Renal and Urinary Systems Flashcards

A 25-year-old man has gross hematuria, hearing loss, and a family history of renal failure. Electron microscopy shows thinning and splitting of the glomerular basement membrane. What is the diagnosis?

Answer: Alport syndrome

Alport syndrome is an X-linked hereditary nephritis caused by mutations in type IV collagen genes, presenting with hematuria, sensorineural hearing loss, and characteristic GBM splitting.

What is the most common cause of nephrotic syndrome in US adults?

Answer: Diabetic nephropathy

Diabetic nephropathy is the leading cause of nephrotic syndrome and end-stage renal disease in adults in the United States.

Renal tubular acidosis type 1 (distal RTA) is associated with which metabolic abnormality?

Answer: Normal anion gap metabolic acidosis with inability to acidify urine below pH 5.5

Distal RTA involves a defect in H+ secretion in the collecting duct, resulting in inability to lower urine pH below 5.5 despite systemic acidosis.

A patient with a kidney stone passes it spontaneously and analysis shows calcium oxalate composition. Which dietary modification is most evidence-based?

Answer: Increased fluid intake to >2.5 L/day

Increased hydration to produce >2.5 L of urine daily is the most universally effective dietary intervention to prevent recurrent nephrolithiasis.

Which osteopathic technique is indicated to address lymphatic drainage of the renal and pelvic region?

Answer: Pelvic diaphragm release

The pelvic diaphragm release improves lymphatic and venous drainage from the pelvic and lower abdominal viscera including the kidneys.

In a patient with ESRD, which chronic complication results from impaired renal conversion of 25-OH vitamin D to its active form?

Answer: Renal osteodystrophy

Loss of 1-alpha hydroxylase activity in the kidney prevents conversion of 25-OH vitamin D to 1,25-(OH)₂ vitamin D (calcitriol), leading to hypocalcemia, secondary hyperparathyroidism, and renal osteodystrophy.