First Aid Flashcards
3 causes of hydronephrosis
Urinary tract obstruction
Retroperitoneal fibrosis
Vesicoureteral reflux
4 causes + the trigger of Potter sequence
ARPKD
Obstructive uropathy (post urethral valves)
Bilateral renal agenesis
Chronic placental insufficiency
Oligohydramnios
Artery affected + 5 conditions ass w/ horseshoe kidney
Inferior mesenteric artery
Hydronephrosis (ureteropelvic junction obstruction)
Renal stones
Infection
Chromosomal aneuploidy syndromes (Turner, T13, T18, T21)
Renal cancer (Wilms, renal cell carcinoma)
3 ass w/ Duplex collecting system
Vesicoureteral reflux
Ureteral obstruction
High risk of UTIs
GFR + eRPF estimation
GFR: inulin, creatinin
eRPF: PAH
Effects of prostaglandins, angiotensin II on GFR, RPF, FF
Prostaglandins: aff art dilation, high RPF, high GFR, no diff in FF
Angiotensin II: eff art constriction, low RPF, high GFR, high FF
Effect of hypovolemia + acute ureteral obstruction on GFR, RPF, FF
Hypovolemia: v.low RPF, low GFR, eff art constriction, high FF
If still low RPF, v.low GFR, renal failure
Acute ureteral obstr: low GFR, low FF
Proximal convoluted tubule
Reabsorbs all glucose, aa, most HCO-, Na, Cl, PO4/3-, K, H2O, uric acid
Secretes NH3 (buffer H+)
PTH: PO4/3- excretion
ATII: Na, H2O, HCO3- reabsorption
Thin ascending loop of Henle
Passively reabsorbs H2O
Makes urine hypertonic
Thick ascending loop of Henle
Impermeable to water
Reabsorbs Na, K, 2Cl and Mg, Ca
Distal convoluted tubule
Reabsorbs Na, Cl
Makes urine hypotonic
PTH: Ca reabsorption
Collecting tubule
Aldosterone in principal cells: reabsorbs Na in exchange for secreting K and H
Aldosterone in alpha-intercalated cells: H secretion, HCO3-/Cl- exchanger activity
ADH: H2O reabsorption
4 findings in Fanconi syndrome
Generalized reabsorptive defect in PCT
High excretion of ~all aa, glucose, HCO3-, PO4/3-
Metabolic acidosis
Hereditary defects, ischemia, multiple myeloma, nephrotoxins/drugs, lead poisoning
4 findings in Bartter syndrome
Reabsorptive defect in thick ascending loop of Henle
Affects Na/K/2Cl cotransporter
Hypokalemia
Metabolic alkalosis w/ hypercalciuria
5 findings in Gitelman syndrome
Reabsorptive defect of NaCl in DCT Hypokalemia Hypomagnesemia Metabolic alkalosis Hypocalciuria
6 findings in Liddle syndrome
High Na reabsorption in collecting tubules (high ENaC activity) Aldosterone ~ undetectable Hypertension Hypokalemia Metabolic alkalosis Ttt: Amiloride
7 findings in Syndrome of Apparent Mineralocorticoid Excess
Deficiency of 11beta-hydroxysteroid dehydrogenase (hereditary or acquired from licorice) Excess cortisol + MC receptor activity Hypertension Hypokalemia Metabolic alkalosis Low aldosterone Ttt: corticosteroids
2 loops for negative feedback of AT II
Short loop: if high AT II, stimulates AT recept on JG cells, inhibit renin release
Long loop: high BP + Na on intrarenal barorecept + macula densa, lowers renin
4 kidney endocrine functions
Erythropoietin
Calciferol
Prostaglandins
Dopamine
3 types of Renal tubular acidosis
Distal (type 1): pH>5.5, alpha-intercalated cells dont secrete H+, metab acidosis, hypoK
Proximal (type 2): pH<5.5, defect in PCT HCO3- reabs, metab acidosis, hypoK
Hyperkalemic (type 4): pH<5.5, hypoaldo, hyperK, low NH4+ excretion
3 findings + 5 Nephritic syndromes
GBM disruption
Proteinuria < 3.5g/day
HTN, high BUN+creat, oliguria, hematuria, RBC casts
Acute poststreptococcal glomerulonephritis Rapidly progressive glomerulonephritis IgA nephropathy (Berger ds) Alport syndrome Membranoproliferative glomerulonephritis
3 findings + 5 Nephrotic syndromes
Podocyte disruption (charge barrier)
Massive proteinuria > 3.5g/day
Hypoalbuminemia, hyperlipidemia, edema
Focal segmental glomerulosclerosis (1* or 2*) Minimal change disease (1* or 2*) Membranous nephropathy (1* or 2*) Amyloidosis (2*) Diabetic glomerulonephropathy (2*)
3 findings + 2 Nephritic-nephrotic syndromes
Profound GBM damage (charge barrier)
Proteinuria > 3.5g/day
Features of nephrotic sd
Diffuse proliferative glomerulonephritis
Membranoproliferative glomerulonephritis
+ in any form of nephrotic sd
Treatment of renal cell carcinoma
Localized: resection
Advanced/metastatic: immunotherapy or targeted therapy
Resistant to chemotherapy and radiation therapy
