Renal part one

Question 1

what is a common congenital kidney disorder that often goes unnoticed as long as the kidney is functioning properly

Answer 1

unilateral kidney agenesis

Question 2

is agenesis of both kidneys incompatible with life?

Answer 2

no and it is rare

Question 3

About ___% of patients are born with potentially significant malformations of the urinary system

Answer 3

10%

Question 4

in which condition do kidneys not develop o normal size

Answer 4

renal hypoplasia

Question 5

if renal hypoplasia effects both kidneys what is a likely out come

Answer 5

renal failure, treated with dialysis

Question 6

how common is horseshoe kidney and when does it cause complications in patients

Answer 6

1 in 600 people becomes problematic when there is a defect that obstructs renal flow

Question 7

what is the most common renal development disorder? What is this disorder due to?

Answer 7

renal cystic dysplasia resulting from abnormal differentiation of the renal structures during the embryonic period along with cyst formation

Question 8

is renal cynic dysplasia typically bilateral or unilateral

Answer 8

it can be either but unilateral is more common

Question 9

how does renal cystic dysplasia appear histologically

Answer 9

there are tube like structures which are enclosed by mesenchyme, larges amount of CARTILAGE ( foci of cartilage) and the glomeruli and tubules are immature

Question 10

renal cynic dysplasia and malignancy

Answer 10

There is no association with malignancy, or genetic link (osmosis)

Question 11

which kidney disease is autosomal dominant and how often does it occur?

Answer 11

Adult Polycystic Kidney Disease

1 in 600

Question 12

which kidney disease is autosomal recessive?

Answer 12

Childhood Polycystic Kidney Disease

Question 13

which kidney disease is characterized by multiple expanding serous or purulent filled cysts of the kidneys

Answer 13

Adult Polycystic Kidney Disease

Question 14

the cyst formed in Adult Polycystic Kidney Disease destroy what part of the kidney

Answer 14

the parenchyma

Question 15

is Adult Polycystic Kidney Disease bilateral or unilateral

Answer 15

bilateral

Question 16

when would a patient present with Adult Polycystic Kidney Disease and which signs are common?

Answer 16

3/4 th decade of life, with a dull or aching pain in the abdomen in back

Question 17

the pain associated with Adult Polycystic Kidney Disease is due to

Answer 17

pressure from expanding cysts

Question 18

enlarged kidneys composed solely of a mass of cysts of varying sizes with little intervening parenchyma describe which renal disorder?

Answer 18

Adult Polycystic Kidney Disease

Question 19

the cyst (with atrophic lining) of Adult Polycystic Kidney Disease arise from

Answer 19

any part of the nephron

Question 20

pressure from cyst in APKD may lead to ischemic atrophy of intervening parenchyma which may lead to which 3 things

Answer 20

hemorrhage, infection and hypertension

Question 21

why may someone experience intermittent gross hematuria in APKD

Answer 21

rupture of intracystic hemorrhage is common

Question 22

in those with APKD which condition occurs in 75% of patients? in 10-30%?
what is another common feature of APKDnot involving the kidneys

Answer 22

hypertension
saccular berry aneurysm (which increase of rupture)
liver cysts are also common

Question 23

how is APKD treated?

Answer 23

liver transplant

Question 24

when do we expect end stage renal failure in patients with APKD?

Answer 24

about age 50

Question 25

Childhood Polycystic Kidney Disease is characterized by

Answer 25

enlarged bilateral kidneys, non-functional at birth

Question 26

kidneys in those with Childhood Polycystic Kidney Disease resemble what?

Answer 26

sponges

Question 27

there are numerous __________ that quickly leads to renal failure shortly after birth

Answer 27

small cysts in the cortex and medulla

Question 28

where do the cysts originate from in CPKD?

Answer 28

the epithelium of the collecting ducts

Question 29

most common cause of UTI

Answer 29

bacteria, viral and fungal are less common

Question 30

which infections may occur simultaneously or in succession of a UTI

Answer 30

Pyelonephritis and Cystitis in either acute or chronic form

Question 31

what are the ways that bacteria reach the urinary tract?

Answer 31

``` hematogenous infection ascending infection (more common) ```

Question 32

UTI primary infection sites

Answer 32

endocardium lungs and G causing hematogenous infection

Question 33

how are ascending UTI infection acquired

Answer 33

sexual intercourse, following urinary catheterization , or following surgical procedures

Question 34

why are UTIs more common in women

Answer 34

the shorter urethra in women allows easier bacterial colonization of the urinary bladder. Pregnancy also increases gender differences in part because of the mechanical effects of the enlarged uterus on the urinary bladder and ureters.

Question 35

what effect do estrogen and progesterone have on the smooth muscles of the urethra, urinary bladder and ureters

Answer 35

relaxing effect, leading to UTIs being more common in women

Question 36

bacteria that cause Acute Pyelonephritis

Answer 36

gram negative rods E COLI also Klebsiella, Enterobacter, Pseudomonas, Serritia, and Proteu

Question 37

what is a suppurative infection of the kidneys that contains foci of pus and focal abscesses?

Answer 37

acute pyelonephritis

Question 38

what is common in serve cases of acute pyelonephritis

Answer 38

pus may permeate the entire kidney and fill the renal pelvis, causing functional loss

Question 39

gross features of acute pyelonephritis

Answer 39

round yellow raised abscess on the Rena surface | surrounding areas of congestion

Question 40

how might a patient with acute pyelonephritis present (list 4)

Answer 40

sudden sharp pain in the costovertebral angle chills fever malaise

Question 41

urinalysis of patient with acute pyelonephritis

Answer 41

pyuria and bacteria | leukocytosis

Question 42

how do we treat patients with acute pyelonephritis

Answer 42

Antibiotic may be used if patient in immunocompetent infection usually subsides on it own

Question 43

complication of pyelonephritis seen largely in Diabetics who suffer from acute pyelonephritis is termed what?

Answer 43

renal papillary necrosis

Question 44

how does necrosis of the renal papillae occur

Answer 44

ischemia and necrosis at the tips of the renal pyramids in combination

Question 45

gross feature of renal papillary necrosis

Answer 45

sharply defined gray-white to yellow necrosis

Question 46

where does the sharply defined gray-white to yellow necrosis of renal papillary necrosis occur

Answer 46

the apical 2/3s of the kidney pyramids

Question 47

chronic pyelonephritis may cause chronic renal failure if what is the underlying cause?

Answer 47

obstruction

Question 48

the recurrent infections seen in chronic pyelonephritis cause bouts of

Answer 48

interstitial inflammation and scarring

Question 49

chronic pyelonephritis effect on the kidneys

Answer 49

loss of renal tissue causes the kidneys to become small and irregularly scarred scarring involving the pelvis or calyces, or both leading to papillary blunting and calyceal deformities.

Question 50

Interstitial fibrosis with a mononuclear cell infiltration describes which kidney disorder microscopically

Answer 50

chronic pyelonephritis | dilation and contraction of tuber lining and epithelium with atrophy of the cells is also common

Question 51

The dilated tubules of chronic pyelonephritis contain pink, glassy colloid casts that suggest the appearance of which tissue?

Answer 51

thyroid tissue

Question 52

which type of arteriolosclerosis is common in chronic pyelonephritis

Answer 52

Proliferative arteriolosclerosis.

Question 53

Acute Tubular Necrosis is characterized by

Answer 53

destruction of tubular epithelial cells with acute suppression of renal function

Question 54

what is the most common cause of acute renal failure

Answer 54

Acute Tubular Necrosis

Question 55

Acute Tubular Necrosis occurs when there is

Answer 55

a sudden decrease in arterial pressure which causes acute hypoperfuison of the kidneys with blood

Question 56

Acute Tubular Necrosis typically occurs following

Answer 56

an MI, all causes of cardiac arrest and all forms of hypotensive shock

Question 57

in Acute Tubular Necrosis where is the reaction in blood flow more prominent and which structures are most affected by ischemia

Answer 57

The reduction of blood flow is more prominent in the cortex, and the cortical tubules are the most affected by the ischemia.

Question 58

Tubular Necrosis of Acute Tubular Necrosis involves with layer of the membrane

Answer 58

basement membrane

Question 59

presence of proteinaceous casts in the distal tubules and collecting ducts called Tamm-Horsfall protein indicate which disorder

Answer 59

acute tubular necrosis

Question 60

while patients wait for ATN recovery some may be put on what?

Answer 60

dialysis | ATN is a reversible lesion