UWORLD RENAL/GI Path

Question 1

ALDO vs ADH where do they work?

Answer 1

CORTICAL vs MEDULLARY collecting duct

Question 2

Damage to the left 12th rib will injury what organ?

Answer 2

left Kidney

Question 3

Part of kidney impermeable to water?

Answer 3

TAL

Question 4

Urine PH, HCO3, and H2PO4 in DKA vs Normal?

Answer 4

low (excrete H ions), low (conserve bicarb), high (excrete titrable acids)

Question 5

Where in the kidney is most of the H2O resorbed?

Answer 5

PCT

Question 6

Pt given dose of this hormone that decreases fractional excretion of urea.

Answer 6

ADH - increases H2O and Urea absorption in Medullary Collecting Duct

Question 7

Fuction of ALDO in cortical collecting duct?

Answer 7

Water and Salt IN

K and H out

Question 8

Where in the kidney has the highest osmolarity? Lowest osmolarity?

Answer 8

Loop of henle (most concentrated)

DCT (least concentrated)

Question 9

Artery that supplies upper ureter?

Answer 9

Renal artery

Question 10

Vessels Lateral to ureters?

Answer 10

internal iliac

Question 11

Hernia below inguinal ligament, and lateral to pubic tubercle?

Medial to this structure?

Answer 11

Femoral hernia. Medial to femooral vessels

Question 12

Hernia in male infants? Older men? Female?

Answer 12

Indirect ingiunal, direct ingiunal, femoral

Question 13

Woman with a hernia. Protrudes through?

Answer 13

Femoral hernia. Femoral ring

Question 14

Hernia in old man. Caused by weakness of?

Answer 14

Direct inguinal. Due to weakness of transversalis fascia

Question 15

Hernia in male infant. Due to?

Answer 15

failure of internal inguinal ring to close and persistent processus vaginalis

Question 16

Persistant processes vaginalis causeswhat 2 pathologies?

Answer 16

Hydrocele and indirect inguinal hernia

Question 17

to what lymph nodes?
Prostate
Bladder

Answer 17

internal iliac nodes

internal(superior part) AND external iliac (inferior part) nodes

Question 18

Lactose intolerant pt given lactose. Changes to stool pH, Breath hydrogen, stool osmotic gap?

Answer 18

decreases (bacteria ferment lactose, increasing hydrogen),
increases (bacteria ferments lactose, increasing hydrogen),
increases (more stuff in stool, higher gap)

Question 19

AIDS pt with small, vesicular ulceration in ESO. Microscopic findings?

Answer 19

HSV. Eosinophilic intranuclear inclusions (Cowdry type A)

Question 20

AIDS pt wit linear ulcerations. Microscopic findings?

Answer 20

CMV. Intranuclear and cytoplasmic inclusions.

Question 21

Pt with gets severe hypotension in abdominal aorta during surgery. Parts of colon affected most?

Answer 21

Watershed areas: splenic flexure and distal sigmoid colon.

Question 22

Diffuse ESO spasms present like?

Answer 22

unstable angina

Question 23

Pt who has painless hematuria might have had exposure to?

Answer 23

Bladder cancer (transitional cell cancer) Rubber, textiles, leather.

Question 24

Clip renal artery. Cell that hypertrophy are of what type? Located?

Answer 24

JG cells (SMCs) hypertrophy to secrete renin. Located on AA.

Question 25

Why Ca-Oxylate urinary stones in Crohn's?

Answer 25

Normally, in bowl Ca binds oxylate and is excreted. In Crohn's Ca binds unabsorbed lipids, oxylate is free to re-enter body and bind Ca, forming stones

Question 26

H. Pylori. Where are the ulcers?

Answer 26

duodenum

Question 27

Histo of ESO shows basal cell hypertrophy and intraepithelial eosinophils.

Answer 27

Reflex esophagitis

Question 28

Pt with diarrhea with mucus. Mass in sigmoid colon and HypoK. Can progress to?

Answer 28

Villous adenomas. Progresses to adenoCA.

Question 29

Pt on NSAID. Type of renal injury?

Answer 29

Papillary necrosis or chronic interstitial nephritis.

Question 30

Colon adencoCA mostly found where?

Answer 30

Rectosigmoid Colon

Question 31

AIDs patient. Colonoscopy shows multiple ulcers and mucosal erosions. Bisopsy shows?

Answer 31

CMV. (inclusion bodies)

Question 32

Pt with diarrhea. Colon biposy shows basophilic clusters on surface of interstinal mucosal cells.

Answer 32

Cryptosporidium

Question 33

Colonoscopy shows discrete, flash-shaped ulcerative lesions with trophozoites?

Answer 33

Entamoeba histolytica

Question 34

Colon biopsy shows crypt abcesses?

Answer 34

UC

Question 35

IgA nephropathy vs Henoch-Schonlein purpura?

Answer 35

HS is IgA neuropathy + extrarenal symptoms (skin lesions, abdominal pain)

Question 36

Uric acid crystal precipitate where?

Answer 36

Collecting duct because of increased acidity

Question 37

Cresentic glomeruli with no immunoglobulin of complement deposits?

Answer 37

ANCA (wegners, microscopic polyangiitis)

Question 38

Sign of right sided colon cancer?

Answer 38

Fatigue, weight loss, anemia (bleeding present but not grossly seen)

Question 39

Pt with signet ring CA of stomach. Gross Appearance?

Answer 39

Linitis plastica (thick and leathery)

Question 40

Pt with ballooning and vacuolar degeneration of proximal tubles. Anion gap metabolic acidosis. Presence of Ca-Oxylate crystals?

Answer 40

Ethylene glycol ingestion.

Question 41

With with heart burn, fingertip ulceration and multiple telangiectasias. Mechanism of heart burn?

Answer 41

CREST. Fibrous replacement of muscularis

Question 42

Deposits in Post-strep GN?

Answer 42

C3

Question 43

Biliary tract infection - sequalae?

Answer 43

Brown stones

Question 44

5 month old with failure to thrive. Bulky and greasy stool. Histo shows?

Answer 44

Abetalipoproteinemia. Histo will show abnormal accumulation of fat in enterocytes.

Question 45

Ischemic ATN - what part of kidney affected?

Answer 45

PCT

Question 46

Parenteral nutrition increases chance for?

Answer 46

Biliary stones from loos of enteral stimulation (stasis)

Question 47

Hypertension - affect on kidney?

Answer 47

Arterial intimal fibroplasia and hyalinization

Question 48

Teen who dies of overwhelming repiratory infection. Suffered multiple pulmonary infections. Diagnosed with steatorrhea. Abnormality of the pancreas?

Answer 48

Cystic fibrosis. Mucus plugs

Question 49

Pt given ampicilin gets fever, maculopapular skin rash, and oliguria. Where in kidney affected?

Answer 49

Acute interstitial nephritis from drugs. (affects interstitium)

Question 50

Recurrent nephrolithaisis in a young pt. What inborn error of metabolism?

Answer 50

Cystinuria. Defect in transporter of Cystine/Arginine/ornithine/lysine. Leads to Cysturia (Aminoaciduria) and cystine stones.

Question 51

Overactivation of these enzymes makes one more susceptible to pro-carcinogens?

Answer 51

Microsomal monoxygenase (P450s) - convert pro-carcinogens to carcinogens

Question 52

Likely outcome of HepB? hepC?

Answer 52

Complete resolution vs stable chronic hepatitis

Question 53

Stones that precipitate in acid? | Base?

Answer 53

Acid - Uric acid, cystine, Ca-Oxylate | Base - struvite and ca-phosphate

Question 54

BPH - changes to renal tissue?

Answer 54

hydronephrosis causes atrophy and scarring of renal tissue

Question 55

External hemorrhoids - location?

Answer 55

Posterior to midline, distal to dentate line

Question 56

Pt with elongation of lamina propria papillae, eosinophils and neutrophils on ESO biopsy

Answer 56

GERD

Question 57

Acidophilic bodies in hepatocytes in hepatitis suggest?

Answer 57

Councilman bodies - apoptosis

Question 58

crohn's vs UC. helper T cells?

Answer 58

Th1 vs Th2

Question 59

Systemic mastocytosis (lots of mast cells) - effect on gastric secretions?

Answer 59

Mast cells - more histamine - more secretions

Question 60

Cresentic GN - crescents consist of?

Answer 60

monocytes, macrophages and fibrin

Question 61

Diarrhea with leukocytes but mostly neurophils?

Answer 61

Salmonella

Question 62

Diarrhea with leukocytes and eosinophils?

Answer 62

Parasites by NOT giardia or entameba

Question 63

Site of lipid digestion vs absorption?

Answer 63

Ileum vs Jejunum

Question 64

Ulcer in distal duodenum?

Answer 64

Zollinger-Elision syndrome. Grastrin secreting tumor

Question 65

OTC drug that can decrease chance for Colon cancer?

Answer 65

Aspirin. COX-2 linked with colon cancer

Question 66

Pt with mast cells in small bowl mucosa. Findings?

Answer 66

Mast cells = histamine = gastric hypersecretion

Question 67

Newborn with imperforate anus. Other findings?

Answer 67

Vesiculocolic fistula (urinary tract infections)

Question 68

Pancreatic pseudocyst - cause? consists of?

Answer 68

Actue pancreatistis. Granulation tissue and cirrhosis

Question 69

Lesser omentum?

Answer 69

Hepatogastric and hepatoduodenal ligament

Question 70

Location where ulcer is least likely to be malignant?

Answer 70

Duodenum

Question 71

Secretory diarrhea caused by what type of growth?

Answer 71

Tubular or villous polyp

Question 72

Absorbed in Ileum?

Answer 72

Bile/B12

Question 73

Live Polio vaccine. How is it given? Benefit?

Answer 73

Applied to mucosal surface. More anti-IgA formation than injected virus

Question 74

Pt with absense of segment of small bowel, with distal ileum winding around vascular stalk. Cause?

Answer 74

Vascular occlusion "apple peel"

Question 75

Infections that Increase Brown stone formation? Through what enzyme?

Answer 75

E coli, Ascaris lumbricodies, Opisthorchis sinesis

Question 76

Danger of hydatid cyst?

Answer 76

Echinococcus granulosus. Can cause anaphylaxis

Question 77

microvesicular fatty change? Problem?

Answer 77

Mito dysfuntion so cannot break down fatty acids

Question 78

Ballooning degeneration of hepatocytes seen in?

Answer 78

Viral hepatitis

Question 79

Portal vein vs hepatic vein?

Answer 79

Into the liver vs out of the liver

Question 80

IgG4 antibodies to Phospholipase A2 receptor?

Answer 80

Membranous nephropathy