Uworld - Renal V

Question 1

marfan

Answer 1

aortic dissection

Question 2

rickets

Answer 2

vit D deficient

Question 3

fat malabsorption

Answer 3

cystic fibrosis

Question 4

deficient alpha-galactosidase

Answer 4

fabry disease

-fibroblasts fail to metabolize ceramide trihexoside

Question 5

fabry disease

Answer 5

deficient alpha-galactosidase
-fibroblast fail to metabolize ceramide trihexoside

early - angiokeratoma (red/blue lesions), hypohidrosis, acroparesthesia

ceramide trihexoside accumulate in tissue - burning neuropathic pain

tx - enzyme replacement therapy

Question 6

ceramide trihexoside accumulation

Answer 6

in fabry disease

Question 7

niemann pick disease

Answer 7

UMN path - spasticity

Question 8

lesch nyhan

Answer 8

spastic, choreathetoid movement and self mutilation

Question 9

diuretic to prevent recurrent stone formation

Answer 9

thiazide

Question 10

MC type of kidney stone

Answer 10

Ca

Question 11

thiazides and Ca

Answer 11

increased reabsorption

• inhibit Na/Cl cotransporter - apical DCT
• decreased Na concentrations
• activate basolateral Na/Ca

hypovolemia induction - increased Na and H2O reabsorption - passaive increase paracellular Ca

Question 12

acidic urine

Answer 12

more stone formation

Question 13

berger disease

Answer 13

IgA nephropathy
-after upper resp infection

painless hematuria
children and young adults

Question 14

mesangial IgA deposits

Answer 14

berger disease

Question 15

gonadal veins

Answer 15

left - drain to left renal v - left side varicocele with obstruction of left renal vein

right - drain to IVC

Question 16

lowest osmolarity in tubule system

Answer 16

DCT and thick ascending limb

Question 17

ADH site of action

Answer 17

V2 receptors - GPCR > cAMP - principal cells aquaporins

Question 18

most concentrated fluid in tubule systsem

Answer 18

collecting duct

Question 19

embryo of ureters

Answer 19

canalize before metanephros produce urine - 8-10 weeks

inadequate canalization - at uteropelvic jxn
-this is MC cause fetal hydronephrosis

Question 20

cailceal sytem and ureter embryo

Answer 20

ureteric bud

Question 21

embryo of kidney

Answer 21

mesoderm - renal parenchyma

Question 22

VUR

Answer 22

antenatal hydronephrosis

-tx is conservative - possible prophylactic antibiotics

Question 23

blood flow upper 1/3 ureter

Answer 23

renal a

Question 24

kidney transplant vasculature

Answer 24

native left in place - donor place retroperitoneal

anastomose donor renal a with recipient external iliac a

donor renal v connected to recipient external iliac v

proximal 1/3 donor ureter - preserved - establish continuity from collecting system of kidney to recipient bladder

Question 25

antiphospholipid Abs

Answer 25

SLE

Question 26

drug induced interstitial nephritis

Answer 26

eosinophilia

Question 27

adverse spironolactone

Answer 27

aldosterone antagonist -gynecomastia, decreased libido, impotence also - remodel cardiac tissue - aldosterone -so if block - decreased morbidity and mortality

Question 28

development of acute pyelonephritis

Answer 28

VUR | -retrograde flow of urine

Question 29

CHF with pulmonary edema tx

Answer 29

loop diuretic - most rapid diuresis

Question 30

adverse of loop diuretic

Answer 30

hypoK, hypoMg, hypoCa

Question 31

JG cell receptors

Answer 31

beta1 so propanolol - beta-antagonist - blocks renin release no effect on ACE - bradykinin levels stay same

Question 32

propanolol in kidney

Answer 32

inhibit beta1 of JG cells - block renin release

Question 33

finasteride

Answer 33

5-a reductase inhibitor inhibit T > DHT

Question 34

dutasteride

Answer 34

5-a reductase inhibitor inhibitor T > DHT tx prostate hyperplasia - decreased volume

Question 35

adverse of 5-a reductase inhibitor

Answer 35

decreased libido, ED

Question 36

terazosin

Answer 36

alpha antagonist

Question 37

tamsulosin

Answer 37

alpha antagonist

Question 38

tx of BPH

Answer 38

terazosin, tamsulosin -preferred initial therapy also - 5-a reductase inhibitors

Question 39

adverse of terazosin

Answer 39

alpha-antagonist orthostatic hypotension and dizzy

Question 40

tolterodine

Answer 40

antimuscarinic - tx of BPH in men with overactive bladder

Question 41

tadalafil

Answer 41

PED5 inhibitor tx of ED

Question 42

henoch schonlein purpura

Answer 42

after upper resp infection young child IgA hypersensitivity - deposit in vessel walls GI - vascultiis - upper/lower GI bleed kidney - mesangial prolif and crescents (identical berger) skin - palpable purpura joint - migratory arthritis

Question 43

strawberry tongue

Answer 43

kawasaki disease

Question 44

inulin estimate

Answer 44

GFR

Question 45

auto dom polycystic kidney disease

Answer 45

manifest patient 40-50yo -enlarged kideny, HTN, renal failure mutation - PKD1 or PKD2 micro cyst present at birth grows over time

Question 46

auto rec polycystic kidney disease

Answer 46

present at birth

Question 47

serum creatinine and GFR

Answer 47

as GFR decrease - creatinine increased

Question 48

FF =

Answer 48

GFR/RPF GFR - creatinine clerance RPF - PAH clearance

Question 49

CL =

Answer 49

[urine] x urine flow rate / [plasma]

Question 50

DDx for metabolic alkalosis

Answer 50

look at urine Cl - then look at volume status