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130 Cards in this Set
- Front
- Back
Most common renal stone composition
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Calcium Oxalate (70%)
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True or false: most patients with calcium oxalate stones have hypercalcemia
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FALSE. Most do not
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Do uric acid and cystine stones tend to form in acidic or basic urine?
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Acidic
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Lung symptom seen with Goodpasture's
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Hemoptysis
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Amyloid deposition enlarging the kidneys?
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Multiple Myeloma
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"Wire loop" thickening of glomerular capillaries
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SLE
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Lens dislocation + kidney disease =
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Alport syndrome
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True or false: Hypertension almost always shows up in advanced renal destruction
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TRUE
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Age group and sex for urethral squamous cell carcinoma
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Older female
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Global dilation within the kidney usually results from?
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Hydronephrosis due to downstream obstruction
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Appearance of kidneys in benign nephrosclerosis
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Smaller with granular surfaces
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In IgA nephropathy (Berger's disease), initial episode of hematuria usually follows a ????
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URI
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Recurrent hematuria in young adult = ???
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IgA nephropathy (Berger's disease)
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Disease with co-morbidity for IgA nephropathy
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Celiac
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Type of antibody deposited in postinfectious glomerulonephritis
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IgG
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What is deposited in glomeruli in membranoproliferative glomerulonephritis?
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IgG + C3
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Usual outcome of poststreptococcal?
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Complete recovery w/o treatment (1% progress to rapid progressive glomerulonephritis)
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True or false: most uric acid stones are related to gout
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FALSE
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CBC abnormality with 5-10% of renal cell carcinoma
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Polycythemia (due to erythropoietin)
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Usual inheritence of Alport
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X-linked (autosomal recessive, dominant patterns do exist)
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Tubular epithelium foam cell are charcteristic of:
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Alport
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Genetic defect in Alport
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Mutation in alpha-5 chain of type IV collagen
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Dark urine + sensorineural hearing loss + corneal erosions
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Alport
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Name some drugs which can cause drug-induced interstitial nephritis
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Sulfonamides, penicillins, cephalosporins, floroquiniolones, anti-TB drugs, thizides, loop diuretics, H2 blockers, NSAIDS, and others
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Type of hypersensitivity with drug-induced interstitial nephritis
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Both type I (increased IgE) and type IV (skin test positivity)
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Likely cause of eosinophil in urine
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Drug induced interstitial nephritis
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Usual delay from use of drug to interstitial nephritis
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2 weeks
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Common cause of hemolytic-uremic syndrome
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Ingestion of verocytotoxin-producing E. Cole (usually O157:H7)
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Child eats meat then has dark urine/stool + glomerular thrombi. Dx?
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Hemolytic-uremic syndrome
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Child w/ nephrotic syndrome and NO other findings. Likely dx?
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Minimal change disease
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Alternate name for minimal change disease
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Lipoid nephrosis
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Variable basement membrane thickening is seen in?
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Alport
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Characteristic EM finding of minimal change disease
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Effacement/fusion of podocyte food processes
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IgG + C3 granular deposition and electron-dense subepithelial humps. Likely dx?
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Postinfectious
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Reason adult with postinfectious glomerularnephritis may have no infection hx
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Infectious was too mild to notice
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Postinfectious glomerulonephritis: worse outcome in kids or adults?
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Adults. 1 in 6 progress to chronic failure, kids almost all recover
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Effect of schistosomiasis on bladder
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Chronic inflammation and scarring
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Bladder outlet obstruction increases risk of?
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Infection (particularly E. Coli)
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Describe malacoplakia. What setting does it normally occur?
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Reaction to chronic bladder infection causes reduced macrophage function, which develop intracellelular concretions (Michaelis-Gutman bodies). Occurs in immunosupression.
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Typical causative organisms in malacoplakia
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E. Coli and Proteus
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Define: tubulorrhexis
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Rupture of tubular basement membrane
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Fibrinoid necrosis in kidney arterioles is typical of?
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Nakugbabt beogrisckerisus
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Name the three phases of acute tubular necrosis
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Initiation (1 day), maintenance, recovery
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Key features of maintenance phase of acute tubular necrosis
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Progressive oliguria, increasing BUN, salt/water overload
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Key features of recovery phase of acute tubular necrosis
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Stead increase in urine output (can be very high), hypokalemia
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Likely dx for painless hematuria in older adult
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Renal neoplasm
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Reason NSAID's decrease GFR
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Less prostaglandins = less afferent vasodilation
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UA findings with renal TB
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Sterile pyuria
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Presence of WBC casts means?
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Infection has gotten to kidney
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Classic lesions in diabetic nephropathy
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Nodular and diffuse glomerusclerosis
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Predictor of future nephropathy in type 1 diabetic
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Microalbuminuria
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Glomerular lesion seen with goodpastures
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Rapidly progressive glomerulonephritis
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C3 nephritic factor is present in
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Type II membranoproliferative glomerulonephritis (dense deposit disease)
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Alternate name for type II embranoproliferative glomerulonephritis
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Dense deposit disease
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Other organ possibly involved in autosomal-recessive PKD
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Liver
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Gene and encoded protein in ARPKD
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PKHD1, Fibrocystin
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Places PKHD1 is expressed
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Kidney, liver, pancreas
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Genes and encoded protein in ADPKD
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PKD1 and PKD2, Polycystin
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Most common renal cystic disease in fetus, infant
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Multicystic renal dysplasia (multicystic dysplastic kidney)
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Relative size of cysts in multicystic renal dysplasia
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Variable
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Easiest way to segregate ARPKD from multicystic renal dysplasia
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Liver involvement
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Pelvicaliceal dilation =
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Hydronephrosis
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Blunted calyces =
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Chronic pylenonephritis
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Most frequent cause of chronic pyelonephritis
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Reflux nephropathy
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Kidneys are shrunken, unequal with deep, irregular surface scars. Likely Dx?
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Chronic pyelonephritis
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Kidneys appearance in SLE nephritis
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Bilateral symmetric involvement, shrunken, finely granular
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Rash and decreased urine output after strep infection. Likely cause?
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Antibiotic sensitive (poststrep glomerulonephritis does not likely cause a rash)
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Most common renal neoplasm in children
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Wilms tumor
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Microscopic pattern of Wilms tumor
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Nephroblastoma (resembles fetal kidney nephrogenic zone)
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Renal cell carcinoma: adults or children
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Adults
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Transitional cell carcinoma: adult or child
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Adults
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Recurrent hematuria after a viral illness in child/young adult = ?
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IgA nephropathy
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Genetic defects in glomerular basement membrane structure = ?
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Hereditary nephritis
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Connection from bladder to umbilicus in child = ?
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Persistant urachus
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What is exstrophy?
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Lower abdomen wall does not develop, bladder has open defect
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Steroid responsive proteinuria in a child
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Minimal change disease
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Reason for name minimal change disease
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Kidney looks normal by light microscopy
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Most likely cause of foot process fusion in minimal change disease
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Injury to visceral epithelium by T cell derived cytokines
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Immune complex deposition in membranous glomerulopathy: steroid responsive?
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Nodular and diffuse glomerusclerosis
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Both postinfectious glomerulonephritis and membranous glomerulopathy can have IgG + C3 deposits. How can you differentiate?
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Postinfectious = electron dense subepithelial humps, membranous = diffuse basement membrane thickening
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Medullar sponge kidney: usually unilateral or bilateral?
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Bilateral in 70%
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Typical presenting age and symptoms of medullary sponge disease
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30's or 40's, can be stones (more than 50%), infections, or recurrent hematuria
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Small cysts in dilated collecting ducts = ?
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Medullary sponge disease
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Composition of staghorn calculi
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Magnesium ammonium phosphate
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Recurrent UTI with urea-splitting organisms (i.e. Proteus) can lead to formation of which stone?
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Staghorn (Magnesium ammonium phosphate)
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This stone is large and projects into calyces
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Staghorn (Magnesium ammonium phosphate)
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Necrotizing papillitis with paillary necrosis is a complicaiton of?
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Acute pyelonephritis
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Dz giving increased predisposition to papillary necrosis following acute pyelonophritis
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Diabetes
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Papillary necrosis can occur with long term use of?
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Analgesics
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Nephropathy occuring with AIDS resembles?
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Focal segmental glomerusclerosis
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Two infection that can cause membranous glomerulopathy
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Hepatitis, malaria (note 85% is still idiopathic)
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Exposure to arylamines (ex: aniline dyes, beta-naphthylamine) increases risk of?
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Bladder cancer (urothelial carcinoma)
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SLE: Nephritic or nephrotic syndrome?
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Nephritic
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RBC casts: nephritic or nephrotic?
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Nephritic
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Both thickening and thinning and glomerular basement membrane = ?
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Alport syndrome
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Oval fat bodies: nephritic or nephrotic?
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Nephrotic syndrome
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Likely cause of unexpected death in ADPKD
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Ruptured berry aneurysm (present in 10-30%)
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Cancer with increased risk in analgesic nephropathy patients
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Transitional cell carcinoma of renal pelvis
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Likely dx in patient with HTN, bilaterally small kidneys, and no significant history of symptoms
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Chronic glomerulonephritis - can develop insiduously w/o preceding acute episodes
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Type of antibody in goodpastures
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IgG
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Type of glomerular lesions in SLE
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Diffuse proliferative (more common) or crescentic (less common) glomerulonephritis
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Typical cause of hyaline arteriolosclerosis in kidneys
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Benign hypertension
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Urine finding in multiple myeloma? Why is this tricky for test questions?
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Bence Jones proteinuria. This is NOT detected by standard dipsticks
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"Stop sign" shaped crystals in urine
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Cysteinuria
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Type of casts seen in multiple myeloma
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Amorphous blue-to-pink casts
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Type of necrosis occuring in renal infarction
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Coagulative
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Cause of scattered petechial hemorrhage + edema in kidneys
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Hyperplastic arteriolosclerosis associated with malignant HTN
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Give the three types of crescentic glomerulonephritis
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Type I - Anti-GBM, Type II - Immune complex, Type III - neither
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Causes of type II crescentic glomerulonephritis
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SLE, Henoch-Schonlein purpura, postinfectious
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Causes of type III crescentic glomerulonephritis
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Wegener's granulomatosis, microscopic polyangiitis
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Renal complication in rheumatoid arthritis
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NONE
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Renal manifestation of chronic hypercalcemia (as with malignancy)
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Initial loss of concentrating ability followed by progressive loss of function
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Renal manifestation of Wegener granulomatosis
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Rapidly progressive (crescentic) glomerulonephritis
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Kidney problems + positive C-ANCA?
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Wegener's granulomatosis
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Alternate name for crescentic glomerulonephritis
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Rapidly progressive glomerulonephritis
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Membranous glomeruonephritis: more likely nephritic or nephrotic?
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Nephrotic
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Name the two distinctive vascular lesions of malignant HTN
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Necrotizing arteriolitis, hyperplastic arteriolosclerosis
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Two most likely causes of papillary necrosis
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Diabetic or analgesic nephropathy
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Focal segmental: presents with nephritic or nephrotic?
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Nephrotic
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Child with steroid-responsive nephrotic syndrome. Likely dx?
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Minimal change disease (lipoid nephrosis)
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Membranoproliferative glomerulonephritis: more likely nephritic or nephrotic?
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Nephritic
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Membranoproliferative glomerulonephritis: more likely adult or child?
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Adult
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Greatest risk factor for urothelial carcinoma of the bladder
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Smoking
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Schistosomiasis is a risk factor for which bladder cancer?
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Squamous cell
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Term used when sclerosis of many glomeruli is present with no clear cause
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Chronic glomerulonephritis
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Most often presenting age range for clear cell carcinoma
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60's or 70's
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Gene lost in 80% of sporadic clear cell carcinomas
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VHL
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Mutation associated with papillary variant of renal cell carcinoma
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MET gene (chromosome 7)
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Most common cause of nephrotic syndrome in adults
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Focal segmental glomerusclerosis
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Dysfunction of podocyte slit diaphragm apparatus is seen with which glomerular lesion?
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Focal segmental glomerusclerosis
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