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Boards > Nephro Uro Anderson > Flashcards

Nephro Uro Anderson Flashcards

1
Q

the afferent arteriole is sensitive to

A

epinephrine

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2
Q

the efferent arteriole is sensitive to

A

angiotensin 2

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3
Q

interpretation of clearance > GFR

A

filtration + net secretion

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4
Q

interpretation of clearance = GFR

A

filtration only or secretion = resorption

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5
Q

interpretation of clearance

A

filtration + net resorption

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6
Q

contraction of afferent arteriole ___ GFR

A

decreases

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7
Q

contraction of efferent arteriole ___ GFR

A

increases

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8
Q

hyperosmolarity results in what response

A

thirst, ADH release

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9
Q

osmoregulation is through what part of the brain

A

hypothalamus

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10
Q

volume regulation is through what two things

A

baroreceptors and macula densa

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11
Q

volume blood loss results in what response

A

sympathetic activation, renin release from JGA

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12
Q

2/3rds of Na and H2O are reabsorbed in the

A

proximal tubule

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13
Q

all glucose, HCO3, and amino acids are reasorbed in the

A

proximal tubule

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14
Q

in the proximal tubule Na is resorbed using

A

Cotransport (glucose, AA, PO4) and countertransport (H+ exchange)

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15
Q

where is the site of Carbonic Anhydrase Inhibitor activity

A

proximal tubule…blocks HCO3 reabsorption

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16
Q

25% of Na is reabsorbed in the

A

thick ascending loop on henle

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17
Q

in the thick ascending loop of henle, Na is reabsorbed using

A

Na-K-Cl cotransporter

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18
Q

% of Na is reabsorbed in the

A

distal tubule/collecting duct

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19
Q

in the distal tubule/collection duct Na is reabsorbed via

A

Na-Cl cotransporter

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20
Q

67% of K is reabsorbed in the

A

proximal tubule

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21
Q

20% of K is reabsorbed in the

A

thick limb…Henle

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22
Q

in the tick limb…Henle the K is reabsorbed via

A

Na-K-2Cl cotransporter

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23
Q

if you have low Na/Cl at the macula densa, what happens

A

release of active renin from JGA = angiotenisin

24
Q

what does angiotensin II do

A

constricts the efferent arteriole causes increased GFR

25
Q

where does angiotensinogen come from

A

liver

26
Q

enzyme that converts angiotensinogen to angiotensin I

A

renin

27
Q

where is renin from

A

JGA

28
Q

angiotensin I is converted to angiotensin II by

A

ACE

29
Q

where is ACE from

A

lung

30
Q

why is renin released from JGA

A

when GFR is low, low blood volume, increased blood osmolarity

31
Q

in addition to constricting the efferent arteriole, angiotensin II does this to the adrenal cortex zona glomerulosa

A

causes release of aldosterone which tell distal tubule to reabsorb Na and excrete K…sodium reabsorption leads to increased water reabsorption, increased blood volume, and decreased blood osmolarity

32
Q

where are osmoreceptors located

A

anterior hypothalamus

33
Q

where does ADH come from

A

posterior pituitary

34
Q

glutamic acid can undergo oxidative deamination to become

A

alpha ketoglutarate

35
Q

what does ALT (alanine aminotransferase) do

A

takes alanine to pyruvate using vit B6

36
Q

what does AST (aspartate aminotransferase) do

A

takes aspartate to oxaloacetate using vitamin B6

37
Q

what are the two original substrates of the urea cycle

A

CO2 and NH4

38
Q

where does the urea cycle happen

A

liver

39
Q

what happens in the mitochondria portion of the urea cycle

A

CO2 and NH4 and put together using carbamoyl phosphate synthetase to create carbamoyl phosphate. Carbamoyl phosphate is them cobined with L-ornathine using ornithine transcarbamoylase and to create L-citruline which goes to the cytosol

40
Q

what happens in the cytosol portion of the urea cycle

A

L-citruline undergoes several transaminations to become L-arginine. L-arginine has urea taken out of it by arginase. L-ornithine is the left over and that goes back into the mitochondria.

41
Q

Acute Nephritis: acute post-strep Glomerulonephritis

A

Red cell casts, 1-2 weeks after recovery from sore throat; Children 6-10 yrs, moderate proteinuria.

42
Q

IgA Nephropathy/Berger’s dz

A

Increased IgA in response to viruses, bacteria, food proteins…Antibodies injure glomerulus (precipitative nature of Ab’s)…Hematuria comes & goes; chronic GN

43
Q

Henoch-Schonlein Purpura

A

Purpuric skin lesions on extensor surface of extremities & buttock…IgA precipitation after respiratory infection, kids 3-8 yrs…Hematuria recurrences for yrs.

44
Q

Goodpasture’s Syndrome

A

Rapid GN with auto-antibodies to basement membrane…Young men who smoke…Death due to renal failure or lung hemorrhage

45
Q

Nephrotic syndrome

A

Heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia, lipiduria
…Kids > dt primary kidney dz
…Adults > SLE, DM, amyloidosis, membranous GN most common cause
…More in men. Immune complexes in basement membrane, food allergy

46
Q

pyelonephritis

A

Affects tubules or interstitium

…Ascending fecal flora, females, pregnancy, BPH (secondary to stasis of urine). Pyelo- indicates renal Pelvis.

47
Q

hydronephrosis

A

dilation of renal pelvis & calyces associated with progressive atrophy of kidney dt obstruction of urine outflow

48
Q

Urolithiasis

A

75% Ca oxalate, radiopaque(show up on X-ray);
25% Radiolucent (no X-ray);
Proteus or Staph infection cause alkaline urine / increase crystal formation
Staghorn calculi = large obstructive stomes in pelvis;
6% uric acid calculi, secondary to gout, radiolucent

49
Q

cystitis

A

Females > males,
E. coli, urethral trauma, bacterial contamination,
Can lead to PN, chronic cystitis,
Frequency, urgency, dysuria, suprapubic pain

50
Q

interstitial cystitis

A

Usually women, chronic cystitis, inflammation of all layers of bladder, normal urinalysis.
Suprapubic pain when bladder is full which is relieved by voiding.

51
Q

Adenocarcinoma/Hypernephroma

A

Cigarette, pipe, & cigar smokers; upper kidney pole, solitary, unilateral…
Metastasize to lung & bone before sx appear

52
Q

Wilm’s Tumor

A

Common primary renal tumor in kids, genetic, age 2-5 yrs,

Large abd mass, painless hematuria, good prognosis with tx

53
Q

Benign Ureteric Tumors

A

polyps. May be too small to cause obstruction

54
Q

malignant ureteric tumors

A

primary rare, transitional cell CA, obstruction, painless hematuria

55
Q

Tumors of the Bladder

A

Risk factors; Industrial solvents, > cigarette smoking.
Transitional cell tumors, benign papilloma; 90% transitional cell carcinoma, squamous cell carcinoma,
Painless hematuria, HCG in urine is marker of aggressive tumor, tends to recur after excision

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