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FEN/Renal Flashcards

1
Q

What is the percentage of body water at 24 weeks?

What percent is extracellular vs intracellular?

A

90%

65% Extracellular

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2
Q

What is the percentage of body water at 24 weeks?

What percent is extracellular vs intracellular?

A

90%

65% Extracellular 25% Intracellular

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3
Q

What is the percentage of body water at term?

What percent is extracellular vs intracellular?

A

80%

45% Extracellular 35% Intracellular

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4
Q

What is the percentage of body water at 1 year of age?

What percent is extracellular vs intracellular?

A

65%

20% Extracellular 45% Intracellular

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5
Q

TBW and ECF _______ with increasing gestational age.

A

decreases

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6
Q

ICF _________ with increasing gestational age.

A

increases

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7
Q

Normal UOP is _____ml/kg/hr

Stool water content is _______ ml/kg/d

A

1-3

5-10

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8
Q

Hypernatremia correction:
_____ for Na over ______
_____ for Na over ______

A

4ml/kg free water for every 1mEq/L Na >145

3ml/kg free water for Na >170

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9
Q

Where and at what proportion does evaporative water loss occur?

A

1/3 via respiratory tract

2/3 via skin

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10
Q

Factors increasing insensible water loss

A 
Increased environmental and body temperature
Decreasing gestational age
Skin breakdown
Congenital skin defects
Radiant warmer
Phototherapy
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11
Q

Factors decreasing insensible water loss

A

Humidity

Plastic heat shield

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12
Q

ADH produced by fetus at

A

11 weeks

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13
Q

ADH is produced _______ and stored in the _______

A

Hypothalamus

Posterior pituitary gland

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14
Q

Osmolality calculation:

A

2(Na) + glucose/18 + BUN/2.8

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15
Q

Nephrogenic DI is caused by

A

Renal tubule ADH insensitivity

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16
Q

Congenital nephrogenic DI is due to either

A

Vasopressin- receptor defect (X-linked recessive)

Aquaporin defect (autosomal)

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17
Q

Increased urine concentration is accomplished in nephrogenic DI through administration of

A

Thiazides

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18
Q

Body fluid with the highest potassium content is

A

Diarrheal stool

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19
Q

Body fluid with the highest chloride content is

A

Stomach

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20
Q

Body fluids with the highest sodium content are

A

Small intestine

Bile

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21
Q

False hypernatremia can occur with

A

Hyperlipidemia
Hyperproteinemia
Hyperglycemia

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22
Q

Na correction calculation

A

(Na desired - Na current) x 0.6 x weight

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23
Q

Carbonic anhydrase is an enzyme that contributes to

A

Acid base balance

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24
Q

pH is _________ correlated to potassium level.

A

Inversely

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25
Acid base balance is regulated by transportation of _____ by the ________ and increased clearance of _____ by the ______
HCO3 - kidneys (to increase base) CO2 - lungs (to decrease acid)
26
Renal tubular acidosis is caused by
Decreased renal tubular H+ secretion OR Decreased HCO3 reabsorption
27
Electrolyte abnormalities in RTA are
``` Hypercalciuria Hypokalemia (d/t increased aldosterone) ```
28
RTA 1 is identified by:
Autosomal dominant Genetic/autoimmune disease Inability to secrete H+ in distal tubule Urine pH >6.2
29
RTA 2 is identified by:
Autosomal recessive Fanconi, cystinosis, tyrosinemia, Lowe Prematurity Decreased original tubular HCO3 reabsorption Urine pH <5.3
30
RTA 3 is identified by:
Aldosterone deficiency/resistance Hyperchloremic/hyperkalemic Metabolic acidosis Poor growth, FTT
31
Renal juxtaglomerular hyperplasia/hypertrophy is
Bartter syndrome
32
Bartter syndrome is marked by
Defective ascending loop chloride transport--> Increased renin Increased aldosterone Hypokalemic metabolic acidosis
33
Kidneys are formed from
Mesoderm
34
Three morphologic stages of embryonic kidneys are
Pronephros, mesonephros, metanephros
35
Nephrogenesis continues until
35 weeks
36
Urine production begins at
10 weeks
37
Preterm infant maximum osmolality is 500 due to
Tubule insensitivity to vasopressin- Short loop of Henle Limited na reabsorption in thick ascending loop
38
Renal blood flow shifts from ____ of cardiac output in utero to ____ after birth
3% 12%
39
Neonatal GFR doubles by
2 weeks of age
40
Most sodium is reabsorbed in the
Proximal tubule Remaining in ascending loop and distal tubule
41
FeNa calculation
Urine Na x plasma creatinine/ | Urine creatine x plasma Na x100
42
FeNa suggestive of prerenal failure is
1-2.5%
43
Potassium is reabsorbed in
Proximal tubule and ascending loop of Henle
44
Bicarbonate in excess of the threshold is secreted in the
Proximal tubule
45
Calcium reabsorption occurs in the
Proximal tubule and loop of Henle (passive) | Distal tubule and collecting ducts (active)
46
80% phosphorus is reabsorbed in
Proximal tubule
47
Tubular reabsorption of phosphorous calculation:
1- ((UrPh x PCr)/ (UrCr x PPh)) X100
48
65% magnesium reabsorption in
Proximal tubule and thick ascending loop
49
RAAS pathway is
Angiotensinogen vasoconstriction, ADH | Aldosterone -->^ Na, Cl, K, H, retain water
50
Pseudohypoaldosteronism
X linked recessive Renal tubule aldosterone resistance Incr aldosterone, renin but still with low Na, high K
51
Large placenta associated with
Congenital nephrotic syndrome (+ incr AFP) | Syphilis
52
GFR calculation
0.45 x height (cm)/ PCr Preterm, 0.33 instead of 0.45
53
Protein reabsorption occurs
Proximal tubule
54
Myoglobinuria is due to
Rhabdomyolysis
55
Kidney length is approximately equal to
Gestational age in weeks
56
Congenital nephrotic syndrome signs
Proteinuria Hypoproteinemia Hyperlipidemia Edema Autosomal recessive Finnish (CNF) - 19q13.1, NPHS1- large placenta Diffuse mesangial sclerosis (DMS) - normal placenta
57
AR PKD signs
``` Chr 6p21 Snowstorm cysts Liver involvement increases with age Hepatic fibrosis Biliary dysgenesis Severe hypertension ```
58
AD PKD signs
Chr 16, - PKD1 16p13.3 polycystin 1 - PKD2 4q. Polycystin 2 Cysts: renal, liver, pancreas, spleen Hypertension Cerebral aneurysms
59
Fanconi syndrome signs
``` Autosomal dominant Associated with Lowes syndrome Proximal tubule dysfunction --> urinary losses Polyuria Low phosphorous, potassium ```
60
Autosomal recessive defective cystine transport is
Cystinosis
61
Progression of cystinosis is from ____ in infants to _____by ____ age
FTT, V/D ESRD 9 years
62
Findings in cystinosis are
Normal plasma cystine | Increased cystine in lysosomes and crystals in slit lamp
63
Oculocerebrorenal syndrome is also called
Lowe's syndrome
64
Lowe's syndrome is inherited
X linked recessive
65
Lowe's syndrome is caused by
Enzyme deficiency due to gene defect, defective Golgi
66
Lowe's syndrome signs
``` Cataracts, glaucoma Mental deficiency Hypotonia Renal tubular dysfunction +/- Congenital nephrotic syndrome Cryptorchidism ```
67
Neonatal UTI is associated with
40% risk of reflux
68
Ectopic ureterocele is
Duplicated renal pelvis and ureter Renal upper pole drained by duplicate ureter abnormally developed Demonstrated on VCUG Excision indicated Females 6:1
69
Cloacal exstrophy is caused by
Failed cloacal septation with ureters, ileum and rudimentary hindgut connected to common cloaca
70
Clinical signs of cloacal exstrophy are
``` Bladder exstrophy omphalocele hydromelia cryptorchidism GU anomalies Limb deformities Hip dislocation ```
71
Bladder exstrophy causes
Defect in infraumbilical mesoderm migration with exposed posterior bladder wall, epispadias, +/- inguinal hernia Male>>female
72
Sacral/lumbar hypoplasia, neurogenic bladder, VUR, and renal agenesis can be
Caudal dysplasia syndrome
73
Cerebrohepatorenal syndrome is also
Zellweger syndrome
74
Glaucoma, brain anomalies, chrondrodystrophy, and cortical renal cysts describe
Zellweger syndrome Autosomal recessive
75
An autosomal recessive syndrome with small thoracic cage and pulmonary hypoplasia, cystic tubular dysplasia and glomerulosclerosis is
Jeune syndrome
76
Polycystic or dysplastic kidneys with encephalocele, polydactyly, cryptorchidism and cardiac anomalies is ____, inherited ____
Meckel-Gruber | Autosomal recessive
77
Tuberous sclerosis is inherited _____ and includes
Autosomal dominant | Fibrous angiomatous lesions, intracranial calcifications, polycystic kidneys and renal angiomyolipomata
78
Congenital cause of nephritic syndrome is
Nail-patella syndrome (autosomal dominant) Hypoplastic-absent patella
79
Palpable kidney, hematuria, and renal failure suggest
Renal vascular thrombosis
80
Hypercalciuria can contribute to nephrocalcinosis in ____% of neonates >____ weeks
25-60% | 32 weeks
81
Risk factors for nephrocalcinosis
``` Loop diuretics Williams syndrome Type 1 RTA primary hyperparathyroidism Bartter's syndrome ```

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