Nephrology Exam||Newest Exam With Over 300 Most
Examinable Questions And Well Verified Correct
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What are the top 5 functions of the kidneys? - ,,,,answer,,,..-remove waste
-control BP by secreting renin which initiates RAAS
-stimulates RBC production by secretion of EPO
-maintains bone health by secreting calcitriol --> reducing Ca2+ loss
-controls pH
What make up about 90% of all renal cancers? - ,,,,answer,,,..renal cell
carcinoma (parenchyma)- includes adenocarcinomas
What are the types of renal cancers? - ,,,,answer,,,..-renal cell carcinoma
(includes adenocarcinoma)
-transitional cell carcinoma - renal pelvis (linked with cigarette smoking)
-wilms' tumor
renal sarcoma- originated from vasculature or connective tissue of kidney
Describe the presentation of a patient with renal cell carcinoma. -
,,,,answer,,,..-*gross or microscopic hematuria*
-flank pain or mass
-fever, weight loss
-solid renal mass on imaging
-night sweats, fever, malaise, weight loss
-*erythrocytosis but anemia is more common*
-*hypercalcemia*
-*stauffer syndrome* - hepatic dysfunction in absence of liver metastasis
What are risk factors for renal cell carcinoma? - ,,,,answer,,,..-*cigarette
smoking is the only environmental risk factor*
,-obesity, HTN, acquired cystic kidney disease associated with dialysis,
ADPKD
-familial causes
Which renal cancer is associated with paraneoplastic syndrome? -
,,,,answer,,,..renal cell carcinoma
-Paraneoplastic syndrome is symptoms due to remote effects of cancer
What is the best initial test for renal cell carcinoma? - ,,,,answer,,,..-US
because it is inexpensive, without radiation and high sensitivity
-then do CT or MRI
-then *biopsy or nephrectomy*
-bone scan if metastasis is suspected
What is the treatment for renal cell carcinoma? - ,,,,answer,,,..-*surgery is
gold standard* - partial or radical- curative in stages 1-3
-resistant to chemo or radiation
Describe renal cell carcinoma staging. - ,,,,answer,,,..I: confined to renal
capsule and <7cm
II: confined to renal capsule and >7cm
III: extends through renal capsule but not through fascia; renal vein, IVC,
or regional nodal involvement
IV: extends through fascia or with distant metastasis
What is Wilms' tumor? - ,,,,answer,,,..-nephroblastoma
-most common renal malignancy in *children*
-African Americans are more at risk
Describe the presentation of a patient with Wilms' tumor? - ,,,,answer,,,..-
abdominal swelling or mass w/o other symptoms- rarely crosses midline
-abdominal pain
-hematuria
,-HTN
-may have subcapsular hemorrhage (fever, rapid abd enlargement,
anemia, HTN)
Which patients should be screened for Wilms' tumor? - ,,,,answer,,,..-
Beckwith-Wiedmann syndrome every 3 months until age 7
-WAGR syndrome every 3 months until age 5
Describe the workup in a patient with a Wilms' tumor? - ,,,,answer,,,..-
*US* then CT or MRI
-*evaluate for lung metastasis*
-SCr, CMP, UA, maybe coagulation studies if indicated
Describe the staging of a Wilms' tumor. - ,,,,answer,,,..I: limited to kidney
and completely excised w/o rupture or biopsy- renal capsule intact
II: tumor extends through renal capsule but all is removed- vessels
outside kidney contain tumor - OR "local spillage on removal"
III: residual tumor confined to abd - involvement of abd lymph nodes-
"diffuse" contamination by rupture- microscopic margins positive post
resection
IV: hematogenous metastasis at any site
V: bilateral renal involvement
How are Wilms' tumors treated? - ,,,,answer,,,..-*surgical excision*
-CTX (chemotherapy) with low risk tumors
-XRT (radiation) for advanced stage and histology
What is the prognosis of Wilms' tumor? - ,,,,answer,,,..5 year survival of
90%
follow with CT - pulmonary and abdominal Q3mo/2 years then Q6mo/2
more years
, What is ADPKD? - ,,,,answer,,,..Autosomal dominant polycystic kidney
disease
-cysts increase with age
-most common hereditary disorder in the US
Describe the presentation of ADPKD. - ,,,,answer,,,..-often have HTN and
abdominal mass (palpable kidneys)
-*family history*
-abdominal/ flank pain
-hematuria
-Hx of UTI/ nephrolithiasis
What genetic mutations were found for ADPKD? - ,,,,answer,,,..PKD1 and
PKD2
-PKD1 has worse prognosis and faster progression of disease
How is ADPKD treated? - ,,,,answer,,,..treat symptoms
-Abd/ flank pain: *cyst decompression/drainage/ removal and
analgesics*
-Hematuria: *bed rest, hydration*
-renal infection: *ABX- fluoroquinolones, bactrim, chloramphenicol*
-nephrolithiasis: *hydration*
-HTN: *cyst decompression and aggressive pharmacotherapy to prolong
ESRD*
-cerebral aneurysms and other vascular problems may occur
-Vasopressin receptor antagonist can slow worsening of kidney function
-avoid caffeine, low protein, low salt diet
A patient has a urinalysis done and it comes back with Bence Jones
protein, what might they have? - ,,,,answer,,,..multiple myeloma
-Bence Jones protein is light chain Ig - causes renal toxicity and
obstruction
-*hypercalcemia* is also found
Examinable Questions And Well Verified Correct
Answers||100% Guaranteed Pass
What are the top 5 functions of the kidneys? - ,,,,answer,,,..-remove waste
-control BP by secreting renin which initiates RAAS
-stimulates RBC production by secretion of EPO
-maintains bone health by secreting calcitriol --> reducing Ca2+ loss
-controls pH
What make up about 90% of all renal cancers? - ,,,,answer,,,..renal cell
carcinoma (parenchyma)- includes adenocarcinomas
What are the types of renal cancers? - ,,,,answer,,,..-renal cell carcinoma
(includes adenocarcinoma)
-transitional cell carcinoma - renal pelvis (linked with cigarette smoking)
-wilms' tumor
renal sarcoma- originated from vasculature or connective tissue of kidney
Describe the presentation of a patient with renal cell carcinoma. -
,,,,answer,,,..-*gross or microscopic hematuria*
-flank pain or mass
-fever, weight loss
-solid renal mass on imaging
-night sweats, fever, malaise, weight loss
-*erythrocytosis but anemia is more common*
-*hypercalcemia*
-*stauffer syndrome* - hepatic dysfunction in absence of liver metastasis
What are risk factors for renal cell carcinoma? - ,,,,answer,,,..-*cigarette
smoking is the only environmental risk factor*
,-obesity, HTN, acquired cystic kidney disease associated with dialysis,
ADPKD
-familial causes
Which renal cancer is associated with paraneoplastic syndrome? -
,,,,answer,,,..renal cell carcinoma
-Paraneoplastic syndrome is symptoms due to remote effects of cancer
What is the best initial test for renal cell carcinoma? - ,,,,answer,,,..-US
because it is inexpensive, without radiation and high sensitivity
-then do CT or MRI
-then *biopsy or nephrectomy*
-bone scan if metastasis is suspected
What is the treatment for renal cell carcinoma? - ,,,,answer,,,..-*surgery is
gold standard* - partial or radical- curative in stages 1-3
-resistant to chemo or radiation
Describe renal cell carcinoma staging. - ,,,,answer,,,..I: confined to renal
capsule and <7cm
II: confined to renal capsule and >7cm
III: extends through renal capsule but not through fascia; renal vein, IVC,
or regional nodal involvement
IV: extends through fascia or with distant metastasis
What is Wilms' tumor? - ,,,,answer,,,..-nephroblastoma
-most common renal malignancy in *children*
-African Americans are more at risk
Describe the presentation of a patient with Wilms' tumor? - ,,,,answer,,,..-
abdominal swelling or mass w/o other symptoms- rarely crosses midline
-abdominal pain
-hematuria
,-HTN
-may have subcapsular hemorrhage (fever, rapid abd enlargement,
anemia, HTN)
Which patients should be screened for Wilms' tumor? - ,,,,answer,,,..-
Beckwith-Wiedmann syndrome every 3 months until age 7
-WAGR syndrome every 3 months until age 5
Describe the workup in a patient with a Wilms' tumor? - ,,,,answer,,,..-
*US* then CT or MRI
-*evaluate for lung metastasis*
-SCr, CMP, UA, maybe coagulation studies if indicated
Describe the staging of a Wilms' tumor. - ,,,,answer,,,..I: limited to kidney
and completely excised w/o rupture or biopsy- renal capsule intact
II: tumor extends through renal capsule but all is removed- vessels
outside kidney contain tumor - OR "local spillage on removal"
III: residual tumor confined to abd - involvement of abd lymph nodes-
"diffuse" contamination by rupture- microscopic margins positive post
resection
IV: hematogenous metastasis at any site
V: bilateral renal involvement
How are Wilms' tumors treated? - ,,,,answer,,,..-*surgical excision*
-CTX (chemotherapy) with low risk tumors
-XRT (radiation) for advanced stage and histology
What is the prognosis of Wilms' tumor? - ,,,,answer,,,..5 year survival of
90%
follow with CT - pulmonary and abdominal Q3mo/2 years then Q6mo/2
more years
, What is ADPKD? - ,,,,answer,,,..Autosomal dominant polycystic kidney
disease
-cysts increase with age
-most common hereditary disorder in the US
Describe the presentation of ADPKD. - ,,,,answer,,,..-often have HTN and
abdominal mass (palpable kidneys)
-*family history*
-abdominal/ flank pain
-hematuria
-Hx of UTI/ nephrolithiasis
What genetic mutations were found for ADPKD? - ,,,,answer,,,..PKD1 and
PKD2
-PKD1 has worse prognosis and faster progression of disease
How is ADPKD treated? - ,,,,answer,,,..treat symptoms
-Abd/ flank pain: *cyst decompression/drainage/ removal and
analgesics*
-Hematuria: *bed rest, hydration*
-renal infection: *ABX- fluoroquinolones, bactrim, chloramphenicol*
-nephrolithiasis: *hydration*
-HTN: *cyst decompression and aggressive pharmacotherapy to prolong
ESRD*
-cerebral aneurysms and other vascular problems may occur
-Vasopressin receptor antagonist can slow worsening of kidney function
-avoid caffeine, low protein, low salt diet
A patient has a urinalysis done and it comes back with Bence Jones
protein, what might they have? - ,,,,answer,,,..multiple myeloma
-Bence Jones protein is light chain Ig - causes renal toxicity and
obstruction
-*hypercalcemia* is also found
