Renal Pathology

Front 1

Consequence of oligohydramnios?

Back 1

Potter's sequence: lung hypoplasia, low set ears and flat facies, development defects of extremities

Front 2

baby with evidence of portal HTN

Back 2

ARPKD

Front 3

oliguria with muddy brown granular casts, hyperkalemia and metabolic acidosis

Back 3

Acute tubular necrosis

what are the BUN:Cr ratio and FENa?

Hint 3

less than 15 and greater than 2%

Front 4

What nephrotoxic agents are responsbile for ATN?

Back 4

aminoglycosides, heavy metals, myoglobinuria, ethylene glycol, radiocontrast dye and urate

Front 5

eosinophils in urine

Back 5

Acute interstitial nephritis

From what?
Other symptoms?

Hint 5

NSAIDs, penicillin, and diuretics

Oliguria, fever and rash within a few days of beginning a drug

Front 6

gross hematuria and flank pain

Back 6

renal papillary necrosis

what are 4 causes?

Hint 6

1) chronic analgesic abuse
2) diabetes
3) sickle cell
4) severe acute pyelonephritis

Front 7

proteinuria >3.5 g/day and fatty casts in urine

Back 7

nephrotic syndrome

what does the proteinuria lead to?

Hint 7

1) pitting edema due to albuminemia
2) infection due to hypogammaglobulinemia
3) hypercoaguable state due to loss of ATIII
4) hyperlipidemia and hypercholesterolemia

Front 8

child with effacement of foot processes with negative immunofluorescence

Back 8

minimal change disease

what is it associated with?

Hint 8

Hodgkin lymphoma

Front 9

effacement of foot processes with poor response to steroids

Back 9

focal segmental glomerulonephritis

Associated with what 3 things?

Hint 9

1) HIV
2) heroin use
3) sickle cell anemia

Front 10

subepithelial deposits with spike and dome appearance

Back 10

membranous nephropathy

associations?

Hint 10

hep B and C
SLE,
solid tumors
drugs (NSAIDs, penicillimine)

Front 11

subendothelial deposits with tram track appearance

Back 11

membranoproliferative glomerulonephropathy (type 1)

associated with?

Hint 11

HBV or HCV

Type II is C3 nephritic factor

Front 12

1st sign of diabetes in kidney?

Back 12

microalbuminuria

Front 13

sclerosis of mesangium

Back 13

Kimmelstiel Wilson nodules of diabetes

pathogenesis?

Hint 13

NEG of vascular basement membrane leading to hyaline arteriolosclerosis (more in efferent arteriole)

Front 14

proteinuria <3.5 g/day with glomerular filtration and RBC casts

Back 14

nephritic syndrome

other signs?

Hint 14

salt retention and periorbital edema, oliguria and azotemia

Front 15

young male with hematuria and hemoptysis

Back 15

Goodpasture's

anti what?

Hint 15

antibody to basement membrane and linear IF

Front 16

wire looping of capillaries

Back 16

diffuse proliferative glomerulonephritis

most common cause of death in?

Hint 16

SLE

Front 17

subepithelial humps

Back 17

post-streptococcal glomerulonephritis

which kind of strep infection carrying what?

Hint 17

Strep pyogenes infection of skin or pharynx which carries M protein virulence factor (usually in children who rarely progress to renal failure)

Front 18

crescents are comprised of what?

Back 18

fibrin and macrophages

Front 19

hematuria, hearing loss and ocular disturvbances

Back 19

Alport syndrome (type 4 collagen defect resulting in splitting of basement membrane) x-linked

Front 20

hematuria with RBC casts following mucosal infection

Back 20

IgA nephropathy (Berger disease)

Front 21

3 types of rapidly progressive glomerulonephritis

Back 21

goodpastures, Wegener's and microscopic polyangitis

Front 22

Waxy casts

Back 22

advanced renal disease or CRF (stasis of flow)

Front 23

WBC casts

Back 23

tubulointerstitial inflammation, acute pyelonephritis, transplant rejection

Front 24

ovoid PAS + hyaline masses in mesangial core

Back 24

Kimmelstiel-Wilson lesions

Front 25

radiolucent stones

Back 25

uric acid stones

Front 26

kid with yellow-brown hexagonal crystals in stones

Back 26

cysteinuria

treat with?

Hint 26

alkalinization of urine

Front 27

stones from urease-positive UTI bugs

Back 27

staghorn calculi made up of ammonia magnesium phosphate

Front 28

most common stones (cancer, PTH)

Back 28

calcium phosphate or oxalate stones

Front 29

crystals that look like envelopes

Back 29

oxalate crystals from ethylene glycol poisoning

Front 30

hematuria, palpable mass, secondary polycythemia, flank pain, fever, weight loss

Back 30

Renal cell carcinoma

spreads?

Hint 30

hematogenously to lung and bone via IVC

Front 31

child with huge, palpable flank mass containing embryonic structures

Back 31

Wilm's tumor (nephroblastoma)

what other symptoms?
deletion of what?

Hint 31

Aniridia, genitourinary malformation, retardation

deletion of tumor suppressor gene WT1

Front 32

painless hematuria?

Back 32

transitional cell carcinoma

risk factors?

Hint 32

Pee SAC: phenacetin, smoking, aniline dyes, cyclophospamide

Front 33

hematuria in an immigrant

Back 33

squamous cell cancer of the bladder due to schistosoma hematobium

Front 34

lab findings of cystitis?q

Back 34

1) cloudy urine with >10 WBCs/hpf
2) positive leukocyte esterase and nitrites
3) greater than 100000 colony forming units

Front 35

fever, CVA tenderness, nausea and vomiting

Back 35

Acute pyelonephritis

causes of UTI?

Hint 35

E. Coli (80%)
Staph saphrophyticus in cystitis (sexually active female)
Proteus, Klebsiella, Enterococcus

Front 36

What is sterile pyuria due to?

Back 36

Chlamydia trachomatis or neisseria gonorrhea

Front 37

asymmetric corticomedullar scarring with blunted calyces

Back 37

chronic pyelonephritis

what is it due to?

Hint 37

obstruction or Vesicoureteral reflux

Front 38

thyroidization of kidney (eosinophilic casts in tubles with WBC casts in urine)

Back 38

chronic pyelonephritis

Front 39

diffuse cortical necrosis is a side effect of what?

Back 39

vasospasm and DIC seen in obstetric complications or septic shock

Front 40

List the events of the 3 stages of ATN:

Back 40

1) Inciting event: hemorrhage, acute MI, sepsis
2) Maintenance phase: oliguric, 1-3 weeks, hyperkalemic, fluid overload
3) Recovery: polyuric, decreased BUN & Cr, hypokalemic

Front 41

microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure

Back 41

HUS

due to e.coli 0:157
most common cause of ARF in children

Front 42

Calcium wasting and phosphate retention in pt with renal failure

Back 42

renal osteodystrophy

what is it due to?

Hint 42

failure of vit D hydroxylation leading to secondary hyperparathyroidism

Front 43

cysts and shrunken kidneys in an adult

Back 43

dialysis cysts

Front 44

small shrunken kidneys with medullary cysts, kidney stones and progressive renal insufficiency?

Back 44

medullary cystic disease

Front 45

colicky pain with hematuria and unilateral flank tenderness

Back 45

nephrolithiasis

Front 46

list 6 features of Chronic renal failure

Back 46

1) Uremia leads to azotemia with nausea, pericarditis, asterixis and encephalopathy
2) Hypertension due to Na and water retention
3)hyperkalemia/met acidosis
4) anemia due to less Epo
5) hypocalcemia from less Vit D
6) renal osteodystrophy

Front 47

renal cell carcinoma has which paraneoplastic syndromes?

Back 47

EPO, renin, PTHrP, or ACTH

Front 48

male smoker with one mass in upper pole of kidney

Back 48

sporadic renal cell carcinoma

Front 49

hemangioblastoma of cerebellum and bilateral renal cell carcinomas

Back 49

Von-Hippel Lindau disease

pathogenesis?

Hint 49

(loss of VHL tumor suppressor gene leads to increase IGF-1)

Front 50

two pathway of transitional cell carcinoma development:

Back 50

1)flat sheets of high grade tumor that then invades with early p53 mutations
2) papillary is low grade then high grade then invades; late p53 mutations

Front 51

Schistosoma hematobium leads to?

Back 51

squamous cell carcinoma of the bladder