Renal 2

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  1. An elderly man presents with flank pain and hematuria. What can be an associated factor? 
    • Hct of 60% (due to EPO production causing polycythemia)
    • (other factors: PTHrP, ACTH, HT)
  2. A person with BPH can produce what bladder complication?
    Bladder outlet obstruction due to bladder hypertrophy: can increase the risk of infections of E.coli and M.TB.
  3. Ischemic acute tubular necrosis presents what on histology?
    Rupture of the basement membrane (tuborrhexis) 
  4. A female undergoes mastectomy of a breast tumor that has spread to her verterbral column, and eventually presents with renal failure. What will most likely be increased in blood?
  5. Shrunken U/L kidney associated with coarse and irregular scarring, blunting and deformity of the calyces, and polyuria. Dx?
    Chronic pyelonephritis (polyuria due to scarring of the tubules)
  6. Shrunken B/L kidneys with a fine granular appearance. Three dx?
    • 1. SLE
    • 2. Chronic glomerulonephritis (ESRD)
    • 3. Benign nephrosclerosis 
  7. Superficial papillary tumors of the bladder have a mutation in what gene?
    Invasive bladder tumors have a mutation in what gene?
    • Chr 9
    • Rb (Chr 13) and p53. 
  8. What is a complication of acute pyelonephritis?
    Renal papillary necrosis.
  9. Most common cause of acute tubular necrosis? 
    • Ischemia: e.g. myocardial infarction. 
    • Note: Benign nephrosclerosis takes years to develop, MI thrombi could cause a renal infarct but would be small.
  10. What is seen on histology of malignant hypertension?
    Fibrinoid necrosis and hyperplastic arteriosclerosis. 
  11. Histology of ARPKD and most common association? 
    • Bilaterally enlarged kidneys with small, radially arranged cysts. 
    • Association with hepatic fibrosis (hepatic cysts and proliferation of bile ducts). 
  12. Acute leukemias predisposes to what stones?
    Rapid cell turnover causes uric acid precipitation.
  13. Difference between nephrotic syndrome vs. pneumonia? 
    Decrease capillary oncotic pressure (transudate) vs. increased permeability to proteinaceous fluid (exudate)
  14. Metabolic alkalosis with hypokalemia and increased K+ urine loss? 
    Diuretics (loops or thiazides)
  15. A well-circumscribed tumor with intercalated cells of the collecting tubules with eosinophilic cytoplasm and prominent mitochondria. 
    Renal oncocytoma
  16. A well-circumscribed mass with complex branching papilloma structures with cuboidal cells and polyglonal shaped? 
    Renal adenoma
  17. A mass with large, foamy macrophages with multinucleated giant cells and PAS+ due to phagolysosomes?
  18. A tumor that resembles transitional cells and has absent mitosis?
    Urothelial papilloma
  19. CVA tenderness occurs at what location? 
    Inferior and lateral to the 12th thoracic vertebrae
  20. A boy has a perianal rash most commonly at night. Treatment? 
  21. What casts are seen with chronic renal disease?
    • 1. waxy casts
    • 2. granular casts
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Renal 2

renal mix
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