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Nephrology Fellowship Reviewer > TMA/TI/Diuretics/Cyst > Flashcards

TMA/TI/Diuretics/Cyst Flashcards

(88 cards)

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1
Q

thrombocytopenia, hemolytic anemia and dysfunction of affected organs

A

Thrombotic microangiopathy

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2
Q

renal dominant disease

A

hemolytic uremic syndrome

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3
Q

Predominant neurological involvement

A

ttp

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4
Q

severe adamts13 deficienct

A

ttp

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5
Q

most sensitive marker of hemopysis due to cell lysis and tissue ischemia

A

elevated ldh

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6
Q

pathological features of tma - blood

A

schistocytes

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7
Q

glomerular capillary wall thickening with thrombi

A

Acute hus

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8
Q

initial treatment of choice in TTP

A

Plasma exchange

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9
Q

recombinized humanized monoclonal antibody that functionally blocks C5, 1st line treatment for children

A

Eculizumab

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10
Q

predominant pathogen in stec-hus

A

E coli 0157

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11
Q

classical prodromal feature of stec-hus

A

Bloody diarrhea

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12
Q

Principal effector mediating tubulointerstitial fibrosis

A

fibroblasts

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13
Q

final common pathway leading to eskd

A

Fibrosis

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14
Q

abrupt deterioration in renal function and characterized by inflammation and edema in the renal interstitium

A

Acute interstitial nephritis

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15
Q

1/3 of cases of drug related ain are caused by

A

antibiotics

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16
Q

pathology of infection causing ain

A

Direct injury

medications used

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17
Q

hallmark pathology of ain

A

Infiltration of inflammatory cells with associated edema usually sparing glomeruli and blood vessels

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18
Q

epithelial cell degenration resembling patchy tubular necrosis with some disruption of the tbm

A

Tubulitis

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19
Q

dress syndrome

A

drug rash
eosinophilia
systemic symptoms
40% of drug induced ain

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20
Q

rising serum crea level but little or no evidence of glomerular or arterial disease, no prerenal factors, no obstruction + clinical hx of exposure to a high risk drug

A

ain

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21
Q

provide confirmatory evidence of AIN

A

Urine eosinophils

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22
Q

gold standard dx of ain

A

Renal biopsy

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23
Q

lymphocytic infiltrates in the peritubular areas of the interstitium usually with edema

A

ain

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24
Q

management of ain

A

withdrawal of factor, supportive care

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25
time when medication should be discontinued that recovery is expected
within 2 weeks
26
dose of steroids in ain
prednisone 1mkd po for 2-3 weeks followed by tapering over 3-4 weeks
27
given to patients who fail to respond to a 2 week course of steroid therapy in ain
cyclophosphamide 4 week 2mkd
28
immunosuppresive agent used in granulomatosis interstitial nephritis
Mycophenopate mofetil
29
used in patients with circulating anti-tbm and anti-gbm antibodies
Plasmapharesis
30
worse prognosis in ain
increasing ageb | biopsy of diffuse disease + interstitial fibrosis
31
amount of analgesic to vayse analgesic nephropathy
6 tablets daily for > 3 years
32
decreased renal size, bumpy contours and papillary calcification
analgesic nephropathy
33
identified risk factor in lithium for ain
Duration of therapy
34
most powerful predictor of ultimate progression to eskd in lithium as cause of ain
> 2.5 mg/dL
35
Tx for lead nephropathy
Chronic edta chelation
36
Bone pain (itai-itai or ouch ouch disease) + osteopenia + renal failure
cadmium
37
hypertension and frequent gout in Ain
Lead
38
presenting feature of sarcoidosis
Nephrolithiasis
39
common cause of chronic renal failure in sarcoidosis
nephrocalcinosis
40
pathogenesis in sarcoidosis
disordered ca metabolism (hypercalcemia or hypercalciuria)
41
noncasseating granulomas of giant cells, histiocyyes and lymphocytes; focal lymphocytic infiltrates and periglomerular fibrosis, no immune deposits
Sarcoidosis
42
tx for patients with sarcoidosis who could not tolerate corticosteroids and effective in decrasing vitamin D and calcium
Ketoconazole
43
renal failure caused by tubulointerstitial nephritis associated with uveitis
Tinu syndrome
44
Tx for tinu syndrome
Steroids
45
most profibrogenic and tubulotoxic fatty acids
oleate and linoleatr
46
most susceptible to luminal attack by C5b-9
Renal tubular epithelial cells
47
marker of tissue fibroblasts
fibroblasts specific protein I
48
most numerous cells in ain
lymphocytes (CD4+ Tcells)
49
inhibits procimal bicarbonate and Na cl reabsorption at the proximal tubule
Carbonic anhydrase inhibitor
50
inhibits sodium water reabsorption proximal tubule
osmotic diuretics
51
inhibits nkcc at medullary and cortical thick ascending limb
Loop diuretics
52
inhibits ncc at distal tubule
Thiazide diuretics
53
enac and mineralocorticoid blocker at connecting and collecting tubules
distal K sparing diuretics
54
prototypic osmotic diuretic
mannitol
55
level of albumin that enhances furosdemide metabolism but decreases tubular secretion of active diuretic
Low serum albumin
56
enhance thiazide binding and tubular action
mineralocorticoids, glucocorticoids and estrogens
57
actions of thiazide and thiazide like
increase water excretion of Na K Cl Mg; reduce Ca
58
prevent amphotericin induced hypoK and hypoMg
Amiloride
59
First line agent fir ECV expansion in cirrhotic ascites
spironolactone + furosemide (100/40)
60
natriuretic antihypertensive; inhibit nacl reabsorption in the proximal tubule and diluting segment, inc in gfr
Adenosine type 1 receptor antagonist: Aminophylline
61
recombinant form of b type natriuretic peptide causes natriuresis and relaxation of smooth muscle cell
nesiritide
62
observation that diuretics no longer produce a negative Na balance
Diuretic braking phenomenon
63
how to overcome diuretic braking
diuretic Na restriction or addition of a second diuretic
64
strategies to overcome diuretic braking
1. restrict dietary salt to prevent postdiuretic salt retention 2. another class of diuretic 3. multiple daily dosing or diuretic with prolonged action 4. Do not stop abruptly 5. Prevent or reverse diuretic induced metabolic alkalosis
65
inadequate clearance of edema despite a full dose of diuretic
Diuretic resistance
66
mainstay therapy for acute decompensated heart failure
vasodilator and diuretic therapy
67
first line treatment in chronic heart failure
Diuretics and ace/arbs Second: bblocker 3rd: Mra or hydralazine-isdn final: digoxin, icd
68
diuretic that impair carbohydrate tolerance and precipitate dm
Hyperglycemia
69
more common ain in the young
tinu and sle
70
more common ain in elderly
drug induced
71
gold standard ain dx
biopsy
72
distal rta with atin
sjogren syndrome
73
most common dx test in ain
urine eosinophil test
74
key finding of atin
interstitial inflammation and tubulits
75
hyperca, hypercalciuria urinary concn defects nephrocalcinosis nephrolithiasis and aki/ckd focal lymphocytic infiltrate and interstitial noncaseating granulomas of giant cells histiocytes and lymphocytes
sarcoidosis
76
dry eyes dry mouth, lymphoplasmacytic interstitial infiltrate, ati
sjogren syndrome
77
multi system do with elev serum igg4 salivary glands, pancreas retroperitoneum and kidneys igg4 possible plasma positive in a stori form pattern
iig4 related
78
uveitis painful red eyes photophobia | mixedwith noncaseating granuloma formation
tinu
79
number of eosinophil per 20x
>10
80
4 leading anticancer agents
ifosfamide (atn) bcg tki (tma) pemetrexed
81
dx criteria for aristocholic acid induced interstitial nephrotis
``` egfr < 60 2 of the 3 - hypocellular interstitial fibrosis - ingestion of aa containing products - dna adducts in the renal tissue or urinary tract ```
82
chronic tubulointerstitial disease in families, ingestion of bread contaminated with aa
balkan endemic nephropathy
83
progressive ckd, gout and hypertension, fanconi
lead nephropathy
84
zn smelter workers ca phos stones fanconi
cadmium
85
most commonly isolated organisms from abscesses
p. mirabilis e. colo Kleb pneumo s. aureus
86
cut off for medically managed cysts
5 cm
87
txfor infected renal cyst
cotri, chloramphenicol, fqx 4 weeks
88
Adpkd criteria
at least 3 15-39 yo 2 cysts in each 40-59 > 60: 4 or more cysts in the kidnet

Nephrology Fellowship Reviewer (29 decks)

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