Kidney and Male Tract Flashcards by Teauna Harper

Main functions of the kidney

blood filtration and urea excretion

How well did you know this?

Not at all

Perfectly

Additional role of kidneys

regulating blood pressure through angiotensin-aldosterone system

How well did you know this?

Not at all

Perfectly

Na concentration sensed by

macula densa cells

How well did you know this?

Not at all

Perfectly

Renin secreted by

juxtaglomerular cells

How well did you know this?

Not at all

Perfectly

Glomerulus attached to

tubule

How well did you know this?

Not at all

Perfectly

Blood is filtered in the

glomerulus

How well did you know this?

Not at all

Perfectly

Kidneys convert _____into 1L of urine

1700L blood/day

How well did you know this?

Not at all

Perfectly

3 hormones released by kidneys

Erythropoietin (EPO)
Renin
Active form of vitamin D biosynthesis

How well did you know this?

Not at all

Perfectly

____ regulates blood pressre through the Renin-Angiotensin system

Renin

How well did you know this?

Not at all

Perfectly

____ stimulates the bone marrow to make red blood cells

EPO

How well did you know this?

Not at all

Perfectly

_____ helps maintain calcium for bones and for normal chemical balance in the body

Vitamin D

How well did you know this?

Not at all

Perfectly

2 most common causes of kidney disease

diabetes

high blood pressure

How well did you know this?

Not at all

Perfectly

Clinical manifestations of renal diseases

azotemia
parenchymal disease of the glomeruli
uremia

How well did you know this?

Not at all

Perfectly

Elevation of blood urea nitrogen (BUN) and creatinine, generally reflects decreased GFR

azotemia

How well did you know this?

Not at all

Perfectly

Characterized not only by failure of renal excretory function but also by a host of metabolic and endocrine alterations resulting from renal damage

uremia

How well did you know this?

Not at all

Perfectly

GFR less than 60 mL/minute/1.73m2 for at least 3 months
and/or persistent albuminuria
GFR about 30% to 50% of normal

chronic kidney disease

How well did you know this?

Not at all

Perfectly

Renal agenesis
Ectopic Kidney
Horseshoe kidney
Renal dysplasia

congenital anomalies

How well did you know this?

Not at all

Perfectly

Congenital Cystic kidney disease.

Acquired cystic kidney Disease

Cystic Kidney diseases

How well did you know this?

Not at all

Perfectly

Minimal change Glomerulopathy (nephrotic)
Focal segmental glomerulosclerosis (FSGS) (nephrotic)
Membranous glomerulopathy (nephrotic)
Type I membranoproliferative Glomerulonephritis (MPGN type I)
Type II membranoproliferative Glomerulonephritis (MPGN type II)
IgA nephropathy (Berger disease) (nephritic)
Anti-Glomerular basement membrane Glomerulonephritis (nephritic)
Acute post infectious glomerulonephritis (nephritic)
ANCA Glomerulonephritis

Immune mediated glomerular inflammation

How well did you know this?

Not at all

Perfectly

Lupus glomerulonephritis (2ry)
Diabetic Glomerulosclerosis (2ry)

Secondary to systemic diseases glomerular inflammation

Hereditary nephritis (Alport Syndrome) (mutation of IV collage)
Thin Glomerular Basement membrane Nephropathy

Isolated glomerular abnormalities glomerular inflammation

Renal vasculitis
Hypertensive nephrosclerosis (benign nephrosclerosis)
Malignant hypertensive nephropathy
Renovascular hypertension
Thrombotic microangiopathy
Cortical necrosis

vascular diseases

Acute tubular necrosis (ATN)
Pyelonephritis
Analgesic nephropathy
Drug-induced (hypersensitivity) tubulointerstitial nephritis
Light-chain cast nephropathy
Urate nephropathy

Tubulointerstitial diseases

Allograft nephropathy
Drug toxicity
Recurrent diseases
Transplant glomerulopathy

diseases in the transplant

Wilms’ Tumor (nephroblastoma) Renal Cell Carcinoma (RCC) Transitional Cell Carcinoma

Malignant Tumors of the Kindey

Complete bilateral agenesis (still born) Unilateral agenesis: compensated by the contralateral kidney (hypertrophy), not a serious matter if there is no associated anomalies.

Renal agenesis

Misplaced in the pelvis

ectopic kidney

Single large midline organ Infant born with fused kidneys May increase risk of obstruction and pyelonephritis; ureters cross over the junction between the two kidneys and are fused at the lower pole.

Horseshoe Kindey

Undifferentiated tubular structures, primitive mesenchyme, heterotopic tissue such as cartilage. Cysts form from the abnormal tubules. Familial, genetic and somatic causes. Palpable flank mass Unilateral Dysplasia (removal of the involved kidney) Bilateral aplastic dysplasia (Potter sequence

renal dysplasia

typical physical appearance and associated pulmonary hypoplasia of a neonate as a direct result of oligohydramnios and compression while in utero.

Potter syndrome

Numerous cysts in the renal parenchyma The most common congenital disease with renal cysts 1:400-1:1000 individuals in the USA 50% develop end-stage renal failure Mutation in PKD1 (85%) The primary cilia of the renal tubular epithelium (tubule growth and sensing urine) 1/3 of ADPKD: have hepatic cysts 1/5 of ADPKD: have cerebral aneurysm and intracranial hemorrhage (cause of death in 15% of ADPKD).

Autosomal Dominant Polycystic Kindey

Rare, infants In the collecting ducts 1:6000-1:40000 25% succumb to the disease in perinatal period (potter sequence) Those who survive, progress to renal insufficiency. Mutation of PKHD1 (fibrocystin protein) Pancreatic cysts, hepatic biliary dysgenesis, fibrosis, and Cystic transformation of the renal collecting ducts Smooth external surface of kidney. Bilateral

Autosomal Recessive Polycystic Kidney Disease

Rarely clinically symptomatic, unless very large. Usually in the outer cortex, simple ones in medulla. In 50% of people over 50 years of age

simple renal cyst

Often develop multiple cortical and medullary cysts (hyperplastic and neoplastic proliferation may develop)

long term dialysis

These cells are phagocytic and secrete the amorphous basement membrane-like material known as the mesangial matrix. They are typically separated from the lumen of the capillaries by endothelial cells. It is in the middle (meso) between the capillaries (angis). It is contained by the basement membrane, which surrounds both the capillaries and the mesangium

intraglomerular mesangial cells

The most common cause of Glomerulonephritis in the world. | nephritic syndrome

IgA nephropathy (Berger disease) (Nephritic)

First two major diagnostic considerations for patients with asymptomatic glomerular hematuria (Nephritic):

Thin Glomerular Basement membrane | IgA Nephropathy

HEMATURIA (visible or microscopic) Variable degrees of proteinuria Decreased glomerular filtration rate. Elevated BUN, serum creatinine Oliguria, salt and water retention, edema, and hypertension Inflammatory damage: endocapillary, extracapillary hypercellularity, leukocyte infiltration and necrosis, hyperplasia of the glomerular cells.

Nephritic syndrome

characteristic of classic anti-GBM disease

Linear

Increased glomerular capillary permeability Severe PROTEINURIA (>3.5g protein/24hrs) Hypoalbuminemia (<3gm/dl) Generalized edema Hyperlipidemia, & lipiduria ( increase lipoprotein synthesis in liver) All glomerular diseases occasionally produce mixed nephritic and nephrotic manifestations (confound clinical diagnosis), except for Minimal-change glomerulopathy ( only Nephrotic Syndrome)

Nephrotic Syndrome

Minimal-change glomerulopathy causes ____ in 75% of children, focal segmental glomerulosclerosis in 35% of adults, and membranous glomerulopathy in 30% of adults

Nephrotic sydrome

are cells in the Bowman's capsule in the kidneys that wrap around the capillaries of the glomerulus.

podocytes

is most frequently mediated by immune mechanisms

Glomerular inflammation

common, highly variable manifestations of lupus nephritis (variable immune complexes) can have many morphologic manifestations on renal biopsy. In general, the more immune complex deposition and the more cellular proliferation, the worse the disease. In this case, there is extensive immune complex deposition in the thickened glomerular capillary loops, giving a so-called wire loop appearance. Autoantibodies against nuclear and nonnuclear antigens (DNA,RNA, nucleoproteins, and phospholipids)

Lupus glomerulonephritis

Leading cause of end-stage renal disease in the US | The most common cause of secondary nephrotic syndrome

diabetic glomeruloscelerosis

Most frequent abdominal solid tumor in children (1:10,000) | WT1

Malignant Tumors of the kidney

most common Primary cancer of the kidney. 80% of Renal Cancers VHL, Von Hippel Lindau

renal cell carcinoma

obstructive symptoms of urinary tract infection, obstruction, acute urinary retention, bladder hypertrophy

NODULAR HYPERPLASIA OF THE PROSTATE (BENIGN PROSTATE HYPERPLASIA

230,000 new cases annually in the US. | 27,000 die annually

INSITU AND INVASIVE ADENOCARCINOMA OF THE PROSTATE