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WP CLUES > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Which part of the Nephron concentrates urine?

A

medulla

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2
Q

What is Goldblatt’s Kidney?

A

Flea-bitten kidney (ruptured capillaries from high blood pressure)

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3
Q

What is Azotemia?

A

“high level of nitrogen” (urea, creatinine)
Increased BUN/Creatinine ratio
renal failure

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4
Q

What is uremia?

A

Azotemia= “high level of nitrogen” (urea, creatinine)

(renal failure) with symptoms

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5
Q

What is Nephritic Kidney Disease?

A

Inflammation with protein loss <3.5 in urine

Increased size of Fenestrations, RBC casts, HTN

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6
Q

What is Nephrotic Kidney Disease?

A

Lost basement membrane charge
Proteinuria >3.5
hypercoagulable
lipiduria

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7
Q

What is seen in Rapidly Progressive Glomerulonephritis (RPGN)?

A

Crescents
Nephritis syndrome

FA581
rapidly deteriorating renal function (days to weeks)
(Crescents are fibrin and plasma protein– C3b, with glomerular parietal cells, monocytes, and macrophages)
Goodpasture syndrome, Wegener (Granulomatosis with polyangiitis), Microscopic Polyangiitis

-angiitis: (inflammation of blood vessels)

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8
Q

What is Drug Induced Hypersensitivity?

A

Eosinophils in the urine

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9
Q

What is Poststreptococcal glomerulonephritis (PSGN)?

A

Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies (deposition on glomerulus basement membrane and mesangium)
Nephritis syndrome

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10
Q

What is Membranous glomerulonephritis (Membranous Nephropathy)?

A

Nephrotic syndrome
EM: “spike and dome” appearance, granular/linear supepithelial spikes and closes

FA580
Primary: antibodies to phospholipase A2 receptor
Secondary: drugs (NSAIDS, penicillamine, gold)
infections (HBV, HCV, syphilis),
SLE, or solid tumors.
**Poor response to steroids

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11
Q

What is Membrano-proliferative glomerulonephritis (MPGN)?

A

Tram tracks seen (Type II has low C3) on LM
Most common in Adults
Nephritic-> Nephrotic

FA581
Nephritis syndrome often copresents with nephrotic syndrome
Type 1: secondary to hepatitis B/C infection (subendothelial IC deposition with granular IF)
Type 2: associated with C3 nephritic factor (decrease C3 levels) also called “dense deposit disease”

“tram track appearance” on H&E and PAS stains.

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12
Q

What is Minimal Change Disease (MCD)?

A

Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier
**excellent response to corticosteroids

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13
Q

What is Focal Segmental glomerulosclerosis (FSGS)?

A

Nephrotic Syndrome
Seen in adults (effacement of foot processes similar to minimal change disease)

Most common in IVDA(IV drug abusers), African American, Hispanics and HIV patients

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14
Q

What are the Vasculitis associated with LOW C3? (6 total)

A 
"PMS in Salt Lake City"
1. Post-Strep GN
2 Membranoproliferative Glomerulonephritis Type II
3 Sub Bacterial endocarditis
4 Serum Sickness
5 Lupus
6 Cryoglobulinemia
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15
Q

What is the Most Common Cause of Kidney Stones?

A

Dehydration

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16
Q

What is the Most common type of Kidney Stone?

A

Calcium Phosphate and Calcium Oxalate

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17
Q

What type of Kidney Stones have Coffin-Lid Crystals?

A 
Triple Phosphate (Struvite)
(Ammonium Magnesium Phosphate)

FA582
Urease + bugs (proteus mirabilis, staphylococcus saprophyticus, klebsiella)
*Can form Staghorn calculi
Increased pH

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18
Q

What type of kidney stones have Rosette Crystals?

A

Uric acid
Associated with Gout
Often seen in Leukemia

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19
Q

What type of kidney stones have hexagonal crystals?

A

Cysteine
Cystine-reabsorbing PCT transporter loses function (cystinuria) and poor reabsorption of Ornithine, Lysine, Arginine (COLA)
*can form Staghorn calculi
“sixtine” stones have SIX sides

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20
Q

What type of kidney stones have envelope or dumbbell-shaped crystals?

A

Calcium oxalate

Correlated with ethylene glycol (antifreeze) ingestion, vitamin C abuse, hypocitraturia, and malabsorption (Crohns disease)

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21
Q

What disease has Aniridia?

A

Aniridia means “absense of an Iris (pupil)
Wilms Tumor
(Most common renal malignancy of early childhood (ages 2–4). Contains embryonic glomerular structures.
Presents with large, palpable, unilateral flank mass)

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22
Q

What disease has Iridocyclitis?

A

Inflammation of Iris

Juvenile rheumatoid Arthritis

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23
Q

What is Phimosis?

A

Foreskin scarred at penis head

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24
Q

What is Paraphimosis?

A

Foreskin scarre at penis base

foreskin will strangulate the gland

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25
Q

What is Urge incontinence?

A

Urgency leads to complete voiding detrusor spasticity leads to small bladder volume

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26
Q

What is Stress Incontinence?

A

Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect

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27
Q

What is Overflow Incontinence?

A

Cannot completely empty bladder

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28
Q

What structures have one-way valves?

A

Urethra and ejaculatory duct

29
Q

What structures have Fake sphincters?

A

Ureters, LES, Ileocecal valve

30
Q

What has WBC Casts?

A

Nephritis

31
Q

What has WBC Casts ONLY?

A

Pyelonephritis

32
Q

What has WBC casts and eosinophils?

A

Interstitial Nephritis (Allergies)

33
Q

What has WBC Casts and RBC Casts?

A

Glomerulonephritis

34
Q

What has Fat Casts?

A

Nephrotic Syndrome

35
Q

What has Waxy Casts?

A

Chronic Renal Failure

36
Q

What has Tubular Casts?

A

Acute Tubular Necrosis (ATN)

37
Q

What has Muddy Brown Casts?

A

Acute Tubular Necrosis (ATN)

38
Q

What has Hyaline Casts?

A

Normal sloughing

39
Q

What has Epithelial Casts?

A

Normal sloughing

40
Q

What has Crescents?

A

RPGN

41
Q

How do you measure afferent renal function?

A

Creatinine or Inulin

42
Q

How do you measure efferent renal function?

A

BUN or PAH (para-aminohippurate= renal plasma flow)

43
Q

What is the afferent arteriole’s job?

A

Monitor pressure (JG cells-Renin release)

44
Q

What is the efferent arteriole’s job?

A

To secrete

45
Q

What can you measure to test afferent arteriole’s function?

A

Glomerular filtration rate (GFR) or Inulin

46
Q

What can you measure to test afferent arteriole’s function?

A

Glomerular filtration rate (GFR) or Inulin

47
Q

How do you test efferent arteriole function?

A

Renal plasma flow (RPF) or PAH

48
Q

What is Pre-Renal Failure?

A

Low flow to kidney; BUN; Creatinine ratio >20/1 in the serum

49
Q

What is intra-Renal Failure?

A

Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1

50
Q

What is Post-Renal Failure?

A

Obstruction (hydronephrosis)

51
Q

What is the job of the Proximal Convoluted Tubule?

A

Reabsorb Glucose, Amino Acids, Salt, Bicarb. >60-80% Reabsorption occurs here

52
Q

What is the job of the Thin Descending Loop of Henle?

A

Reabsorbs Water

53
Q

What is the job of the TAL of Henle?

A

Makes the concentration gradient by reabsorbing Na, K, Cl, Mg, and Ca without water. (Impermeable to H2O)

54
Q

What is the job of the early distal tubule?

A

Concentrate urine by reabsorbing NaCl

55
Q

What is the job of the late Distal Tubule and Collecting Duct?

A

Final concentration of urine by reabsorbing water and excretion of acid

56
Q

What does the Macula Densa do?

A

Measures osmolality (osmoles of solute-kg)

57
Q

What does the JGA do?

A

Measures volume, secretes renin (low volume state)

58
Q

What is Fanconi Syndrome?

A

Due to old Tetracycline use

Produces Urine phosphates, Glucose, and Amino Acids

59
Q

What is Bartter’s Syndrome?

A

JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney’s ability to reabsorb potassium

FA570
Thick ascending loop of Henle (affects Na/K2Cl- cotransporter)
Metabolic alkalosis, hypokalemia, hypercalciuria
(similar to chronic loop diuretic use)

60
Q

What is Psychogenic Polydipsia?

A

Drinking a lot of water, diluting Na in blood

61
Q

What is Hepatorenal Syndrome?

A

High urea from the Liver leads to: increased Glutaminase, Ammonia, GABA- Kidney shuts down

62
Q

What is Type I RTA (Renal Tubular Acidosis)?

A

Distal RTA: H/K in collecting duct is broken, high urine pH

63
Q

What is Type 2 RTA (Renal Tubular Acidosis)?

A

Proximal RTA: bad Carbonic Anhydrase, lost all HCO3-

64
Q

What is Central Pontine Myelinolysis?

A

“Locked-in Syndrome”

This happens when you correct serum sodium faster than 0.5 mEq/hr. (infarct the PONS- patient can only blink)

65
Q

What disease states have increased Anion Gap?

A 
"MUDPILES"
Methanol
Uremia
DKA
Paraldehyde/Phenoformin
INH/ Iron tablets
Lactic Acidosis
Ethylene Glycol
Salicylates
66
Q

What are the IgA Nephropathies?

A

HSP
Berger’s
Alport Syndrome

67
Q

What is the most common Nephrotic disease in diabetics?

A

Nodular Sclerosis

68
Q

What is the most common Nephrotic disease complication with cancer?

A

Amyloidosis

WP CLUES (22 decks)

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