Cysts and Inherited Disorders of the Kidney MCQs

In complicated UTI (e.g., CAUTI), E. coli remains the predominant organism Organisms causing UTI: SEEK PP Staph saprophyticus coli Enterococcus Klebsiella Proteus Pseudomonas Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 135, Pg: 1071

A young hypertensive with palpable kidneys and cysts on ultrasound points to the diagnosis of ADPKD (autosomal dominant polycystic kidney disease). Polycystic kidney disease is associated with increased levels of EPO which lead to polycythemia. Associations of ADPKD: Cardiovascular: Intracranial aneurysm (5 times more common than general population), can rupture to cause subarachnoid hemorrhage. Diffuse arterial dolichoectasia of the anterior and posterior cerebral circulation → predisposed to arterial dissection and stroke. Mitral valve prolapse. Insufficiency of the mitral, aortic, and tricuspid valves. Gastrointestinal: Colonic diverticula Abdominal wall hernia Polycystic liver disease Reference: Harrison's Principles of Internal Medicine, 21 st Edition, Page Number 2350-2354.

Retroperitoneal fibrosis is a disease featuring the proliferation of fibrous tissue in the retroperitoneum, the compartment of the body containing the kidneys, aorta, renal tract and various other structures. It may present with lower back pain, renal failure, hypertension, deep vein thrombosis and other obstructive symptoms. It may have an autoimmune etiology. 1/3 rd cases are secondary to malignancy, medications, aortic aneurysm or certain infections. Methyldopa, methysergide, amphetamines, beta blockers, cocaine and LSD are drugs which cause retroperitoneal fibrosis. Azathioprine is used to treat the condition. Reference: Harrison's Principles of Internal Medicine 21 st ed, Ch: 319 Pg: 2375