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Step 1 DIT > 14. Renal > Flashcards

14. Renal Flashcards

1
Q

What artery prevents a horseshoe kidney from ascending in the abdomen?

A

IMA

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2
Q

What fundamental problem creates Potter sequence?

A

oligohydramnios

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3
Q

What cell type releases renin?

A

juxtaglomerular cells

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4
Q

What are the 3 stimuli that induce renin release?

A
  • beta-adrenergic stimulation
  • low renal arterial BP (sensed by JG cells)
  • decreased Na+ in distal convoluted tubule (sensed by macula densa)
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5
Q

What effect will a renal stone that obstructs the ureter have on GFR and FF?

A
  • decreased GFR
  • no change in RPF
  • thus, decreased FF
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6
Q

What is the maximal serum glucose concentration at which glucose can be absorbed in the tubules?

A

350 mg/dL

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7
Q

What vitamin deficiency results from Hartnup disease?

A

niacin (B3) –> pellagra

note: Hartnup disease is when there is deficiency of neutral amino acid transporters in proximal renal tubular cells (ex. tryptophan)
- thus, decreased tryptophan for conversion to niacin

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8
Q

What is the equation for the renal clearance of any substance?

A

Renal clearance = UV/P

  • U = urine concentration of particular substrate (mg/mL)
  • V = urine flow rate (mL/min)
  • P = plasma concentration of substrate (mg/dL)
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9
Q

What segment of the renal tubule matches each of the following statements?
- reabsorbs 67% of the fluid and electrolytes filtered by the glomerulus

A

prox tubule

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10
Q

What segment of the renal tubule matches each of the following statements?
- site of secretion of organic anions and cations

A

prox tubule

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11
Q

What segment of the renal tubule matches each of the following statements?
- always impermeable to water

A

thick ascending limb

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12
Q

What segment of the renal tubule matches each of the following statements?
- permeable to water only in the presence of ADH

A

late distal tubule, collecting duct

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13
Q

What segment of the renal tubule matches each of the following statements?
- site of Na/2Cl/K co-transporter

A

thick ascending limb

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14
Q

What segment of the renal tubule matches each of the following statements?
- site of isotonic fluid reabsorption

A

prox tubule

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15
Q

What segment of the renal tubule matches each of the following statements?
- site responsible for diluting urine

A

thick ascending limb

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16
Q

What segment of the renal tubule matches each of the following statements?
- only site where glucose and amino acids are reabsorbed

A

prox tubule

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17
Q

What segment of the renal tubule matches each of the following statements?
- water reabsorption in the loop of Henle

A

thin descending limb

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18
Q

What are the 2 main cell types of the collecting duct?

A
  • principal cell

- intercalated cell

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19
Q

What type of diuretic is each of the following drugs?

- triamterene

A

K+ sparing

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20
Q

What type of diuretic is each of the following drugs?

- acetazolamide

A

carbonic anhydrase inhibitor

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21
Q

What type of diuretic is each of the following drugs?

- hydrochlorothiazide

A

thiazide

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22
Q

What type of diuretic is each of the following drugs?

- bumetanide

A

loop

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23
Q

What type of diuretic is each of the following drugs?

- spironolactone

A

K+ sparing (aldo-antagonist)

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24
Q

What type of diuretic is each of the following drugs?

- ethacrynic acid

A

loop (non-sulfa)

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25
Q

What type of diuretic is each of the following drugs?

- mannitol

A

osmotic diuretic

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26
Q

What type of diuretic is each of the following drugs?

- metolazone

A

thiazide

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27
Q

What type of diuretic is each of the following drugs?

- chlorthalidone

A

thiazide

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28
Q

What type of diuretic is each of the following drugs?

- furosemide

A

loop

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29
Q

What type of diuretic is each of the following drugs?

- amiloride

A

K+ sparing

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30
Q

What type of diuretic is each of the following drugs?

- torsemide

A

loop

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31
Q 
What diuretic or class of diuretic would be most useful in each of the following situations? 
- acute pulmonary edema
A

loop

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32
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- idiopathic hypercalciuria (--> calcium stones)
A

thiazide

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33
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- glaucoma (2)
A

acetazolamide, mannitol

34
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- mild to moderate CHF with expanded ECV
A

loop

35
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- in conjunction with loop or thiazide diuretics to retain K+
A

K+ sparing

36
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- edema associated with nephrotic syndrome
A

loop

37
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- increased intracranial pressure
A

mannitol

38
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- mild to moderate hypertension
A

thiazide

39
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- hypercalcemia
A

loop

40
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- altitude sickness
A

acetazolamide

41
Q 
What diuretic or class of diuretic would be most useful in each of the following situations?
- hyperaldosteronism
A

spironolactone, eplerenone

42
Q

What is the site of action of the thiazides?

A

distal convoluted tubule

43
Q

A patient with heart failure exacerbation needs medical diuresis but has a sulfa allergy. What diuretic can be used?

A

Ethacrynic acid (loop)

44
Q

Which electrolyte disturbance fits each of the following presentations?
- correcting too rapidly may result in central pontine myelinolysis

A

hypo Na+

45
Q

Which electrolyte disturbance fits each of the following presentations?
- peaked T waves

A

hyper K+

46
Q

Which electrolyte disturbance fits each of the following presentations?
- tetany

A

hypo Ca2+, hypoMg2+

47
Q

Which electrolyte disturbance fits each of the following presentations?
- arrhythmias

A

hyper K+, hypo K+, hypo Mg2+

48
Q

Which electrolyte disturbance fits each of the following presentations?
- decreased deep tendon reflexes

A

hyper Mg2+

49
Q

Which electrolyte disturbance fits each of the following presentations?
- flattened T waves, U waves on EKG

A

hypo K+

50
Q

What factors/substances cause hyperkalemia? (8)

A
  • acidosis
  • low insulin
  • beta-blocker
  • digitalis
  • cell lysis (rhabdo, crush injury)
  • hyperosmolarity
  • K+ sparing diuretics
  • ACE inhibitors (b/c of decrease in aldosterone)
51
Q

What factors/substances cause hypokalemia? (5)

A
  • insulin
  • beta agonist
  • alkalosis
  • loops
  • thiazides
52
Q

What are the causes of acidosis with elevated anion gap?

A

MUD PILES

  • methanol
  • uremia
  • diabetic ketoacidosis
  • propylene glycol
  • iron tablets/isoniazid
  • lactic acidosis
  • ethylene glycol
  • salicylates (late)
53
Q

A patient is found to have both glomerulonephritis and pulmonary vasculitis. What two diagnoses should be considered?

A
  • Goodpasture

- GPA (Wegener)

54
Q

An 8 yo girl presents with abdominal pain, hip and knee pain, and purpura on the backs of the arms and legs. U/A shows microscopic hematuria and mild proteinuria. What is the most likely diagnosis?

A

IgA nephropathy (HSP)

55
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- linear pattern of IgG deposition on IF

A

Goodpasture

56
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- lumpy-bumpy deposits of IgG, IgM, and C3 in the mesangium

A

PSGN

57
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- Deposits of IgA in the mesangium

A

IgA nephropathy

58
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- anti-GBM antibodies, hematuria, hemoptysis

A

Goodpasture

59
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- crescent formation in the glomeruli

A

RPGN (crescentic)

60
Q

Which glomerular disease would you suspect most in a patient with the following findings?
- wire-looping appearance on LM

A

lupus-nephritis

61
Q

What are the defining features of nephrotic syndrome? (3)

A
  • proteinuria > 3.5 g/day
  • hypoalbuminemia
  • peripheral edema
62
Q

Glomerular histology reveals multiple mesangial nodules. This lesion is indicative of what disease?

A

Diabetic glomerulonephropathy

- Kimmelstiel-Wilson lesions

63
Q

Which glomerular disease would you suspect most?

- most common nephrotic syndrome in adults

A

FSGS

64
Q

Which glomerular disease would you suspect most?

- EM: effacement of epithelial foot processes

A

minimal change

65
Q

Which glomerular disease would you suspect most?

- nephrotic syndrome associated with hep B

A

membranoproliferative glomerulonephritis (MPGN)

66
Q

Which glomerular disease would you suspect most?

- nephrotic syndrome associated with HIV

A

FSGS

67
Q

Which glomerular disease would you suspect most?

- EM: subendothelial humps and tram-track appearance

A

MPGN

68
Q

Which glomerular disease would you suspect most?

- LM: segmental sclerosis and hyalinosis

A

FSGS

69
Q

Which glomerular disease would you suspect most?

- purpura on back of arms and legs, abdominal pain, IgA nephropathy

A

Henoch-Schonlein purpura (HSP)

70
Q

Which glomerular disease would you suspect most?

- EM: spiking of the GBM due to electron-dense subepithelial deposits

A

membranous nephropathy

71
Q

What is the WAGR complex?

A

Wilm’s tumor
Aniridia
GU malformation
Retardation (mental)

72
Q

What are the risk factors for transitional cell carcinoma? (3)

A
  • smoking
  • aniline dyes
  • cyclophosphamide
73
Q

What GU pathology fits each of the following descriptions?

- most common tumor of the urinary tract

A

TCC

74
Q

What GU pathology fits each of the following descriptions?

- most common renal malignancy of early childhood (age 2-4)

A

Wilm’s

75
Q

What GU pathology fits each of the following descriptions?

- most common type of renal stone

A

calcium

76
Q

What GU pathology fits each of the following descriptions?

- type of renal stone associated with Proteus vulgaris

A

struvite stones

77
Q

What GU pathology fits each of the following descriptions?

- red cell casts

A

acute glomerulonephritis

78
Q

What GU pathology fits each of the following descriptions?

- waxy casts

A

chronic renal failure (long standing kidney disease)

79
Q

What are the classic features of drug-induced acute interstitial nephritis? (4)

A

fever, rash, eosinophilia, azotemia

80
Q

What changes will be seen in a BMP in a pt with renal failure? (3)

A
  • high K+
  • low Ca2+
  • high BUN and Cr

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