Test 1 Flashcards
(229 cards)
1
Q
Which gland can be enlarged during bilateral renal agenesis?
A
adrenal
2
Q
Is adrenal hypoplasia more common as a unilateral or bilateral defect?
A
unilateral
3
Q
What other two organs can cysts manifest during ADPKD? Interfere with function?
A
liver and spleen
no
4
Q
Why can ADPKD cause hemorrhage? What type of bleed?
A
berry aneurysm
subarachnoid
5
Q
What gene is affected during ARPKD?
A
PKHD1
6
Q
Is ARPKD a smooth or rough appearing kidney?
A
smooth
7
Q
What disease process is ARPKD associated with?
A
congenital hepatic fibrosis
8
Q
What type of immunofluorescence pattern would Goodpastures have?
A
linear
9
Q
Which immunoglobulins are stained for with immune fluorescence?
A
G/A/M
10
Q
Which complement proteins are stained for with immune fluorescence?
A
C3 and C1q
11
Q
Which TWO light chains are stained for using immunofluorescence?
A
kappa and lambda light chains
12
Q
What type of casts are seen during nephrotic syndrome?
A
fatty
13
Q
What type of casts are seen during nephritic syndrome?
A
RBC
14
Q
What structure ‘breaks’ during nephritic syndrome?
A
capillary loops
15
Q
Is FSGS nephritic or nephrotic?
A
nephrotic
16
Q
What is another name for Lipoid Nephrosis?
A
MCD
17
Q
What is the cardinal feature of FSGS?
A
glomerular scarring
18
Q
What is the most common virus to cause FSGS?
A
HIV
19
Q
What is the most common drug to cause FSGS?
A
heroin
20
Q
Familial FSGS can be caused by defective genes for what structure?
A
Podocytes
21
Q
What does FSGS show on light microscopy ?
A
segmental sclerosis
22
Q
Which two proteins may be seen during IF regarding FSGS? Where?
A
IgM and C3
areas of sclerosis
23
Q
What does membranous Glomerulopathy show on LM?
A
‘spikes’
24
Q
What does membranous Glomerulopathy show on IF?
A
granular IgG and C3
25
Where are the EM deposits seen during Membranous Glomerulopathy?
subepithelial
26
Is MPGN nephritic or nephrotic?
both
27
Does MPGN respond to seroids?
no
28
Where are the deposits seen during Type One MPGN?
subendothelial
29
Where are the deposits seen during Type Two MPGN?
intramembranous
30
What cell proliferates during MPGN?
mesangial
31
Which disease has tram tracks? What gets split?
MPGN
basement membrane
32
What gets deposited during Type One MPGN?
C3 and IgG
33
What gets deposited during Type Two MPGN?
C3 nephritic factor
34
What is the function of C3 nephritic factor?
stabilizes C3 convertase
35
Would Type Two MPGN have high or low levels of C3?
low
36
According to Fang, what are the two causes of Acute Nephritic Syndrome?
diffuse proliferative glomerulonephritis
Crescenteric glomerulonephritis
37
What are the three causes of Diffuse Proliferative Glomerulonephritis?
ANCA
Goodpastures
Lupus
38
What is low during PSGN?
low C3
39
Which immune cell invades during PSGN?
neutrophil
40
What structures are present during PSGN? Where?
humps
sube-P-ithelial
41
Main treatment for Goodpastures?
Plasmapharesis
42
What does Fang say are the two diseases causing immune complex deposition that causes Rapidly Progressing Glomerulonephritis?
Lupus
IgA nephropathy/HSP
43
Which cell type proliferates during IgA Nephropathy?
mesangium
44
Which type of IF staining would take place during IgA Nephropathy?
granular
45
Which specific chain of of Type IV Collagen is disrupted during Alport?
alpha-five
46
What disease has basement membrane splitting?
Alports
47
What is the only disease that causes deposition of all classes of immunoglobulin?
Lupus
48
Does amyloidosis more commonly present as nephrotic or nephritic?
nephrotic
49
Which solvent can cause ATN?
carbon tetrachloride
50
What is the mnemonic for Interstitial nephritis?
PSRD
51
'Thyroidization' of the tubule regards what disease?
chronic pyelonephritis
52
Which renal neoplasm is always located within the cortex?
papillary
53
What are the two most common presenting symptoms during RCC?
abdominal mass
hematuria
54
What specific type of kidney cancer is VHL associated with?
clear cell carcinoma
55
What gene is involved with papillary carcinoma of kidney?
MET
56
Which renal cell carcinoma has the best prognosis?
Chromophobe
57
Foamy macrophages are found during what type of renal neoplasm?
papillary carcinoma
58
Where are the three locations of cavernous hemangiomas during VHL?
cerebellum
brainstem
retina
59
Which type of kidney cancer is most likely to obstruct the kidney lumen?
transitional
60
Which chromosome are WT1 and WT2 located?
11
61
Blastema refers to what kidney tumor?
Wilms
62
Why does ectopic kidney cause UTIs more often?
tortuosity of ureter
63
What can dialysis do to the kidney?
cysts
64
What two genes are involved with ADPKD?
PKD1 or PKD2
65
What breaks during nephritic syndrome?
capillary loops
66
Does MCD have diffuse or focal foot process effacement?
diffuse
67
Is FSGS nephrotic or nephritic ?
nephrotic
68
Is HTN common in FSGS?
yes
69
Does membranous glomerulonephropathy have a thickened or thinned capillary wall?
thickened
70
What cell proliferates during MPGN?
mesangial
71
What gets deposited during Type One MPGN?
C3 and IgG
72
Strep with what type of hemolysis can cause PSGN?
beta
73
What two cells proliferate during PSGN?
endothellial and mesangial
74
Does the visceral or parietal epithelium proliferate during crescent formation?
parietal
75
What is the most common IgA Nephropathy presentation?
recurrent hematuria
76
Does Alport effect boys or girls more often?
boys only
77
What presents with deafness, Goodpasture or Alport?
Alport
78
What type of pattern for Alport?
basket-weave
79
What type of light for amyloidosis?
polarized
80
What type of scars for chronic pyelonephritis?
Pitting Geographic
81
What are the three risks factors for RCC?
smoking
chronic renal failure
acquired cystic disease
82
What are maintenance fluids related to?
metabolism
83
Does total body water increase or decrease from birth onward?
decrease
84
100 kcal of expenditure is related to what?
100 mL of fluid
85
What are fluid requirements for a child per day that weighs 3-10 kg?
100 mL/kg/day
86
What are fluid requirements for a child per day that weighs 10-20 kg?
1000 mL + 50 mL/kg
87
What are fluid requirements for a child per day that weighs >20 kg?
1500 mL + 20 mL/kg
88
Mild dehydration in an older child would correspond to what percent loss? Total volume lost?
3 %
30 mL/kg
89
Moderate dehydration in an older child would correspond to what percent loss? Total volume lost?
6 %
60 mL/kg
90
Severe dehydration in an older child would correspond to what percent loss? Total volume lost?
9 %
90 mL/kg
91
Mild dehydration in a younger child would correspond to what percent loss? Total volume lost?
5 %
50 mL/kg
92
Moderate dehydration in a younger child would correspond to what percent loss? Total volume lost?
10 %
100 mL/kg
93
Severe dehydration in a younger child would correspond to what percent loss? Total volume lost?
15 %
150 mL/kg
94
What is worse, hyponatremic or hypernatremic dehydration?
hypo
95
How much bolus volume for a neonate?
10 mL/Kg
96
How much bolus volume for an infant?
20 mL/Kg
97
How much bolus volume for an older child?
10 mL/Kg
98
Which two fluids for a adolescent bolus?
NS or LR
99
How much potassium required per day?
1 mEq/kg/day
100
How much chloride required per day?
3 mEq/kg/day
101
How much sodium required per day?
2 mEq/kg/day
102
What is the equation for correcting calcium based off of albumin?
(Ca mg/dL)[(0.8) (4- albumin)]
103
Does calcitonin increase or decrease the excretion of phosphate in the kidney?
decrease reabsorption
104
What does hypercalcemia do to the QT interval?
shorten
105
What does acidosis do to free calcium levels?
increase
106
Can lithium be associated with an increase or decrease in calcium levels? By what mechanism?
increase
inhibits calcium feedback on PTH
107
What is the best way to treat hypercalcemia?
saline fluid
108
Does calcium stabilize or destabilize the membrane?
stabilize
109
According to Aoki, which drug can increase Vitamin D metabolism?
phenobarbital
110
What is the problem with Type One rickets?
1-alpha-hydroxylase deficiency
111
What is the problem with Type Two rickets?
Vitamin D receptor mutation
112
Would acidosis cause hyper or hypophosphotemia?
Hyper
113
Which OTC drug can deplete phosphate?
antacids
114
Which condition can present with hypermagnesia?
pre-ecclampsia
115
Would hypomagnesia shorten or prolong the QT?
prolong
116
What is the normal sodium value and units?
135-145 mmol/L
117
What is a common symptom of hyponatremia?
weakness
118
Hyponatremia below what value? Severe hyponatremia is below what value?
135
severe= 120
119
Does central pontine myelinolysis occur when treating hypo or hypernatremia?
hypo
120
Excess of what two substances can cause pseudohyponatremia?
hyperlipidemia
hyperproteinemia
121
What does cortisol do to ADH secretion?
decrease
122
What is the relationship between CRH and ADH?
CRH mimmics ADH
123
Does SIADH have edema?
no
124
What two labs are usually low during SIADH?
uric acid
BUN
125
According to Fang, what percent of saline should be used to treat severe hyponatremia? What would the level of serum soidum be?
3%
126
What does Demeclocycline antagonize?
ADH
127
Does lithium cause central or nephrogenic diabetes insipidus?
nephrogenic
128
Does primary polydipsia trend towards hyper or hyponatremia?
hypo
129
What is the normal range and units for potassium?
3.5-5.5 mmol/L
130
Would increased or decreased pH cause hypokalemia?
increased
131
Would ileus be caused by hyper or hypokalemia?
hypo
132
What is the maximum infusion rate when treating hypokalemia?
10-20 mmol/Hr
133
Using KCl will help treat hypokalemia and what else?
metabolic alkalosis
134
What is the best initial treatment for hyperkalemia?
calcium
135
How much calcium gluconate to treat hyperkalemia? Over how long?
10 mL or 10%
2-5 minutes
136
Would hypo or hyperkalemia predispose to digitalis toxicity?
hyper
137
What drug to use when treating hyperkalemia in a patient with pre-existing metabolic acidosis?
sodium bicarb
138
Which beta-agonist to treat hyperkalemia?
albuterol
139
What does sodium polystyrene sulfonate exchange?
sodium for potassium
140
What is the fastest and most efficient way to lower potassium?
dialysis
141
Which organ synthesizes urea?
liver
142
Would BUN be high or low during nephrotic syndrome?
low
143
What does carney say is the value for post-renal azotemia?
10-20
144
What does carney say is the value for intra-renal azotemia?
less than 10
145
Would the urine pH be increased or decreased during dehydration?
decreased
146
Only which type of cell found in the urine is diagnostic?
tubular
147
What type of casts are seen in nephrotic syndrome?
fatty
148
What type of casts are seen in advanced renal failure?
waxy/broad
149
In percentage, what is the FENa of pre-renal disease?
less than one
150
In percentage, what is the FENa of ATN?
> 2 %
151
What does Fang say is the normal number for anion gap?
12
152
What does Fang say is the normal number for bicarb?
25
153
What is the function of the delta ratio?
to ascertain if there is metabolic alkalosis on top of a metabolic acidosis
154
What is the formula of the delta ratio?
Δ AG/Δ bicarb
155
What does a delta ratio greater than two mean?
both M. acidosis and M. alkalosis
156
What maintains metabolic alkalosis?
inability of kidney to secrete bicarb
157
What is the bicarb greater than during metabolic alkalosis?
40 mmol/L
158
What two ion deficiencies maintain metabolic alkalosis?
chloride depletion
hypokalemia
159
Which diuretic could be used to treat metabolic alkalosis?
acetazolamide
160
What type of ions are most often the cause of increased anion gap metabolic acidosis?
unmeasured anions
161
How do the kidneys compensate for loss of bicarb?
hold onto chloride
162
What is the equation for serum osmolality gap?
(2)(Na) + glucose/18 + BUN/2
163
What is the value for the normal serum osmolal gap?
10-15
164
What is the purpose of Winters formula?
to assess respiratory compensation for a metabolic acidosis
165
What sort of acid/base state would one be in if the PCO2 were greater than the calculated value regarding the winters formula?
respiratory acidosis
166
What sort of acid/base state would one be in if the PCO2 were LESS THAN than the calculated value regarding the winters formula?
respiratory alkalosis
167
What is Wilsons pH equation?
6.10 + log [HCO3]/0.03(PCO2)
168
How many protons are removed and how many bicarbs are added to the blood when one phosphate is removed?
one proton removed
one bicarb added
169
What rxn is catalyzed by glutaminase?
glutAMINE to glutAMATE
170
What reaction is catalyzed by glutamate dehydrogenase?
glutamate into αKG and NH3
171
Which type of cells secrete bicarb in the nephron? During what acid base status does this happen?
type B intercalated
metabolic alkalosis
172
Distal acidification of the urine is accomplished by what pump? What stimulates this?
H+ ATPase
acid
173
What is the lowest pH of urine the kidney can make?
4.4
174
Which form of phosphate are protons secreted in?
H2PO4
175
According to FANG, what part of the nephrono becomes cystic during ARPKD?
collecting duct
176
Are podocytes part of the visceral or parietal epithelium?
visceral
177
What substance is in the tubules during MCD?
lipid
178
What stain is used for FSGS?
trichome
179
What is the inheritance pattern for Alport Syndrome?
X-linked dominant
180
Does the GBM thicken or thin during Alports?
thicken
181
What is another term for papillary kidney cancer?
chromophil
182
What is the drawback to calcitonin therapy ?
tachyphylaxis
183
What two ion imbalances can cause Nephrogenic Diabetes Insipidus?
hypercalcemia
hypokalemia
184
Serum bicarb below what value is considered metabolic acidosis?
fifteen
185
What are the first five divisons of the renal artery?
renal
segmental
interlobar
arcuate
interlobular
186
Does the afferent or efferent arteriole form the vasa recta?
efferent
187
According to Matz, is the basal lamina anionic or cationic?
anionic
188
Does the DCT have a brush border?
no
189
Where in the urinary tract does transitional epithelium begin?
minor calyx
190
According to Matz, where are the three obstructions regarding the flow of the ureter?
pelvis into ureter
pelvic brim (external iliac)
into bladder
191
What part of the urethra is narrowest?
membranous
192
According to Matz, what pelvic floor muscle is most important to prevent involuntary urination?
pubococcygeus
193
What did DiSole say is the equation for GFR?
GFR = VU/P
194
A creatinine of two corresponds to a GFR of what?
60 mL/min
195
What is DiSole's equation for RPF?
[PAH]/0.9
196
CT with or without contrast for possible stones?
without
197
What does Nish say is the imaging modality for a simple cyst?
ultrasound
198
Would no attenuation following contrast be indicative of a benign or malignant mass?
benign
199
What type of renal neoplasm infiltrates?
transitional
200
A renal incidentaloma is almost always benign if under what size?
3cm
201
A renal incidentaloma is malignant 85% of the time if greater than what size?
6cm
202
What is the cutoff for Hounsfeld units regarding a benign or malignant mass?
10 HU
203
Do benign or malignant masses washout? What percentage of washout?
benign
> 60%
204
What does Nish say is the best imaging modality to determine if an incidentaloma is benign or malignant?
CT with washout
205
Does the BM thicken or thin during MPGN?
thicken
206
What three immune deposits take place during PSGN?
IgG
IgM
C3
207
Where do the immune complexes deposit during PSGN?
GBM and Mesangium
208
Which renal neoplasm has loss of chromosomes ?
chromophobe
209
Which has abundant capillaries, clear cell or papillary?
clear
210
Is hyponatremia more often caused by disorders in water or sodium handling?
water
211
Which type of saline is used first when treating hypernatremia? Second?
first = isotonic
second = hypotonic
212
What are the two causes of an increased Serum Osmolal Gap?
methanol
ethylene glycol
213
What two anions is ethlyene glycol metabolized to?
oxalate and hippurate
214
Would metabolic alkalosis be associated with hyper or hypokalemia?
hypokalemia
215
What type of bleed can increase BUN?
GI bleed
216
Would tubular problems result in LMW proteins or albumin to be in the urine?
LMW
217
Would overflow problems result in LMW proteins or albumin to be in the urine?
LMW
218
According to Carney, when would RBC casts be seen?
glumerulonephritis
219
Nerve supply to the bladder arises from which vertebral levels?
T10 - L2
220
Do renal calculi tend to be recurrent?
yes
221
According to Nish, what two signs have very high positive and negative predictive value?
hydroureter
perinephric stranding
222
According to NIsh, what is the mechanism for why Ultra Sound may miss kidney stones?
takes many hours for collecting system to dilate
223
What is more dense, a cyst or RCC?
RCC
224
Which enzyme can be expressed by non-Hodgkins Lymphoma? Treat with?
1-alpha-hydroxylase
glucocorticoids
225
Which diuretic does Fang say causes hyponatremia?
Hydrochlorothiazide
226
What does thyroid hormone do to function of ADH?
inhibit
227
According to Carney, does rhabdomyolysis cause blood to be in the urine?
yes
228
Which renal measurement will be abnormal in pt's on diuretics?
FENa
229
What cant be excreted when one has defective renal tubular acidification?
metabolic acids
