All Flashcards
Kidney develops from which embryological layer (process)
Intermediate mesoderm—Urogenital Ridge-Metanephric duct—-a)Blastema
b)Ureteric bud
Blastema= excretory s Bud= collecting s
Which cells produce erythropoetin
Interstitial fibroblasts
Explain RAAS and TGF (Autoregulation)
Low gfr—JG apparatus—renin—Aldosterone and ACE
Aldosterone—increased na+—inc vol—inc gfr
ACE—AT1–AT2—-constrict eff arteriole—inc gfr
High GFR—high na+—macula densa (sensory)—adenosine—constriction of aff arteriole—low gfr
JG apparatus
JG cells (renin)
Lacis cells (renin)
Macula Densa (TGF)
Chyluria causes
Filaria
TB
Trauma
RCC
Red diaper syndrome organism
Serotia mascarens
Isosthenuria causes (density same as blood)
ATN
CKD
Recurrent Gross Hematuria
Causes
Alport IgA nephropathy ADPKD Anaplastic (RCC) Analgesic Nephropathy (RPN+)
TBMD (familial hematuria)
Urolithiasis/hypercalciuria
Triad of RPN (renal pap necrosis)
Colicky lower back pain
Hematuria
Renal dysfunction
RPN causes
Pyelonephritis Obstruction Sickle cell anemia TB Chronic alcoholism Analgesic nephropathy Radiation DM
Ring sign/lobster claw sign of kidney seen in
REnal pap necrosis
Significant proteinuria?
> 2g/d
But pathological proteinuria = >150mg
Mild = <1 Mod = 1-3.5 Sev = > 3.5
TABU proteins in urine
Tamm horsefall (uromodulin)
IgA precursor
BJp
Urokinase
Main proteins in tubular proteinuria
TH
B2M
Albumin-b2m protein ratio in glomerular and tubular proteinuria
> 1000:1. <10:1
Normal = 50-200
Causes of tubular proteinuria
Reduced resorption
Fanconi anemia
Wilsons disease
Lead poisoning
HTN
Granular casts by ?
ATN
WBc cast?
Pyelonephritis
Interstitial nephritis
Graft rejection
Causes of sterile pyuria
Stone TB Graft Rejection Partially treated UTI Interstitial nephritis
Decoy cell cast?
BK virus nephropathy
Post transplant
Calcium phosphate Triple phosphate(staghorn) Amoxicillin Ciprofloxacin Calcium oxalate Uric acid
Star like bruschite Coffin lid struvite Broom Firecracker (star shaped) Envelope Rhomboid/Diamond
KDIGO AKI
S.cr >0.3mg/dl in 2 days
S.cr > 50% of baseline in 7 days
U/o <0.5/mg/kg/hr for >6 hours
ATN causes(IIT)
Ischemia (shocks)
Infection: pneumonia/lepto/mal/UTI
Toxins: tacro/cyclos/contrast/aminog/amB/snakebite
AIN causes (DIA)
Drugs: Every Abx (EXC- amB/aminoglyco)
Infection : staph/strep/legionella
AID: Sjogren
Novel biomarkers AKI
NGAL KIM 1 Cystatin C TIMP 2 IL-8 IGF BP7
CKD with non shrunken kidney
DM
ADPKD
Amyloidosis
HIV
Mcc CKD
DM
MC Adult onset cause CKD
ADKPD
MC childhood onset cause CKD
Nephronopthises
Skin features CKD
Pruritus
Urochrome pigmentation
Lindsay nail (1/2-1/2)
Endocrine CKD
Dec testo/estro
Inc prolactin
Improving DM
Non endocrine causes of hyperprolactinemia
CLD
CKD
Drugs (Anti-dopaminergic——-antipsych)
Epilepsy
EKBOMS’s disease causes what
Causes restless leg syndrome
(PLMB) periodic limb movement disorder
GBM microscopic contents(3)
A345 collagen 4 chains
Laminin 11
Heparan sulphate
Podocytes allow how much dimension transport?
4nm only
Albumin re absorbed by which receptors in PCT
Megalin and cubulin
Drugs causing MCD
RIN
Rifampicin
Interferon
NSAIDS
Drugs causing FSGS
HAPE
Heroin
Analgesics
Pamiclonate
Ecstacy
Drugs causing MN
GMC-PD
Gold Mercury Captopril Probenecid D-penicillamine
Common virus causing FSGS MCD
HIV
Parvo
Malignancies in MCD FSGS MGN
HL. NHL. Breast/Lung Col/Kidney
Reflux nephropathy causes which disease (among nephrotic syndrome)
FSGS
AID etiology in which Nephrotic syndrome disease
MGN
Thrombotic complication is the main complication of which nephrotic syndrome disease
MGN
Main complication of FSGS
CKD (50%)
MGN antibodies
Anti PLA2 Ab (mc)
Anti THSDA1 Ab
Which channel mutation in FSGS
TRPC6 cation
Lipoid nephrosis is a feature of?
MCD
IF of FSGS and MGN
IgM IgG
Depositis in MGN
Sub epithelial
Silver stain— spike and dome pattern
Lipid droplets in tubules found in which disease?
FSGS
MCD they are found in renal parenchyma
Aka collapsing GN?
FSGS
Synthetic ACTH is used in Rx of
MGN
Acts in melanocortin teceptor on podocytes
Steroid dependent nephrotic syndrome DOC
Cyclophosphamide
DOC SRNS
Cyclosporine
Steroid Resistant
Earliest detectable stage of DN
Microalbuminuria
Rx ACE
PSGN a/w which infection
Impetigo»_space;» Pharyngitis
Delayed hematuria
Deposits in IgAN (where and what)
Mesangial
IgA C3 Properidin IgM IgG
Deposits in PSGN
Sub epithelial + sub endothelial
Lumpy bumpy -IgM+IgG
Defective galactosylysation takes place where IgA
Tonsils
(Secretes NAG—Ag enzyme—attracts Ab—defective production)
Rx IgAN- TONSILLECTOMY
Pulmonary Renal syndrome organisms
Legionella
Hanta
Drugs causing PRS
PTU
D-penicillamine
Goodpastures antigen
NC1 domain—a3 chain of COLLAGEN 4
MPGN other names
Membranoproliferative GN
Lobar GN
MesangioCAPILLARY GN
(NOT MESANGIOPROLIFERATIVE-IgAN)
2° causes of MPGN
Hep C*** Cryoglobinuria SLE Carcinomas*** Breast Ovary Lung SABE
Bx of MPGN
Sub Endothelial deposits
Separation of GBM from Endothelium by mesagium proliferation (TRAM TRACK/DOUBLE CONTOUR)
Ddx of MPGN
M»F
Cryoglobulinemia (F>>M) Stress ulcers+ Raynauds+ Arthralgia, Fatigue+
Inheritance of alport
XLR(Xq22-24)»_space; AR»_space; AD
Mutation in alport
a5 chain of COL4 > a3 > a4
Alport EM
Basket Weave appearance
LM of alport
FSGS
ADTKD (tubulointerstitial disease) other name
MCKD
Medullary Cystic Kidney Disease
Nephronopthisis EXTRA RENAL Symptoms
Cysts (renal)
Senior Loken Syndrome (Ret pigmentosa)
Skeletal dysplasiA
Joubert Syndrome (cerebellar vermis hypoplasia)- MOLAR TOOTH
Bart-Biedl syndrome
Mutations in MCKD
I = MUCI II = UMOD
Mutation in Nephronopthisis
NPHP1-NPHP20
Mc NPHP2
Protein lost in NEPHRONOPTHISIS
Nephrocystin (CILIARY FN)
Nephronopthisis is a CILIOPATHY