Renal embryology
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Step 1 Express 2022-Renal
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Shifts K + into Cell → Hypokalemia Shifts K + out of Cell → Hyperkalemia Acidosis Alkalosis β-adrenergic agonists β-blocker Lysis of cells Digitalis Hyperosmolarity Hypo-osmolarity Insulin High Blood Sugar (insulin deficiency) 39. By what mechanism does insulin cause hypokalemia? (p 614) ____________________________ ______________________________________________________________________________ 40. What is the primary electrolyte disturbance in metabolic acidosis? (p 616) ___________________ ______________________________________________________________________________ 41. What is the immediate respiratory response to metabolic acidosis, and does P CO 2 increase or decrease? (p 616) _______________________________________________________________ 42. What are the eight causes of increased anion gap metabolic acidosis? (p 616) _______________ ______________________________________________________________________________ ______________________________________________________________________________ page 6 Step 1 Express 2022 workbook: RENAL © First Aid for the USMLE Step 1, 2022 edition PATHOLOGY 43. What glomerular diseases can be considered both nephritic and nephrotic syndromes? (p 619) ______________________________________________________________________________ 44. What five clinical findings are associated with nephritic syndrome? (p 619) ___________________ ______________________________________________________________________________ 45. What four clinical findings are associated with nephrotic syndrome? (p 619) __________________ ______________________________________________________________________________ 46. A 10-year-old boy presents with periorbital edema and cola-colored urine, which are both beginning to resolve without intervention. Electron microscopy of a kidney biopsy specimen shows subepithelial immune complex (IC) humps. Which form of nephritic syndrome does he most likely have? (p 620) __________________________________________________________________ 47. Match the nephritic syndrome with its characteristic finding on microscopy. (p 620) _____ A. Acute poststreptococcal glomerulonephritis 1. Crescent-moon shape on LM _____ B. Alport syndrome 2. IC deposits in mesangium _____ C. Diffuse proliferative glomerulonephritis 3. Subepithelial IC humps on EM _____ D. IgA nephropathy 4. Split basement membrane _____ E. Rapidly progressive glomerulonephritis 5. “Wire looping” of capillaries on LM _____ F. Membranoproliferative glomerulonephritis 6. “Tram-track” appearance on H&E, PAS 48. Granulomatosis with polyangiitis (Wegener) is ____________ (PR3-ANCA/c-ANCA or MPO- ANCA/p-ANCA) positive, whereas microscopic polyangiitis is ____________ (PR3-ANCA/c-ANCA or MPO-ANCA/p-ANCA) positive. (p 620) 49. Diffuse proliferative glomerulonephritis and membranoproliferative glomerulonephritis can present as either ______________ or ______________ syndrome. (pp 620-621) Step 1 Express 2022 workbook: RENAL page 7 © First Aid for the USMLE Step 1, 2022 edition 50. Match the nephrotic syndrome with its characteristic finding. (p 622) _____ A. Amyloidosis 1. Associated with chronic disease _____ B. Diabetic glomerulonephropathy 2. Podocyte foot process effacement on EM _____ C. Focal segmental glomerulosclerosis 3. Hyalinosis, segmented sclerosis on LM _____ D. Membranous nephropathy 4. Kimmelstiel-Wilson lesion on LM _____ E. Minimal change disease . 5. “Spike-and-dome appearance” on EM 51. What is the most common cause of nephrotic syndrome in African Americans and Hispanics? (p 621) __________________________________________________________________________ 52. In diabetic glomerulonephropathy, what causes mesangial expansion? (p 622) _______________ ______________________________________________________________________________ 53. Kidney stones are most commonly composed of what element? (p 623) _____________________ ______________________________________________________________________________ 54. Both antifreeze and vitamin C abuse can result in the formation of which type of crystals? (p 623) _____________________________________________________________________________ 55. An 80-year-old man with leukemia presents with hematuria and right-sided flank pain. Which type of kidney stone is he most likely to have? And how would this stone appear on x-ray? (p 623) ______ ______________________________________________________________________________ ______________________________________________________________________________ page 8 Step 1 Express 2022 workbook: RENAL © First Aid for the USMLE Step 1, 2022 edition 56. Match the renal pathology with its characteristic findings. (pp 625-627, 629-630) _____ A. Acute pyelonephritis 1. Associated with aniline dye exposure _____ B. Acute tubular necrosis 2. Associated with diabetes _____ C. Squamous cell bladder carcinoma 3. Associated with obstetric catastrophe _____ D. Chronic pyelonephritis 4. Associated with paraneoplastic _____ E. Diffuse cortical necrosis syndromes 5. Granular muddy brown casts in urine _____ F. Acute interstitial nephritis 6. Nephroblastoma _____ G. Renal cell carcinoma 7. Hematuria, no casts _____ H. Renal papillary necrosis 8. Pyuria and azotemia _____ I. Urothelial carcinoma 9. Thyroidization of kidney _____ J. Wilms tumor 10. WBC casts in urine 57. Which three general types of renal dysfunction can lead to acute kidney injury? (p 626) _________ ______________________________________________________________________________ 58. True or false: Unilateral postrenal outflow obstruction can lead to acute kidney injury. (p 626) ____ ______________________________________________________________________________ 59. A patient's urine osmolarity is <350 mOsm/kg, urine sodium level is >40 mEq/L, fractional excretion of sodium is >4%, and BUN/creatinine ratio is >15:1. Is the cause of the acute renal failure most likely to be prerenal, renal, or postrenal? (p 626) ________________________________________ 60. A patient’s urine osmolarity is >500 mOsm/kg, urine sodium level is <10 mEq/L, fractional excretion of sodium is <1%, and BUN/creatinine ratio is >20:1. Is the cause of the acute renal failure most likely to be prerenal, renal, or postrenal? (p 626) ________________________________________ 61. What are the eight consequences of renal failure represented by the mnemonic MAD HUNGER? (p 627) __________________________________________________________________________ ______________________________________________________________________________ Step 1 Express 2022 workbook: RENAL page 9 © First Aid for the USMLE Step 1, 2022 edition 62. What is the most common cause of secondary hypertension in adults? What other vascular pathology is usually involved? (p 629) _______________________________________________ _____________________________________________________________________________ 63. What gene is mutated in autosomal dominant polycystic kidney disease? (p 628) ______________________________________________________________________________ 64. What are the two major complications associated with autosomal dominant polycystic kidney disease? (p 628) ________________________________________________________________ ______________________________________________________________________________ 65. What are the complications of autosomal recessive polycystic kidney disease in utero and after the neonatal period? (p 628) __________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 66. Name the four components of the WAGR complex. (p 630) _______________________________ ______________________________________________________________________________ Download 170.08 Kb. Do'stlaringiz bilan baham: 
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