Internal Disorders 2 Exam 3 Combined Quizlets

Struvite stones are due to what

Kidney infection

Struvite stones are due to what?

Kidney infection

Struvite stones are due to?

Kidney infection

When Vitamin D is taken in excess, the organ that can be permanently damaged is:

Kidneys

Potter's syndrome

Lack of amniotic fluid leads to deformities of limbs, face, and ears

Most common heavy metal toxicity in US

Lead

A 5 year-old patient presents to your office with delayed learning, fatigue, abdominal pain, loss of appetite, anemia, paleness, and irritability. You order labs for the patient, and they showed bland urinary sediment and hyperuricemia (renal insufficiency). What does your patient have:

Lead based nephropathy

A child presents with signs of delayed learning and pseudo lines upon imaging, what is this indicative of

Lead nephropathy

A child presents with signs of delayed learning and pseudolines upon imaging, what is this indicative of?

Lead nephropathy

Child presents w/ signs of delayed learning and pseudolines upon imaging. Dx?

Lead nephropathy

Patient presents post stroke with reduced desire to urinate and difficulty stoping micturition once started

Lesion of superior frontal gyrus

Patient presents post stroke with reduced desire to urinate and difficulty stopping micturition once started?

Lesion of the superior frontal gyrus

Acute kidney disease timing

Less than 7 days

A 44 year-old Caucasian female presents to your clinic complaining of bilateral wrist and hand pain with apparent ulnar deviation. Upon palpation and joint assessment of the hands, you find the deformities of the hands can be reversed with manipulation. Inspection reveals a rash beneath the eyes and over the bridge of the nose. If this patient presented with swelling of the extremities, history of hypertension, and decreased urine output, you could suspect:

Lupus Nephritis

M/c/c of nephrotic syndrome in adults

Membranous glomerulonephropathy

Patient presents with fever, anorexia, purpura, and livedo racemose. What should be at the top of your differential?

Microscopic polyangiitis

Patient presents with fever, anorexia, purport, and livedo racemose. What should be at the top of your differential

Microscopic polyangitis

Pt presents w/ fever, anorexia, purpura, and livedo racemose

Microscopic polyangitis

A 3 year old child is brought to the office with severe peripheral edema, exertional dyspnea, and abnormal fluid retention within her abdomen despite her recent loss of appetite. Lab work is immediately indicated and the results were as follows: heavy proteinurea, hypoalbuminemia, and hyperlipidemia. Which of the following differentials should be at the top of your list?

Minimal change disease

A child presents with full blown nephrotic syndrome, what should be at the top of your differential

Minimal change disease

A child presents with full blown nephrotic syndrome, what should be at the top of your differential?

Minimal change disease

M/c/c of nephrotic syndrome in children?

Minimal change disease

Punched out lesions seen on x-rays are seen in which pathology?

Multiple Myeloma

Thomas, 71 year old male, presents to the office with persistent back pain which began two weeks ago. The patient denies any recent trauma or injury. He notes he feels more fatigued than normal because the pain has been keeping him up at night. Thomas has a history of low back pain in which he used chiropractic care to manage his pain, but Thomas states this is a different type of pain because his "bones hurt." Lower lumbar and pelvis series were completed. Punched out lesions were noted on Thomas's femurs and ilia bilaterally. Based on the patient's presentation, what condition would you put at the top of your differential diagnosis?

Multiple Myeloma

What condition is classically characterized by the presence of bence jones proteins

Multiple myeloma

What condition is classically characterized by the presence of bence jones proteins?

Multiple myeloma

Mrs. Amy Schumer, a 33 year-old Caucasian female, BMI 24, presented to your office complaining of unexplained low back pain. She also complained of "bone pain" and described it as a deep boring ache in her thigh. You decide to do a CBC and an x-ray series. On her x-ray you notice punched out lesions, and on the CBC you note she is hypercalcemic with normochromic anemia. Based off of the above findings, what is your diagnosis?

Multiple myeloma leading to chronic tubulointerstitial nephritis

Which of the following is associated with hypercalcemia? Select all that apply.

Muscle weakness Bradycardia Nephrocalcinosis Arrhythmias

Patient presents w/ flank pain and Smokey brown urine

Nephritic Syndrome

What condition is characterized by hematuria, oliguria, HTN, and edema?

Nephritic Syndrome

What condition is categorized by hematuria, oliguria, HTN, and edema?

Nephritic syndrome

Jonathan, 55 year old male, presents to the clinic today complaining of generalized "puffiness" in his face, hands, and ankles as well as abdominal pain. The patient states he did not eat breakfast this morning because he lacks an appetite. Two weeks ago Jonathan noticed that he became short of breath while walking his dog after work and it has progressively worsened since then. Jonathan denies a history of recent infection or antibiotic use. Upon initial inspection, you note his eyelids appear swollen and his abdomen distended. During the peripheral vascular exam, there is notable edema in his hands and ankles. Urinalysis indicates proteinuria (4000 mg/24 Hours) and lipoprotein analysis indicates hypercholesterolemia. Based on the patient's presentation and lab findings, what is the most likely diagnosis?

Nephrotic Syndrome

What condition is characterized by proteinuria, hyboalbuminemia, edema, hyperlipidemia?

Nephrotic syndrome

Post-renal disease indicates?

Obstruction

What is the most concerning complication of congenital abnormalities?

Obstruction Infection and stone formation

What is the most concerning complication congenital abnormalities?

Obstruction Infection Stone formation

Which type of pt would need to be screened for renal artery stenosis?

Onset of HTN <30 y/o Severe HTN >55 y/o Accelerated HTN Sudden unexplained pulmonary edema

sHPT nephrosclerosis

Pathological bone fractures due to CDK is most likely the result of ... Select TWO answers. a.) sHPT b.) decreased renal erythropoietin production c.) nephrosclerosisrenal d.) metabolic acidosis e.) azotemia

Pt presents 1-4 weeks after a strep infection w/ HTN and smoky-brown urine

Post-infectious glomerulonephritis

Patient presents 1-4 weeks after a strep infection with HTN and smoky brown urine

Post-infectious glomerulonephropathy

Patient presents 1-4 weeks after a strep infection with HTN and smoky brown urine?

Post-infectious glomerulonephropathy

Benign prostatic hyperplasia and kidney stones are a common cause of what type of renal failure?

Post-renal

BPH and kidney stones are common causes of what type of acute failure?

Post-renal Post-renal indicates obstruction

BPH and kidney stones are common causes of what type of acute failure

Post-renal/obstruction

A mother brings her 6 year-old son into your office due to a history of frequent URTIs and ear infections. His most recent infection was 2 weeks ago, however since it was not as severe as other infections he has had, so instead of the usual antibiotic therapy, his MD suspected a virus and suggested she let it "run its course" with increased fluids and bed rest, but this time, his mother reports, "he is still not 100%" She states his urine has had a cloudy, brownish appearance despite increasing water and Pedialyte intake, but bowel movements remain normal. Physical exam reveals temperature of 100.2 F, mild edema of the extremities, and pain with muscle guarding upon palpation of the costovertebral region. Eyes, skin, and oral mucosa are all clear and within normal limits with visual inspection. The most likely diagnosis is:

Post-streptococccal glomerulonephritis

A 64 year-old African American man with a 3 year history of hypertension and diabetes mellitus, for which he takes hydrochlorthiazide and metformin respectively, presents to your clinic with shoulder pain and stiffness of insidious onset, that he has been addressing using 300mg acetaminophen 3x per day. Upon postural exam and palpation, he expresses deep, aching pain in his thoracolumbar junction and paraspinal musculature. He denies having vomited, or feeling feverish. Upon urinalysis you would expect his etiology and GFR to be.

Pre-renal; Decreased

A female has a UTI that hasn't gone away in two weeks. Top of differential?

Pyelonephritis

How do patients present w/ an allergic reaction to medication?

Rash, fever, oliguria, proteinuria, swelling

A lesion to the superior frontal gyrus can be the result of a stroke and lead to?

Reduced desire to urinate, difficultly stopping micturition once started

ACE inhibitors

Relax blood vessels and help reduce amount of water reabsorbed by kidney

A 72 year old male patient presents to your office after "peeing blood this morning", associated symptoms include fatigue, weight loss, fever and acute flank pain. Your top differential diagnosis would be?

Renal Cell Carcinoma

Mrs. Frida Kahlo, a 29 year-old female, presented complaining of abdominal pain. She has a 10-pack year history of smoking, and a 3-month history of hypertension. After completing a focused history and physical exam, you find that the patient is healthy without any additional or unusual risk factors. What would be at the top of your differential diagnosis?

Renal artery stenosis: Fibromuscular dysplasia

60 y/o male present w/ flank and back pain. He has a low-grade fever. He notes that he does not struggle w/ urinating. There is hematuria found w/ urinalysis. Dx?

Renal cell carcinoma

64 y/o male present w/ right-sided mass and hematuria but no change in urine. Dx?

Renal cell carcinoma

64 year old male presents with a painful right sided mass and hematuria but no change in pee, what is the diagnosis

Renal cell carcinoma

64 year old male presents with a painful right sided mass and hematuria but no change in pee. What is the diagnosis?

Renal cell carcinoma

What is the m/c benign renal tumor?

Renal fibrous/hamartoma

Young boy w/ sickle cell dz presents to office w/ flank pain, hematuria, and polyuria. What should you consider?

Renal infarct

What condition presents w/ damage to skeletal muscle and breakdown of fibers that lead to release of myoglobin in blood and cola-colored urine?

Rhabdomyolysis

What condition presents with damage to SKM and breakdown of the fibers that lead to the release of myoglobin into the blood

Rhabdomyolysis

What condition presents with damage to skeletal muscle and breakdown of the fibers that lead to the release of myoglobin into the blood?

Rhabdomyolysis

Young woman w/ joint pain and malar rash

SLE

Pt had a URTI and now has hematuria and a fever for two weeks, following what condition?

Secondary glomerulonephritis (nephritic syndrome)

What physical exam finding would you expect to see in a patient who has nephrotic syndrome?

Severe peripheral edema

Acute pyelonephritis is more common in ___and the patient will present with ____.

Sexually active females, general malaise and flank pain

Features of hypokalemia

Spastic paralysis Fatigue Constipation

Post-menopausal woman presents w/ involuntary leak of small amounts of urine when she coughs or sneezes. Dx?

Stress incontinence

Postmenopausal woman presents with involuntary leak of small amounts of urine when she coughs or sneezes.

Stress incontinence

Postmenopausal woman presents with involuntary leak of small of urine when she coughs or sneezes

Stress incontinence

When are kidney stones most prevalent

Summer

All of the following are true relative to a newborn diagnosed with autosomal recessive polycystic kidney disease except:

The cysts associated with the disorder can develop anywhere along the nephron

A 35 year old female presents with fever, CNS involvement, hemolytic anemia, and thrombocytopenia. Upon a urinalysis, proteinuria, hematuria, and renal insufficiency are noted. What does your patient have:

Thrombotic Thrombocyptopenic Purpura

What is the triad of hemolytic anemia, thrombocytopenia, and acute kidney injury indicative of?

Thrombotic microangiopathies More specifically hemolytic uremic syndrome

What is the triad of hemolytic anemia, thrombocytopenia, and acute kidney injury indicative of?

Thrombotic microangiopathies (hemolytic uremic Syndrome)

<40 y//o F w/ fever, CNS involvement, hemolytic anemia, thrombocytopenia

Thrombotic thrombocytopenia purpura

Lola Bunny a 35 year old female presents to your office today with a fever, hemolytic anemia, thrombocytopenia, a noticeable CNS involvement along with purpura bilaterally on the lower legs. A histological exams reveals thrombi consisting of fibrin and platelets in the terminal interlobular arteries, the afferent arterioles and glomerular capillaries. What is the most likely condition pertaining to Mrs. Bunny?

Thrombotic thrombocytopenia purpura

nephritic Wegener's granulomatosis

Timmy presents at the nephrology ward 2 weeks after a throat infection. Findings see picture. Timmy shows signs of the _______ syndrome. The most likely DDx is _______

What symptoms are associated with chronic kidney disease

- Anemia - Polyneuropathies - CNS disturbances

What are the m/c/c of chronic kidney disease

- HTN - DM

What are the common signs and symptoms of chronic pyelonephritis

- HTN - Frequency/dysuria - Flank pain

What is the most concerning complication of congenital anomalies

- Obstruction - Infection and stone formation

Which type of patient would need to be screened for RAS

- Onset of HTN under age 30 - HTN age 55+ - Malignant HTN - Accelerated HTN - Sudden unexplained pulmonary edema

What is the triad of hemolytic anemia, thrombocytopenia, and acute kidney injury indicative of

- Thrombotic microangiopathies - Hemolytic uremic syndrome

Glomerulonephritis

3 weeks after an episode of GABHS pharynngitis, a nine-year-old male presents with oliguria, BUN-to-serum Cr 15:1, and FENa 2.5%, and urine sediment positive for dysmorphic RBCs with casts. What renal disease is most likely? a.) Hemolytic-uremic syndrome b.) HUS is caused by E. coli, not GABHS. c.) Glomerulonephritis d.) Tubulointerstitial nephritis e.) Acute tubular necrosis

Intrinsic AKI

3 weeks after an episode of GABHS pharynngitis, a nine-year-old male presents with oliguria, BUN-to-serum Cr 18:1, and FENa 2.5%, and urine sediment positive for dysmorphic RBCs with casts. What category of renal disease is most likely? a.) Intrinsic AKI b.) Prerenal AKI c.) Nephrolithiasis d.) Postrenal AKI

Which of the following are indicators for testing someone w/ renal artery stenosis?

55 y/o w/ accelerated HTN

Segmental sclerosis of the glomeruli

A 36-year-old African-American man comes to the physician for a 4-week history of swollen legs. He has difficulty putting on socks because of the swelling. Two years ago, he was diagnosed with sleep apnea. He takes no medications. He is 171 cm (5 ft 6 in) tall and weighs 115 kg (253 lb); BMI is 39 kg/m2. His pulse is 91/min and blood pressure is 135/82 mm Hg. Examination shows periorbital and bilateral lower extremity edema. A renal biopsy is obtained. Which of the following is most likely to be seen under light microscopy of the patient's renal biopsy specimen? a.) Diabetic hyaline arteriolosclerosis b.) Amyloid deposition in the mesangium c.) Diffuse thickening of glomerular capillaries d.) Fibrin crescents within the glomerular space e.) Segmental sclerosis of the glomeruli f.) Eosinophilic nodules within the glomeruli

Salt retention

A 40-year-old woman comes to the physician because of a 1-week history of fatigue, dark urine, and a feeling of heaviness in her legs. Two weeks ago, she returned from a vacation to Brazil, where she spent most of her days exploring the city of Rio de Janeiro on foot. She also gained 3 kg (7 lb) during her vacation. She has systemic lupus erythematosus. Her only medication is hydroxychloroquine. Her temperature is 37.5°C (99.5°F), pulse is 78/min, and blood pressure is 162/98 mm Hg. Physical examination shows 2+ pretibial edema bilaterally. Urinalysis shows: Which of the following is the most likely cause of this patient's leg findings? a.) Hypoalbuminiemia b.) Reduced cardiac stroke volume c.) Increased capillary permeability d.) Salt retention e.) Venous insufficiency

Acute tubular necrosis

A 52-year-old female undergoes IV urography (pyelogram) for diagnosis of suspect kidney stones. The woman has had several episodes of left lower back pain and macroscopic hematuria for two weeks. During the week after the procedure, the patient develops continuously decreasing urine volume. Lab positive for BUN-to-serum Cr 10:1, urine osmolality < 300 mOsm, urine Na 45, FENa 2.5%, and a urine sediment positive for granular casts with brown pigment and epithelial cells. What is the most likely differential diagnosis? a.) Uremia b.) Tubulointerstitial nephritis c.) Glomerulonephritis d.) Acute tubular necrosis

Fatty casts

A 6-year-old boy is brought to the physician because of increasing swelling around his eyes for the past 3 days. During this period, he has had frothy light yellow urine. He had a sore throat 12 days ago. He appears tired. His temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 105/65 mm Hg. Examination shows periorbital edema and pitting edema of the lower extremities. Cardiopulmonary examination shows no abnormalities. Which of the following findings on urinalysis is most likely associated with this patient's condition? a.) Waxy casts b.) Hyaline casts c.) Fatty casts d.) WBC casts e.) RBC casts f.) Muddy brown casts

Normal glomeruli on light microscopy

A 6-year-old girl is brought to the physician because of increasing swelling around her eyes for the past 3 days. Her vital signs are within normal limits. Physical examination shows periorbital edema and abdominal distention with shifting dullness. Laboratory studies show a serum albumin of 2 g/dL and a serum cholesterol concentration of 290 mg/dL. Urinalysis shows 4+ proteinuria and fatty casts. Histological examination of a kidney biopsy specimen is most likely to show which of the following findings? a.) Granular subepithelial deposits of IgG, IgM, and C3 on immunofluorescence b.) Normal glomeruli on light microscopy c.) Deposits of IgG and C3 at the glomerular basement membrane on immunofluoresence d.) Subepithelial dense deposits on electron microscopy e.) Mesangial proliferation on light microscopy f.) Effacement of foot processes of podocytes on light microscopy

BUN/serum creatinine ratio 25:1

A 68-year-old man is admitted to the intensive care unit after open abdominal aortic aneurysm repair. The patient has received 4 units of packed red blood cells during the surgery. During the first 24 hours following the procedure, he has only passed 200 mL of urine. He has congestive heart failure and hypertension. Current medications include atenolol, enalapril, and spironolactone. He appears ill. His temperature is 37.1°C (98.8°F), pulse is 110/min, respirations are 18/min, and blood pressure is 110/78 mm Hg. Examination shows dry mucous membranes and flat neck veins. The remainder of the examination shows no abnormalities. Laboratory studies show a serum creatinine level of 2.0 mg/dL and a BUN of 48 mg/dL. His serum creatinine and BUN on admission were 1.2 mg/dL and 18 mg/dL, respectively. Further evaluation of this patient is most likely to reveal which of the following findings? a.) Decreased urine osmolality b.) Proteinuria c.) Hematuria d.) RBC casts e.) BUN/serum creatinine ratio 25:1

GABHS

A patient experiences acute kidney injury (failure) after a recent episode of scarlet fever. What is the most likely cause of kidney injury in this case?

Samantha, 29 year old female, presents to the office with a chief complaint of general malaise and severe right flank pain. The patient states she has been experiencing nausea, chills, and dysuria for the past three days. Upon examination you note her temperature is slightly elevated and she reports tenderness along her costovertebral angle during palpation. The patient states she suffered from a urinary tract infection two weeks ago in which she took antibiotics prescribed by her primary care physician. Elevated leukocytes and bacteria were both reported on the patient's urinalysis. Based on the patient's presentation and laboratory findings, what is the most likely diagnosis?

Acute Pyelonephritis

What disease is commonly caused by an allergic reaction to a medication and presents w/ a rash and arthralgia?

Acute drug induced interstitial nephritis

What disease is commonly caused by an allergic reaction to a medication and presents with a rash and arthralgia?

Acute drug induced interstitial nephritis

What disease is commonly caused by an allergic reaction to medication and presents with a rash and arthralgia

Acute drug induced interstitial nephritis

A patient presents post-URTI and presents w/ joint pain, malar rash, and dark urine. Dx?

Acute glomerulonephritis

Bob Billings, a 10 year-old male, presented complaining of joint pains, dark urine and lack of appetite. His mother also reports that he had an upper respiratory tract infection 2 weeks ago. After completing a urine analysis, you find blood in his urine. Based off of the above findings, what is at the top of your differential?

Acute glomerulonephritis

Jim Morrison presents to your clinic today with an acute onset of pain in the right posterior upper quadrant. He reports that he has just began a new regiment of antibiotics that he has never taken before. After sending his blood out for lab work it returns revealing he has elevated potassium, hypercalcemia and hyperuricemia. What is the most likely cause for his pain.

Acute interstitial nephritis

A 44 year old female presents with flank pain, costovertebral angle tenderness, fever, chills, nausea and vomiting. The patient also describes recent dysuria and increased urgency. A urine sample is taken and sterile urine is found. Your top differential diagnosis would be:

Acute pyelonephritis

JoAnne Hart presents distressed and in a great deal of pain (7/10) that has progressed to this point within 3 hours. The pain is shown to be underneath the ribs on the right side. She reports feeling feverish at one point but then having chills as well. She vomited and then made a call to the office. Further history taking revealed that she has dysuria and also saw a "tinge of pink" in her urine. An abdominal exam was done and found a positive Murphy's punch.

Acute pyelonephritis

Sexually active female presents w/ costovertebral angle tenderness, fever, chills. Dx?

Acute pyelonephritis

Sexually active female presents with costovertebral angle tenderness, fever, chills

Acute pyelonephritis

What condition is characterized by ischemia that is prolonged over 6 hours?

Acute tubular necrosis

What conditions is characterized by ischemia that is prolonged over 6 hours

Acute tubular necrosis

Caused by overabundance of urate cells formed by breakdown

Acute urate nephropathy

Tumor lysis syndrome is the m/c/c of what condition

Acute urate nephropathy

Which of the following conditions is associated with tumor lysis syndrome?

Acute urate nephropathy

A patient with Aplort's syndrome may present with which of the following symptoms?

All of the above

Heavy Metal Nephropathy is caused by ingestion, inhalation or absorption through the skin or mucous membranes of which metals?

All of the above

Thomas Pickels is a 76 year old that presents to your office with severe diarrhea for the last three days. He states it has blood in it and he's vomited several times, starting two days ago. Thomas believed that he had food poisoning from undercooked meat but then noticed his urine output was also very little to none. He mentioned that he feels irritable and "out of my wits". You order a CBC and find what?

All of the above

Which type of patient would need to be screened for RAS?

All of the above (Onset of HTN at age <30 or severe HTN at age 55+, malignant HTN, accelerated HTN, and sudden unexplained pulmonary edema)

What symptoms are associated with chronic kidney disease?

All the above--> Anemia, Polyneuropathy, CNS confusion, coma, fits

Arnold Shortman is a 5 year old with congenital cataracts. His parents brought him in to see you because they has recently noticed blood in his urine. Arnold has had trouble hearing and eyesight which was diagnosed when he was 2. A urinalysis found proteinuria and hematuria while a CBC found thrombocytopenia and enlarged platelets. What condition does Arnold have?

Alport Syndrome

Child presents with cataracts and sensorineural deafness

Alport's syndrome

Kenny McCormick is a 23 year old that has been experiencing sudden unexplained shortness of breath. He has a history of hypertension that he has been compliantly taking his medications for this but it seems to be getting worse. On lung exam we find transmitted voice sounds and dull percussion note B/L in lower lobes. He mentioned that his urine out out has been slightly decreased even though he's been drinking more water. Kenny's findings fall under what category?

American College of Cardiology/American Heart Association guidelines for screening a Renal Artery Stenosis

Pt presents w/ peripheral neuropathy, SOB, arrhythmia, proteinuria, swelling of legs/feet

Amyloidosis

Renal artery stenosis

An individual presents with oliguria and azotemia due to severe narrowing of the kidney's main arteries due to atherosclerosis. The name of the disease is

renal artery stenosis prerenal

An individual presents with oliguria and azotemia due to severe narrowing of the kidney's main arteries due to atherosclerosis. The name of the disease is _________ This disease causes _________

S&S associated w/ chronic kidney disease?

Anemia, polyneuropathies, CNS disturbances

Lillian DeVille is a 7 year old female that presents with complaints of nausea. Her mom states that she's been feeling poorly for 4 weeks and has had a sore throat. Her mom also shared that Lillian complained of blood in her urine but is not voiding a lot. During inspection a mild fever was noted as well as moderate hypertension with peripheral edema. A throat exams revealed erythematosus with swollen tonsils A urinalysis discovered proteinuria, gross hematuria, azotemia and a low GFR. What is found in the blood to help confirm diagnosis?

Anti-streptomycin O antibodies

The most common medication in children that can cause rhabdomyolysis is:

Antihistamines

A 26 year old female patient presents with general malaise, slightly febrile with chills, flank plain, nausea, and dysuria. She has never experienced this before and it has progressively worsened. Lab work is ordered and reveals neutrophilic leukocytosis, elevated ESR and CRP, as well as hematuria. Acute pyelonephritis is now at the top of your diagnostic differential, which of the following would have likely caused this disorder in this patient?

Ascending/retrograde E. coli infection

What is the m/c/c of renal artery stenosis?

Atherosclerosis

What disease presents with hepatic abnormalities that are more problematic than the kidney problems

Autosomal recessive polycystic disease

What disease presents with hepatic abnormalities that are more problematic than the kidney problems?

Autosomal recessive polycystic disease

Patient presents post URTI and now complains of chest pain and heart murmur

Bacterial endocarditis

Patient presents post URTI and now complains of chest pain and heart murmur?

Bacterial endocarditis

What condition is due to longstanding essential HTN?

Benign nephrosclerosis

What is the m/c/c of acute urinary retention in men

Benign prostatic hyperplasia

What is the most common cause of acute urinary retention in men?

Benign prostatic hyperplasia

What are the m/c/c of acute urinary retention syndrome?

Benign prostatic hyperplasia Bladder Pelvic/urethral masses

What is the m/c hyperplastic lesion leading to urinary obstruction?

Benign prostatic hypertrophy

What is the m/c/c of acute urinary retention in men?

Benign prostatic hypertrophy

What condition is due to longstanding essential HTN

Bening nephrosclerosis

nephrotic Minimal change disease

Brian, 10 years old and stung by a bee, presents at the nephrology ward . He also has hypoalbuminemia, hyperlipidemia, and frothy urine with fatty casts. 24 hour urine collection shows massive proteiuria (> 3.5 g protein lost in urine/24 hr). Brian shows signs of the ______ syndrome. The most likely DDx is ______

Heavy metal toxicity linked w/ breast cancer, cardiovascular dz, chronic kidney dz

Cadmium

What is the m/c type of kidney stone?

Calcium oxalate

An established patient of yours presents to your office complaining of joint pain after spending a week in the hospital for acute tubular necrosis. She is a 50 year-old, overweight, African American female who underwent surgery for a cholecystectomy a month ago. She had been diagnosed with Atrial Fibrillation and had been taking Warfarin prior to her surgery, but did not cease usage appropriately before surgery which resulted in a hemorrhage, and led to ATN. This patient is now at greater risk of which renal disorder:

Chronic kidney disease

What disease is characterized by 3 month progression of kidney damage

Chronic kidney disease

What disease is characterized by 3 month progression of kidney damage?

Chronic kidney disease

What condition is caused by parenchymal scarring, recurring infections, obstructions, and reflux nephropathy

Chronic pyelonephritis

What condition is caused by parenchymal scarring, recurring infections, obstructions, and reflux nephropathy?

Chronic pyelonephritis

Involuntary twitching of the facial muscles when the facial nerve is lightly tapped just anterior to the external auditory meatus, indicating hypocalcemia is:

Chvostek sign

Mrs. Jenny Monae, a 33 year-old female, presented to your office complaining of muscle cramps in her back and legs. She also complained of muscle spasms in her throat. You elicit an involuntary twitching of the facial muscles by light tapping on the facial nerve. What sign have you elicited and what is it associated with?

Chvostek sign, Hypocalcemia

What is the most significant risk factor in regard to bladder cancer

Cigarette smoking

What is the most significant risk factor in regard to bladder cancer?

Cigarette smoking

What is the most significant risk factor in regards to bladder cancer?

Cigarette smoking

What is a common cause of hypokalemia

Diuretics

What is a common cause of hypokalemia?

Diuretics

Acquired or Congenital sac-like outpouchings through a weak point in the bladder are known as:

Diverticula

nephritic Goodpasture disease

Dorothy presents at the nephrology ward presenting with hemoptysis and oliguria.. Findings see picture. Dorothy shows signs of the _______ syndrome. The most likely DDx is _______

What physical exam finding would you find in both Nephritic and Nephrotic syndromes?

Edema

Tim Little is a patient that has an embryonic tumor that has areas of necrosis and hemorrhage. These tumors are aggressive and often metastasize to the lung. Choose from below everything else that would apply to this patient:

Elevated heart rate Hematuria Age 2

Hemolytic crisis, rhabdomyolysis & crush syndrome are seen in which category of acute tubular necrosis:

Endogenous toxic

Pt has burning and tingling discomfort

Fabry's syndrome

Features of hyperkalemia

Flaccid paralysis Bradycardia Asystole

Pt presents w/ nephrotic syndrome, recent URTI, Hodgkin's lymphoma

Focal segmental glomerulosclerosis

Michael, 31 year old Caucasian male, presents to the office complaining of shortness of breath any time he exerts himself as well as a productive cough which began three weeks ago. He states that he often notices blood in his sputum. On general inspection he appears pale and his temperature measures 38˚C. A chest series was performed and you note fluffy infiltrates in the lung fields. You order a blood analysis to test for HLA-BR2 which comes back positive. Based on the patient's presentation and lab findings, what is the most likely diagnosis?

Goodpasture's Syndrome

What disease is predominantly seen in young, white, male smokers

Goodpasture's syndrome

What disease is predominantly seen in young, white, male smokers?

Goodpasture's syndrome

nephrotic Focal segmental glomerulonephrosclerosis

Gregory, 55-year-old Hispanic male, presents at the nephrology ward. He has hypoalbuminemia, hyperlipidemia, and frothy urine with fatty casts. 24 hour urine collection shows massive proteiuria (> 3.5 g protein lost in urine/24 hr). Gregory shows signs of the ______ syndrome. The most likely DDx is ______

What is the most common complication of kidney hypoplasia

HTN

What is the most common complication of kidney hypoplasia?

HTN

What are the most common causes of chronic kidney disease?

HTN and diabetes

What are the common signs and symptoms of chronic pyelonephritis?

HTN, frequency/dysuria, and flank pain

Clinical features that indicate rapidly progressive glomerulonephritis

Hematuria, oliguria, HTN

Your patient comes in complaining of back pain. After running labs and tests, you notice the patient has hemolysis, thrombocytopenia, and an acute kidney injury. What does your patient have:

Hemolytic uremic syndrome

Craig, 6 year old male, presents to the office today with raised reddish-purple spots mainly on his legs, feet, and buttocks. His mother states he has been complaining of abdominal pain and nausea for the past two days. Craig had two episodes of diarrhea this morning. Upon physical examination, there is notable ankle edema. Based on the patient's presentation, what condition would you put at the top of your differential diagnosis?

Henoch-Schonlein Purpura

The most dangerous classic complication of Autosomal Recessive Polycystic Kidney Disease is:

Hepatic Fibrosis

Susie Carmichael has come to your office with complaints of persistent back pain. She has delt with the pain but recently noticed numbness and weakness which seems to be suggestive of a cord or nerve root compression. She also states that she has had multiple bacterial infections over the last 3 months. You take X-rays and notice "punched out lesions" in her pelvis. A blood sample would reveal what finding leading to renal failure?

Hypercalcemia

What is caused by vitamin D toxicity, cancer, HPT and is associated with nephrogenic diabetes insipidus

Hypercalcemia

What is caused by vitamin d toxicity, cancer, HPT and is associated with nephrogenic diabetes insipidus?

Hypercalcemia

Which of the following is not a clinical presentation of a patient with multiple myeloma?

Hyperkalemia

Which of the following signs/symptoms would a patient diagnosed with Goodpasture's syndrome most likely NOT complain of?

Hypertension

Charles Finster is a 47 year old Caucasian male who presents with exertional dyspnea. During the physical exam, peripheral edema along with eyelid edema are noted on inspection. He is hypertensive. The abdominal findings included a fluid wave while a urinalysis displayed high levels of proteinuria. What other abnormal finding would be present?

Hypoalbuminemia

What are pre-renal cause of acute renal failure

Hypoperfusion due to low blood pressure and ischemia

What are pre-renal causes of acute renal failure?

Hypoperfusion due to low blood pressure and ischemia

Brian, 22 year old male, presents today with a complaint "tea colored urine," which he noticed Tuesday morning. The patient states that he has experienced flank pain and swelling in his feet since Tuesday as well. He was diagnosed with an upper respiratory infection by his primary care physician one week ago. The patient was prescribed an antibiotic by his PCP, but states it has not helped. Urinalysis indicates hematuria. Based on the patient's clinical presentation, what immunoglobulin is most likely to be build up in the patient's mesangium?

IgA

Apolo Ohno is a 27 year old Asian-Pacific male that presents with recurrent bouts of flank pain. His physical exam was unremarkable except for a slightly elevated blood pressure. He was diagnosed with an upper respiratory tract infection two weeks ago and has noticed blood in his urine episodically. A urinalysis found mild proteinuria and macroscopic hematuria and a biopsy was performed. What defining feature is present?

IgA deposits

What is the most common cause of glomerulonephritis in young (15-30) male Asian pacific males?

IgA nephropathy (bergers)

What is the m/c/c of glomerulonephritis worldwide

IgA nephropathy/Bergers

What is the m/c/c of glomulonephritis in young (15-30) Asian pacific males

IgA nephropathy/Bergers

What is the most common cause of glomerulonephritis worldwide?

IgA nephropathy/bergers

When are kidney stones most prevalent?

In the summer

Hyper-excitability or inflammation of the lower urinary tract comes from?

Infection or stones

Patients diagnosed with hypocalcemia will experience (Choose all that apply)

Irritability & anxiety Muscle cramps Tetany

What is a common cause of urate nephropathy?

Tophaceous gout

What is a common cause of chronic urate nephropathy

Tophacious gout

What is a common cause of chronic urate nephropathy?

Tophacious gout

Jim Henson a 65 year old patient presents to your office today with right posterior upper quadrant pain. While gathering the history you discover that he has various preexisting conditions such as diabetes mellitus, hypovolemia, and chronic kidney disease. based on the patients history what is the most likely cause of his pain?

Tubular necrosis

According to the European consortium published criteria, which of the following does not validate the diagnosis of Henoch-Schonlein Purpura along with the finding of lower limb predominant purpura

Under the age of 20 at onset of first symptoms

What is the most significant problem immediately after birth with Autosomal Recessive Polycystic Kidney Disease?

Underdeveloped lungs

What type of UTI presents when the urinary tract is not sterilized during therapy

Unresolved

The symptoms that occur following an acute kidney injury occur because of:

Uremia

What condition is described as gonococcal or non-gonococcal and presents with dysuria and cloudy pee that "smells weird"?

Urethritis

What condition is described as gonococcal or non-gonococcal and presents with dysuria and cloudy pee that smells weird

Urethritis

What is cause by hyperexcitability/inflammation of the lower urinary tract from infection or stones?

Urge incontinence

What is caused by hyper-excitability/inflammation fo the lower urinary tract from infection of stones

Urge incontinence

What condition is characterized by necrotizing granulomatous lesions of respiratory tract?

Wegener's granulomatosis

What condition is characterized by necrotizing granulomatous lesions of the respiratory tract?

Wegener's granulomatosis

What condition is characterized by necrotizing granulomatous lesions of the respiratory tract

Wegner's granulomatosis

Oliguria

What finding is indicative of prerenal KI? a.) Hypertension b.) Oliguria c.) FENa > 3% d.) Hydronephrosis on ultrasonogram

Unmanaged prerenal AKI

What is the most common cause of intrinsic acute kidney injury? a.) Rhabdomyolysis b.) Ascending UTI c.) Glomerulonephritis d.) Unmanaged prerenal AKI

renal artery stenosis (RAS)

What is the most common cause of secondary hypertension?

Azotemia

What is the term for elevated BUN & serum creatinine? a.) Uremia b.) Azotemia c.) Chronic kidney disease d.) Decreased GFRAcute kidney failure

ACE inhibitor

What kidney-protective drug is recommended in individuals who have acute or chronic kidney disease, hypertension and proteinuria? a.) aminoglycocide b.) loop diuretic (furosedmide) c.) NSAID d.) ACE inhibitor

CT scans reveal indentations on the curvature of the kidney in those with AN. CT scans reveal papillary calcification in those with AN. NSAIDs tend to decrease GFR.

Which of the following are true? Select all that apply. a.) CT scans reveal indentations on the curvature of the kidney in those with AN. b.) CT scans reveal papillary calcification in those with AN. c.) NSAIDs tend to increase blood flow to the kidney. d.) Prostaglandins cause vasoconstriction of glomerular afferent arterioles. e.) Those with analgesic nephropathy (AN) tend to have enlarged kidneys. f.) NSAIDs tend to decrease GFR.

A child presents with a nontender abdominal mass and HTN, what is at the top of your differential

Wilm's tumor

Child presents w/ non-tender abdominal mass and HTN. Top of differential?

Wilm's tumor

A child presents with a nontender abdominal mass and HTN. What is at the top of your differential?

Wilms tumor

Your patient, Inigo Montoya, has been complaining of back pain for a while now. It's origin is unexplained. Their history shows that they have kidney problems diagnosed by their M.D. and they remember their doctor saying the terms "hypercalcemia" and "anemia". You are also aware of your patient having had many bacterial infections since you have known them. You finally are able to get down to a diagnosis with the help of a new finding. Which of these were found?

X-ray revealed punched out lesions

A 32 year old female presents with hematuria, mild proteinuria, adn pyuria. Clinical signs revealed fever peripheral eosinophilia, and a skin rash that developed about two weeks after stopping an antibiotic.

acute drug induced interstitial nephritis

A 35 year old male presents with anemia, hypercalemia, and imparted renal function. The radiograph shows punched out lesions. What is the most likely diagnosis?

chronic myeloma

A 5 year old female has presented with fatigue, anemia, weight loss, vomiting, and constipation. Opaque metaphyseal bands are present in the lower femur and upper tibia. What is the most likely diagnosis?

lead poisoning

A 62 year old male comes in with sever flank pain, hematuria, and fever. He also has a history of congenital urologic structural disorder. What is the most likely diagnosis?

pyelonephritis

John is a 28-year-old male with a BMI of 26 you have been treating for 3 months for various sport related injuries. He works as a Funeral Director but has taken a part time job at the Crossfit gym two doors down from your practice after "being bitten by the crossfit bug." He is usually very upbeat and energetic at his appointments, but today he presents feeling fatigued, achy in his limbs, more so than usual for a workout, and states he has had dark urine for the past 24 hours. Physical exam indicates moderate decreases in upper and lower extremity ranges of motion and increased swelling leading to less muscle definition than noted in the past. Laboratory workup consistent with rhabdomyolysis would NOT include

serum hypokalemia

Patient presents post URTI and presents with joint pain, malaria rash, dark urine

Acute glomerulonephritis

Girl had previous bladder infection and then experienced malaise, fever, flank pain, and tenderness. Dx?

Acute pyelonephritis

Tumor lysis syndrome is the m/c/c of what condition?

Acute urate nephropathy

Child presents w/ cataracts and sensorineural deafness

Alport's syndrome

What is a multi-system disorder that commonly results in intracranial aneurysm which can cause stroke and intracranial hemorrhage

Autosomal dominant polycystic kidney disease

What is a multi-system disorder that commonly results in intracranial aneurysm which can cause stroke and intracranial hemorrhage?

Autosomal dominant polycystic kidney disease

What disease presents with hepatic abnormalities that are more problematic than kidney problems?

Autosomal recessive polycystic disease

Pt presents post-URTI and now complains of chest pain and heart murmur. Dx?

Bacterial endocarditis

What condition is d/t longstanding essential HTN?

Benign nephrosclerosis

Caused by deposition of sodium urate crystals in medullary interstitium

Chronic urate nephropathy

S&S of hypocalcemia

Chvostek sign Trousseau sign

Obstruction to urine flow can occur at the level of the posterior urethra and presents with?

Distended bladder Dribbling Vomiting Failure to thrive

What structures in the kidney could be damaged through an allergic or toxic reaction to medications?

Glomerulus, nephrons, interstitium

Triad of glomerulonephritis, pulmonary hemorrhage, and antibody to basement membrane antigens

Goodpasture's Syndrome

What disease is predominately seen in young, white, male smokers?

Goodpasture's Syndrome

M/c complication of kidney hypoplasia

HTN

What are common signs and symptoms of chronic pyelonephritis?

HTN Frequency/dysuria Flank pain

What are the two m/c/c of chronic kidney disease?

HTN and DM

Child presents w/ palpable purpura in LE, abdominal pain, arthralgia/arthritis

Henoch-Schonlein purpura

Obstruction in the ureter will most commonly lead to?

Hydronephritis

What is caused by vitamin D toxicity, cancer, hyperparathyroidism and is associated w/ nephrogenic diabetes insipidus?

Hypercalcemia

What are pre-renal causes of renal failure?

Hypoperfusion d/t low blood pressure and ischemia

Most common cause for glomerulonephritis worldwide?

IgA nephropathy (Berger's disease)

What is the m/c/c of glomerulonephritis in young (15-30) Asian pacific males?

IgA nephropathy (Berger's disease)

Malignant nephrosclerosis

Increase in diastolic pressure over 130mmHg

Group A beta hemolytic strep, tonsillar abscess, Janeway lesion, causing valvular heart disease

Infective endocarditis

Congenital abnormalities of kidney lead to increased risk of what?

Kidney stones and UTI

A child presents w/ full blown nephrotic syndrome. What should be at the top of your differential?

Minimal change disease

What condition is classically characterized by the presence of Bence-Jones proteins?

Multiple Myeloma

What condition is categorized by hematuria, oliguria, HTN, and edema

Nephritic syndrome

Chronic kidney disease timing

Over 3 months

D/t chronic urination retention via weak detrusor or peripheral nerve damage

Overflow incontinence

What type of UTI presents when the urinary tract is not sterilized during therapy?

Unresolved

Epispadias

Urethral opening of penis on topside "pee on glasses"

Hypospadias

Urethral opening of penis on underside "pee on boots"

What condition described as gonococcal or non-gonococcal presents w/ dysuria and cloudy pee that smells weird?

Urethritis

What is the cause of hyperexcitability/inflammation of the lower urinary tract from infection or stones?

Urge incontinence

Why are diverticula of bladder important?

Urine stasis, increased risk of bladder infection, increased risk of stone formation, and increased risk of obstruction