Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > GU 1 (Step up son) > Flashcards

GU 1 (Step up son) Flashcards

1
Q

What happens in proximal convoluted tubule?

A

Glucose, amino acids, metabolites, and sodium (2/3) are reabsorbed
Cl- and H2O go along gradient
HCO3- is reabsorbed via carbonic anhydrase

Organic acids (uric acid) and bases are SECRETED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens in the descending loop of Henle?

A

Permeable to water…deeper increases osmotic gradient –> reabsorption of water/concentration of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens in the ascending loop of Henle?

A

Active reabsorption via Na+/K+/2Cl- cotransporter

Reabsorption of Mg2+, Ca2+, and K+ via paracellular diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens in the distal convoluted tubule?

A

Impermeable to water
Na+ and Cl- are reabsorbed via Na+/Cl- transporter
Ca2+ reabsorbed via PTH activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens in the collecting tubule and duct?

A

Aldosterone causes principal cells to reabsorb Na+ and secrete K+
Intercalated cells secrete H+ and reabsorb K+
ADH drives H2O reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why do loop diuretics help with treating pulmonary edema caused by volume overload?

A

Beyond getting rid of fluid, the also have a direct pulmonary vasodilatory effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where do loop diuretics work? What are the side effects?

A

Loops inhibit Na/K/2Cl cotransporter in the ascending limb

Ototoxicity
Hyperuricemia
Hypokalemia
Hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where do thiazides work? What are the side effects?

A

Thiazides inhibit Na/Cl cotransporter in the distal convoluted tubule

Hypokalemia
HyperGLUC…Glucose, Lipids, Uric acid, Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes pyelonephritis?

A

E. coli (most common)
Staph sapro, Klebsiella, and proteus also can
Candida in immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is pyelonephritis treated?

A

Fluoroquinolones
Aminoglycosides (gentamicin)
3rd gen cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can happen if a pregnant woman gets pyelo?

A

preterm labor and low birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kind of kidney stones will not show up on AXR?

A

Uric acid stone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a pathologic difference between calcium oxalate stones and calcium phosphate stones?

A

Calcium oxalate: idiopathic

Calcium phosphate: Hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes persistent hematuria in patients less than 20?

A

Glomerular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes persistent hematuria in patients between 20 and 50?

A

Adult PCKD
Neoplasm (bladder, kidney, prostate)
Glomerular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes persistent hematuria in patients Older than 50?

A

Adult PCKD
BPH
Neoplasm (bladder, kidney, prostate)
Glomerular disease

17
Q

What is a possible complication of PCKD?

A 
Subarachnoid hemorrhage (15% of PCKD patients)
MVP
18
Q

What is elevated with renal cell carcinoma? What other malignancies cause this?

A

Erythropoietin

Hepatocellular carcinoma
Pheochromocytoma
Hemangioblastoma

19
Q

Watch out for Acute Interstitial Nephritis (AIN) after starting a new drug (it’s a long list)…

A

…look for signs of ARF, N/V, malaise, rash, fever; also eosinophilia

20
Q

A kid comes in concerned about brown pee and swelling. On review, he had a fever, sore throat, and tender lumps on his neck a couple of weeks ago. What is a possible diagnosis? What would be seen on labs? How should he be treated?

A

Likely poststreptococcal glomerulonephritis

UA: hematuria and proteinuria
Antistreptolysin O titer (ASO): high
Electron microscopy (EM) of GBM: bumpy deposits* of IgG and C3

Self-limited…supportive if necessary (edema, HTN)

21
Q

What is seen with EM of IgA nephropathy (Berger disease)? How should it be treated?

A

Mesangial cell proliferation

Occasionally self-limited
ACEI and statin for prolonged proteinuria
Corticosteroids if becomes nephrotic (proteinuria > 3.5g/day)

22
Q

REVIEW: How is Goodpasture syndrome treated?

A

Plasmapheresis

Corticosteroids and immunosuppressive agents can help

23
Q

Mom brings young infant in because of hematuria. Also says that the baby doesn’t react to whistling and other high-pitched sounds and the baby’s eyes are cloudy. What is a likely diagnosis? What would be seen on EM? What can be done?

A

This is likely Alport Syndrome (defect in collagen IV in basement membrane)

EM shows a split basement membrane*

ACEI helps w/ proteinuria
Transplant can be complicated by Alport induced Goodpastures

24
Q

What causes the crescents with rapidly progressive glomerulonephritis (RPGN)? What is it called if ANCA+? How is it managed?

A

Basement membrane wrinkling with inflammatory cells and fibrous material in Bowman capsule

Pauci-Immune RPGN

Steroids, plasmapheresis, and immunosuppressive agents kinda help…but transplant is usually required

25
Q

What happens with Lupus nephritis? How is it treated?

A

Proliferation of endothelial and mesangial cells

Corticosteroids
ACEI
Statin

26
Q

REVIEW: Granulomatosis with polyangiitis (Wegener’s) has what lab elevation?

A

c-ANCA

27
Q

SUMMARY: How are nephritic syndromes treated?

A

Corticosteroids

ACEI and Statins to reduce proteinuria

28
Q

What is the most common nephrotic syndrome in kids? what is seen on EM? how is it treated?

A

Minimal Change Disease

Effacement of foot processes

Steroids

29
Q

What is the most common nephrotic syndrome in adults? How is it treated?

A

Focal Segmental Glomerular Sclerosis (FSGS)

Steroids, cytotoxic agents, ACEI, statins
Rarely transplant…usually recurs anyway

30
Q

What type of nephrotic syndrome presents with spike and dome BM thickening? What abnormal treatment is required?

A

Membranous globerulonephritis

Requires anticoagulation…renal vain thrombosis

31
Q

A patient with either a systemic infection or autoimmune condition comes in for progressively frothy urine that may be getting a little darker. What is a concern? What would be seen on EM if that were the case?

A

Membanoproliferative glomerulonephritis

Train tracks

32
Q

A patient comes in w/ hx of uncontrolled DM now having frothy urine. What is the pathology of the disease? What might be seen on EM? How is it managed?

A

Diabetic nephropathy (diffuse or nodular) results from basement membrane and mesangial thickening

BM thickening for sure
Round nodules (Kimmelstiel-Wilson nodules) w/ nodular type

DM treatment
Dietary protein restriction
ACEI

33
Q

What is the most common cause of acute renal failure?

A

Drugs –> ATN –> ARF

34
Q

What is indicated by hematuria and red cell casts on UA?

A

Glomerular or vasculitic disease

35
Q

What is indicated by epithelial casts?

A

ATN

36
Q

What is indicated by pyuria with waxy casts?

A

Interstitial disease or obstruction

37
Q

What is indicated by pyuria alone?

A

Infection

38
Q

How is FENa calculated? what does it indicate?

A

FENa = (urine Na/serum Na)/(urine cr/serum cr)

Less than 1% –> prerenal
Greater than 2% –> ATN

39
Q

How should ARF be managed?

A 
Prevent fluid overload
Stop drugs causing ATN
Low protein diet
Steroids
Dialysis

Step 2 (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions