p.3
Acute Kidney Injury (AKI) Definitions and Causes
What is the definition of oliguria?
Urine output of <400 mL/24 h.
p.8
Glomerular Diseases and Their Characteristics
What distinguishes Henoch-Schönlein purpura from IgA nephropathy?
Younger age (<20 years old), preceding infection, and abdominal complaints.
p.6
Nephrotic vs. Nephritic Syndrome
What is the most common cause of nephrotic syndrome in the elderly?
Membranous Glomerulonephritis (MGN).
p.5
Glomerular Diseases and Their Characteristics
What is the most common cause of glomerulonephritis worldwide?
Malaria and schistosomiasis.
p.1
Renin-Angiotensin-Aldosterone System
What triggers the macula densa to detect decreased blood pressure or GFR?
Decreased blood pressure or decreased GFR.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What is pathognomonic of vesicoureteral reflux?
Flank pain that occurs only with micturition.
p.2
Renal Replacement Therapy Options
What are the most common organisms in peritoneal dialysis-related peritonitis?
Gram-positive cocci, including Staphylococcus.
p.6
Nephrotic vs. Nephritic Syndrome
What is the mnemonic for signs and symptoms of nephrotic syndrome?
EPAL: Edema, Proteinuria >3.0g/day, HypoAlbuminemia, HyperLipidemia.
p.7
Glomerular Diseases and Their Characteristics
What is the main cause of Rapidly Progressive Glomerulonephritis (RPGN)?
Can be anti-GBM antibody-induced, immune complex-mediated, or pauci-immune.
p.8
Glomerular Diseases and Their Characteristics
What is the triad of Wegener's granulomatosis?
Necrotizing granulomas of the respiratory tract, necrotizing or granulomatous vasculitis, and focal necrotizing or crescentic glomerulonephritis.
p.4
Chronic Kidney Disease (CKD) Management and Complications
What is the leading cause of morbidity and mortality in patients at every stage of CKD?
Cardiovascular disease (CVD).
p.7
Glomerular Diseases and Their Characteristics
What is Post-Streptococcus Glomerulonephritis (PSGN) caused by?
Group A beta-hemolytic streptococcus (GABHS).
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What are common independent risk factors for acute cystitis?
Frequent sexual intercourse, history of UTI, and a new sexual partner.
p.7
Glomerular Diseases and Their Characteristics
What is Alport Syndrome characterized by?
Hereditary structural defect in collagen IV leading to hematuria, hearing loss, and blindness.
p.6
Nephrotic vs. Nephritic Syndrome
What are the diseases presenting with nephritic syndrome?
Goodpasture syndrome, Alport syndrome, Lupus nephropathy.
p.1
Renin-Angiotensin-Aldosterone System
What is the role of angiotensin II?
Stimulates aldosterone release, increases Na+ reabsorption, K+ secretion, and H+ secretion.
p.7
Glomerular Diseases and Their Characteristics
What are the characteristic findings in PSGN on electron microscopy?
Hypercellular glomeruli, 'lumpy-bumpy' deposits of IgG and C3, subepithelial humps.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What is the definition of Acute Kidney Injury (AKI)?
A rise of at least 0.3 mg/dL within 48 hours or 50% higher than baseline within 1 week; or reduction in urine output to < 0.5 mL/kg/h for >6 hours.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What are typical symptoms of cystitis?
Dysuria, urinary frequency, and urgency.
p.1
Renin-Angiotensin-Aldosterone System
What do principal cells of the late distal tubule absorb and secrete?
Absorb Na+ and H2O, and secrete K+.
p.6
Nephrotic vs. Nephritic Syndrome
What type of proteinuria is associated with Membranous Glomerulonephritis (MGN)?
Non-selective proteinuria.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What are the most common clinical conditions associated with prerenal azotemia?
Hypovolemia and decreased cardiac output.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What is the most common cause of bilateral hydronephrosis in boys?
Posterior urethral valves.
p.2
Renal Replacement Therapy Options
What are the most common additives to peritoneal dialysis solutions?
Heparin, antibiotics, and insulin.
p.8
Glomerular Diseases and Their Characteristics
What are the common presentations of IgA nephropathy?
Recurrent episodes of macroscopic hematuria often accompanied by proteinuria during or immediately following an upper respiratory infection, or persistent asymptomatic microscopic hematuria.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What is the most common etiologic agent in acute uncomplicated UTIs?
E. coli, accounting for 75-90% of isolates.
p.2
Chronic Kidney Disease (CKD) Management and Complications
What are clear indications for initiation of renal replacement therapy in patients with CKD?
Uremic pericarditis, encephalopathy, intractable muscle cramping, evidence of malnutrition, and fluid & electrolyte abnormalities refractory to other measures.
p.8
Acute Kidney Injury (AKI) Definitions and Causes
What is the most common variant of Hemolytic Uremic Syndrome (HUS)?
D+ (diarrhea-associated) HUS, also known as enterohemorrhagic E. coli (EHEC) HUS.
p.8
Chronic Kidney Disease (CKD) Management and Complications
What is the most severe manifestation of scleroderma characterized by accelerated hypertension and rapid decline in renal function?
Scleroderma renal crisis (SRC).
p.5
Glomerular Diseases and Their Characteristics
What is a characteristic appearance of kidneys in endocarditis-associated GN?
Subcapsular hemorrhages with a 'flea-bitten' appearance.
p.6
Nephrotic vs. Nephritic Syndrome
What is the appearance of deposits in Membranous Glomerulonephritis?
Spike & dome appearance with subepithelial IgG and C3 deposits.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What factors are associated with pyelonephritis?
UTI in the previous 12 months, maternal history of UTI, diabetes, and incontinence.
p.6
Nephrotic vs. Nephritic Syndrome
What are the signs and symptoms of nephritic syndrome?
Oliguria, Hematuria, Hypertension, Azotemia.
p.4
Chronic Kidney Disease (CKD) Management and Complications
What is a major side effect of calcium-based phosphate binders?
Total-body calcium accumulation and hypercalcemia.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What is a distinguishing feature of fever in pyelonephritis?
A high, spiking 'picket-fence' pattern that resolves over 72 hours of treatment.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What drugs are considered relatively safe for UTI treatment in early pregnancy?
Nitrofurantoin, penicillin, and cephalosporins.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What is the standard care for pregnant women with overt pyelonephritis?
Parenteral beta-lactam with or without aminoglycosides.
p.8
Chronic Kidney Disease (CKD) Management and Complications
What is the goal in treating scleroderma renal crisis?
Reduce SBP by 20 mmHg and DBP by 10 mmHg every 24 hours until BP normalized.
p.5
Glomerular Diseases and Their Characteristics
What characterizes Membranoproliferative GN (MPGN)?
Thickening of the GBM with mesangioproliferative changes.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What is the most common protein found in urine?
Uromodulin/Tamm-Horsfall Protein.
p.6
Nephrotic vs. Nephritic Syndrome
What is the most common cause of nephrotic syndrome in children?
Minimal Change Disease (MCD).
p.4
Chronic Kidney Disease (CKD) Management and Complications
What does ESRD refer to in the context of CKD?
Stage 5 CKD with a GFR of less than 15%.
p.1
Erythropoietin Production and Function
Where is erythropoietin (EPO) produced?
In the interstitial cells of the peritubular capillaries.
p.2
Renal Replacement Therapy Options
How many hours of hemodialysis do the majority of ESRD patients receive each week?
9 - 12 hours divided into 3 equal sessions.
p.8
Chronic Kidney Disease (CKD) Management and Complications
What is the first-line therapy in scleroderma renal crisis unless contraindicated?
Treatment with ACE inhibitor.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What are the most common causes of intrinsic AKI?
Sepsis, ischemia, and nephrotoxins.
p.6
Nephrotic vs. Nephritic Syndrome
What type of deposits are found in Renal Amyloidosis?
Subendothelial and mesangial amyloid deposits.
p.5
Glomerular Diseases and Their Characteristics
What is microalbuminuria a sensitive indicator of?
The presence of diabetes.
p.9
Nephrolithiasis: Types and Management
What type of stones are associated with Proteus mirabilis?
Struvite stones (magnesium ammonium phosphate stones).
p.4
Renal Replacement Therapy Options
In which situations is Continuous Renal Replacement Therapy often preferred?
Severe hemodynamic instability, cerebral edema, and significant volume overload.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What condition is associated with light chain cast nephropathy?
Multiple myeloma, commonly known as myeloma kidney.
p.6
Nephrotic vs. Nephritic Syndrome
What is the mnemonic for nephritic syndrome signs and symptoms?
OHHA: Oliguria, Hematuria, Hypertension, Azotemia.
p.5
Glomerular Diseases and Their Characteristics
When does PSGN typically develop after a skin infection?
2-6 weeks after skin infection.
p.5
Glomerular Diseases and Their Characteristics
Which M protein serotypes of Streptococcus pyogenes are associated with impetigo?
M types 47, 49, 55, 2, 60, and 57.
p.4
Chronic Kidney Disease (CKD) Management and Complications
What is the primary cause of anemia in CKD?
Insufficient production of erythropoietin (EPO) by the diseased kidneys.
p.1
ADH Mechanism and Triggers
What is the effect of ADH on the collecting ducts?
Inserts aquaporins (AQP-2) to increase water reabsorption.
p.1
Acute Kidney Injury (AKI) Definitions and Causes
What effect does vasoconstriction of the efferent arteriole have on filtration fraction?
It will decrease the filtration fraction.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What distinguishes Gitelman's syndrome from most forms of Bartter's syndrome?
Severe hypomagnesemia and hypocalciuria.
p.9
Nephrolithiasis: Types and Management
What is the pathogenesis of struvite stones?
Bacterial urease production leading to urinary tract infections (UTIs).
p.2
Nephrolithiasis: Types and Management
What imaging test is used for the diagnosis of nephrolithiasis?
Helical computed tomography (CT) scanning without radiocontrast enhancement.
p.4
Chronic Kidney Disease (CKD) Management and Complications
What is microalbuminuria and its significance in early nephropathy?
It represents the presence of proteinuria increasing to 30-300 mg/24h, indicating renal disease.
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What indicates an invasive infection of the upper urinary tract?
Unilateral back or flank pain and fever.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What happens to renal autoregulation when systolic blood pressure falls below 80 mmHg?
Renal autoregulation usually fails.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What are the three broad categories of AKI?
Prerenal AKI, Intrinsic AKI, and Post-renal AKI.
p.1
ADH Mechanism and Triggers
What are the main triggers for ADH secretion?
Decreased blood volume and decreased blood pressure.
p.1
Nephrolithiasis: Types and Management
What is the permeability of the descending limb of the Loop of Henle?
Permeable to water and impermeable to solutes.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What is the triad of symptoms associated with heavy metal (lead) nephropathy?
Saturnine gout, hypertension, and renal insufficiency.
p.7
Nephritic vs. Nephritic Syndrome
What is a common pediatric cause of nephritic syndrome?
Post-Streptococcus Glomerulonephritis (PSGN).
p.10
Urinary Tract Infections (UTI) Risk Factors and Management
What recent activity is an independent risk factor for acute cystitis?
Recent use of a diaphragm with spermicide.
p.2
Chronic Kidney Disease (CKD) Management and Complications
What is the test for measurement of albuminuria?
Urinary albumin to creatinine ratio.
p.7
Glomerular Diseases and Their Characteristics
What is a key feature of Goodpasture Syndrome?
Presence of anti-GBM antibodies and hematuria with hemoptysis.
p.6
Nephrotic vs. Nephritic Syndrome
What is the characteristic feature of Minimal Change Disease (MCD)?
Effacement of foot processes.
p.2
Renal Replacement Therapy Options
What is the most important complication of arteriovenous grafts?
Thrombosis of the graft and graft failure.
p.5
Glomerular Diseases and Their Characteristics
What is the most common cause of renal amyloidosis?
Fibrillar deposits of immunoglobulin light chains (AL).
p.5
Glomerular Diseases and Their Characteristics
What is Poststreptococcal GN (PSGN) prototypical for?
Acute endocapillary proliferative GN.
p.7
Chronic Kidney Disease (CKD) Management and Complications
What is the most severe type of lupus nephritis?
Class IV Nephritis, characterized by global, diffuse proliferative lesions.
p.7
Chronic Kidney Disease (CKD) Management and Complications
What is a significant complication for patients with crescents on biopsy in lupus nephritis?
Predisposition to renal-vein thrombosis and other thrombotic complications.
p.4
Chronic Kidney Disease (CKD) Management and Complications
What is the classic lesion of secondary hyperparathyroidism in CKD?
Osteitis fibrosa cystica.
p.1
ADH Mechanism and Triggers
What happens to free water clearance (CH20) when ADH is present?
Free water is reabsorbed and CH20 is negative.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What causes Bartter's syndrome?
Mutations affecting any of five ion transport proteins in the thick ascending limb (TAL).
p.4
Chronic Kidney Disease (CKD) Management and Complications
What stage of CKD is associated with normocytic, normochromic anemia?
As early as Stage 3 CKD, almost universal by Stage 4 CKD.
p.5
Glomerular Diseases and Their Characteristics
What is a key feature of Type I MPGN?
Presence of subendothelial deposits and low C3.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What is a hallmark feature of TIN associated with uveitis?
Painful anterior uveitis.
p.9
Nephrolithiasis: Types and Management
What is the treatment for struvite stones?
Complete removal by a urologist.
p.5
Glomerular Diseases and Their Characteristics
What is the primary treatment for endocarditis-associated GN?
Eradication of the infection with 4-6 weeks of antibiotics.
p.3
Acute Kidney Injury (AKI) Definitions and Causes
What is the most common clinical course of contrast nephropathy?
A rise in SCr beginning 24-48 hours following exposure, peaking within 3-5 days, and resolving within 1 week.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What causes Analgesic nephropathy?
Long-term use of compound analgesic preparations containing phenacetin, aspirin, and caffeine.
p.1
Nephrolithiasis: Types and Management
What is the permeability of the ascending limb of the Loop of Henle?
Permeable to solutes and impermeable to water.
p.9
Nephrolithiasis: Types and Management
What is the focus for cystine stone prevention?
Increasing cystine solubility through medications like tiopronin or penicillamine.
p.9
Chronic Kidney Disease (CKD) Management and Complications
What is Liddle's syndrome characterized by?
Early and severe hypertension, hypokalemia, and metabolic alkalosis with low plasma aldosterone and renin levels.
