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Flashcards in Renal System Deck (48):
1

MS patients have which type of urinary incontinence? What is the mechanism?

Urge incontinence.

Lesions above the sacral region of the spinal cord results in a loss of higher center control of micturition. Causes detrusor muscle hyperreflexia ("spastic bladder")

2

What is Potter Sequence?

P = pulmonary hypoplasia
O = oligohydramnios - stimulus
T = twisted skin (wrinkled)
T = twisted face (Potter facies/flat facies)
E = extremities defects (club foot)
R = renal agenesis, bilateral

3

Cause/inciting factor for Potter Sequence?

Renal anomalies -> oligohydramnios -> POTTER

4

Pipestem fibrosis (periportal fibrosis) + patient swam in a freshwater lake recently =

Hepatic schistosomiasis - S. japonicum, S. mansoni

5

Blood supply of proximal, middle and distal ureter

Proximal = renal artery
Middle = multiple anastamoses
Distal = superior vesicle artery

6

Which type of urinary incontinence is common in type 1 DM patients? What is the mechanism?

Overflow incontinence

Diabetic autonomic neuropathy -> decreased innervation of the detrusor muscle results in impaired contraction

7

Chronic kidney hypoperfusion results in hyperplasia and hypertrophy of which cells?

Juxtaglomerular cells = modified smooth muscle cells that are part of the afferent arteriole

8

Non-lactose fermenting cause of UTI?

Pseudomonas aeruginosa

9

"Lumpy-bumpy" deposits + tea colored urine + periorbital edema =

Post-streptococcal glomerulonephritis

10

What are the Post-Streptococcal glomerulonephritis deposits made of and where are they located?

IgG, IgM, C3

subepithelial deposits

11

Kimmelsteil Wilson nodules =

Nephrotic vs Nephritic

Diabetic nephropathy

Nephrotic

12

What is the first thing you should think of if someone has been taking naproxen for 3+ month daily?

Chronic interstitial necrosis (drug-induced)

13

Dysuria definition

painful urination

14

Which structure blocks the ascent of the kidneys in a horseshoe malformation?

Inferior mesenteric artery (L3)

15

Clearance of which substance is used to calculate RBF and RPF?

PAH

16

Clearance of which substances is used to calculate GFR?

-inulin
-creatine

17

Female + glomerulonephritis + photosensitive skin rash+ arthalgias + reproductive age =

Systemic Lupus Erythematosus

18

Female + arthralgias + african american + prolonged PTT + 2 spontaneous abortions + positive PRP test + negative Treponema pallidum immunoassay =

Antiphospholipid antibody syndrome

19

2 causes of sterile pyuria =

-acute pyelonephritis - rare
-non-gonococcal urethritis + cystitis - Chlamydia or Ureaplasma

20

Toddler's painless GI bleeding =

Meckel's diverticulum = failure of obliteration of the vitelline/omphalomesenteric duct

21

Failure of abdominal wall closure, viscera not covered with peritoneum =

Gastroschisis

22

internal urethral sphincter
-contraction
-relaxation

contraction = sympathetic
relaxation = parasympathetic

23

Thyroidization of the kidney =

chronic pyelonephritis

24

Crescent shaped proliferation within the glomerulus =

What are they made of?

Rapidly Progressive Glomerulonephritis

Crescents made of fibrin + plasma proteins (C3b)

25

Wire looping of capillaries =

Diffuse Proliferative Glomerulonephritis

26

Tramtracks on PAS stain + subendothelial deposits =

Membranoproliferative glomerulonephritis Type 1

27

Pathology of Membranoproliferative glomerulonephritis Type 2 =

C3 convertase stabilization -> decreased levels of active C3 -> less inflammation

28

Crescent glomeruli + sinusitis + lung involvement + negative IF stain =

Granulomatosis with polyangitis (Wegner's) -> Rapidly progressive glomerulonephritis

29

Negative IF stain + proteinuria = 5 + child =

Minimal Change Disease

30

Which phase of ATN is this?

oliguric - hyperkalemia, metabolic acidosis, increased ECF volume, hyponatremia, hypocalcemia

Maintenance phase
(2nd)

31

Which phase of ATN is this?

polyuric - hypokalemia

Recovery phase
(3rd)

32

How to differentiate between causes of metabolic alkalosis?

-Urine Cl
-Volume status

33

Obliteration of what neonatal structure leads to the adult medial umbilical ligament?

Umbilical artery

34

Obliteration of the urachus leads to what adult structure?

Median umbilical ligament

35

Stones that form in basic urine (high pH)

-Calcium phosphate
-Ammonium magnesium phosphate (struvite)

36

Stones that form in acidic urine (low pH)

-Calcium oxalate
-Uric acid
-Cystine

37

IL-2's anti-tumor effects are due to the action of

IL-2 stimulates T cells and NK cells to mature and proliferate (also stimulates B cells and monocytes)

NK cells and T cells help fight off tumor cells (malignant melanoma and renal cell carcinoma)

38

proximal tubular cell ballooning + vacuolar degeneration + flattening of tubular epithelial cells + FENa >2% (increased)

Acute Tubular Necrosis

39

medullary cysts lined with cuboidal or urothelial epithelium + cystic dilation of collecting ducts

Medullary Sponge Kidney

40

Deficiency of neutral AA transporters in the PCT and enterocytes

Hartnup disease (AR)

Can lead to a niacin deficiency (due to lack of tryptophan absorption) -> Pellagra

41

Differences in presentation between post-streptococcal GN and Berger disease

Post-streptococcal GN = 2 weeks post-pharyngitis, mostly occurs in children

Berger disease = 5 days post-URI, recurrent

42

Henoch-Schonlein purpura is what type of hypersensitivity?

Type III - IgA immune complex deposition in small vessels

43

deaf + hematuria + progressive renal failure + Xlinked Recessive

Alport syndrome = mutation in type IV collagen

44

Most common cause of nephropathy in HIV+ patients

Focal segmental glomerulosclerosis
-HIV patients have a collapsing variant

45

Beckwith-Wiedmann Syndrome

-Wilms tumor
-Macroglossia
-Organomegaly
-Hemihypertrophy

mutation in WT2

46

WAGR complex

-Wilms tumor
-Aniridia
-Genitourinary malformations
-mental Retardation

deletion of WT1

47

Papillary necrosis causes (4)

-Sickle cell disease or trait
-Acute pyelonephritis
-NSAIDs
-Diabetes mellitus

48

Cause of stress incontinence

-urethral sphincter dysfunction
-loss of urethral support