in Collage IV causing absence a3a4a5 chain

Question 27

Predictors of ESRF in pauci-immune pattern?

Answer 27

eGFR < 15%
Normal glomeruli percentage
Tubular atrophy/Interstitial fibrosis

15% of Normal glomeruli or Tube-In

Question 28

IgG + C3 likes to deposit in?

IgG1 likes to deposit in?

IgG3 likes to deposit in?

Answer 28

IgG + C3/ non-amyloid fibrils = Fibrillary GN - mesangial deposits

IgG1 = Immunotactoid GN - capillary wall deposits + microtubules on EM

IgG3 = membranoproliferative GN - granular deposits on EM

Question 29

Treatment of IgG4, MUSK MG disease?

Answer 29

Rituximab