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51 Cards in this Set

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Consequence of oligohydramnios?
Potter's sequence: lung hypoplasia, low set ears and flat facies, development defects of extremities
baby with evidence of portal HTN
ARPKD
oliguria with muddy brown granular casts, hyperkalemia and metabolic acidosis
Acute tubular necrosis

what are the BUN:Cr ratio and FENa?
less than 15 and greater than 2%
What nephrotoxic agents are responsbile for ATN?
aminoglycosides, heavy metals, myoglobinuria, ethylene glycol, radiocontrast dye and urate
eosinophils in urine
Acute interstitial nephritis

From what?
Other symptoms?
NSAIDs, penicillin, and diuretics

Oliguria, fever and rash within a few days of beginning a drug
gross hematuria and flank pain
renal papillary necrosis

what are 4 causes?
1) chronic analgesic abuse
2) diabetes
3) sickle cell
4) severe acute pyelonephritis
proteinuria >3.5 g/day and fatty casts in urine
nephrotic syndrome

what does the proteinuria lead to?
1) pitting edema due to albuminemia
2) infection due to hypogammaglobulinemia
3) hypercoaguable state due to loss of ATIII
4) hyperlipidemia and hypercholesterolemia
child with effacement of foot processes with negative immunofluorescence
minimal change disease

what is it associated with?
Hodgkin lymphoma
effacement of foot processes with poor response to steroids
focal segmental glomerulonephritis

Associated with what 3 things?
1) HIV
2) heroin use
3) sickle cell anemia
subepithelial deposits with spike and dome appearance
membranous nephropathy

associations?
hep B and C
SLE,
solid tumors
drugs (NSAIDs, penicillimine)
subendothelial deposits with tram track appearance
membranoproliferative glomerulonephropathy (type 1)

associated with?
HBV or HCV

Type II is C3 nephritic factor
1st sign of diabetes in kidney?
microalbuminuria
sclerosis of mesangium
Kimmelstiel Wilson nodules of diabetes

pathogenesis?
NEG of vascular basement membrane leading to hyaline arteriolosclerosis (more in efferent arteriole)
proteinuria <3.5 g/day with glomerular filtration and RBC casts
nephritic syndrome

other signs?
salt retention and periorbital edema, oliguria and azotemia
young male with hematuria and hemoptysis
Goodpasture's

anti what?
antibody to basement membrane and linear IF
wire looping of capillaries
diffuse proliferative glomerulonephritis

most common cause of death in?
SLE
subepithelial humps
post-streptococcal glomerulonephritis

which kind of strep infection carrying what?
Strep pyogenes infection of skin or pharynx which carries M protein virulence factor (usually in children who rarely progress to renal failure)
crescents are comprised of what?
fibrin and macrophages
hematuria, hearing loss and ocular disturvbances
Alport syndrome (type 4 collagen defect resulting in splitting of basement membrane) x-linked
hematuria with RBC casts following mucosal infection
IgA nephropathy (Berger disease)
3 types of rapidly progressive glomerulonephritis
goodpastures, Wegener's and microscopic polyangitis
Waxy casts
advanced renal disease or CRF (stasis of flow)
WBC casts
tubulointerstitial inflammation, acute pyelonephritis, transplant rejection
ovoid PAS + hyaline masses in mesangial core
Kimmelstiel-Wilson lesions
radiolucent stones
uric acid stones
kid with yellow-brown hexagonal crystals in stones
cysteinuria

treat with?
alkalinization of urine
stones from urease-positive UTI bugs
staghorn calculi made up of ammonia magnesium phosphate
most common stones (cancer, PTH)
calcium phosphate or oxalate stones
crystals that look like envelopes
oxalate crystals from ethylene glycol poisoning
hematuria, palpable mass, secondary polycythemia, flank pain, fever, weight loss
Renal cell carcinoma

spreads?
hematogenously to lung and bone via IVC
child with huge, palpable flank mass containing embryonic structures
Wilm's tumor (nephroblastoma)

what other symptoms?
deletion of what?
Aniridia, genitourinary malformation, retardation

deletion of tumor suppressor gene WT1
painless hematuria?
transitional cell carcinoma

risk factors?
Pee SAC: phenacetin, smoking, aniline dyes, cyclophospamide
hematuria in an immigrant
squamous cell cancer of the bladder due to schistosoma hematobium
lab findings of cystitis?q
1) cloudy urine with >10 WBCs/hpf
2) positive leukocyte esterase and nitrites
3) greater than 100000 colony forming units
fever, CVA tenderness, nausea and vomiting
Acute pyelonephritis

causes of UTI?
E. Coli (80%)
Staph saphrophyticus in cystitis (sexually active female)
Proteus, Klebsiella, Enterococcus
What is sterile pyuria due to?
Chlamydia trachomatis or neisseria gonorrhea
asymmetric corticomedullar scarring with blunted calyces
chronic pyelonephritis

what is it due to?
obstruction or Vesicoureteral reflux
thyroidization of kidney (eosinophilic casts in tubles with WBC casts in urine)
chronic pyelonephritis
diffuse cortical necrosis is a side effect of what?
vasospasm and DIC seen in obstetric complications or septic shock
List the events of the 3 stages of ATN:
1) Inciting event: hemorrhage, acute MI, sepsis
2) Maintenance phase: oliguric, 1-3 weeks, hyperkalemic, fluid overload
3) Recovery: polyuric, decreased BUN & Cr, hypokalemic
microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure
HUS

due to e.coli 0:157
most common cause of ARF in children
Calcium wasting and phosphate retention in pt with renal failure
renal osteodystrophy

what is it due to?
failure of vit D hydroxylation leading to secondary hyperparathyroidism
cysts and shrunken kidneys in an adult
dialysis cysts
small shrunken kidneys with medullary cysts, kidney stones and progressive renal insufficiency?
medullary cystic disease
colicky pain with hematuria and unilateral flank tenderness
nephrolithiasis
list 6 features of Chronic renal failure
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
renal cell carcinoma has which paraneoplastic syndromes?
EPO, renin, PTHrP, or ACTH
male smoker with one mass in upper pole of kidney
sporadic renal cell carcinoma
hemangioblastoma of cerebellum and bilateral renal cell carcinomas
Von-Hippel Lindau disease

pathogenesis?
(loss of VHL tumor suppressor gene leads to increase IGF-1)
two pathway of transitional cell carcinoma development:
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
Schistosoma hematobium leads to?
squamous cell carcinoma of the bladder