Nephrology Flashcards
What does the ureteric bud form?
Renal pelvis, infundiublae, calyces and collecting ducts
What does the metenephric mesenchyme form?
Glomerulus, PCT, DCT, Loop of hence
In a drowning incident with hypoxia which areas of the kidney will be affected the most?
Loop of henle, PCT
What conditions can cause neonatal onset of fanconi syndrome?
Tyrosinaemia, Galactosemia, Mitochondrial disease
How do you test for cystinosis?
Elevated cystine levels in WBC and corneal deposits seen by ophthalmology
Treatment for corneal deposits in Cystinosis?
Cysteamine (mercaptamine)
Which part of the nephron does acetazolamide work?
PCT
Which part of the nephron does amiloride work?
CD
Which part of the nephron does chlorothiazide work?
DCT
Which part of the nephron does spironolactone work?
CD
What channel does amiloride work on?
ENAC on the Collecting duct
What electrolyte disturbance does Gitelman Syndrome cause?
Hypokalaemia, hypomagnesaemia, Alkalosis, Hypocalciuria
What electrolyte disturbance does Bartter syndrome cause?
Polyuria, hypochloraemia, hypokalaemia, alkalosis, hypercalciuria - nephrocalcinosis
Equation for Fraction of excreted Na+?
(Urine Na x Plasma Cr)/(Urine Cr x Plasma Na) x 100
Pre-renal <1%
Renal >2%
What is the gene for genetically x-linked diabetes insipidus?
AVPR2 gene coding for the ADH receptor
Treatment of nephrogenic DI?
Low solute diet
Water
Diuretics - tricks kidney to reabsorb at the PCT
What is Liddle Syndrome?
Gain in function of the aldosterone system causing increased Na and excretion of K+ with resulting hypertension.
Treatment low salt diet and amiloride
How long can nephritis develop after HSP condition?
3 months
What does split thickened glomerular basement membrane with basket weave appearance indicate on histology renal biopsy?
Alport syndrome
What is the gene and inheritance for Alport syndrome?
COL4A5 - X linked 80%. Encodes for Type IV collagen which makes up the framework of the basement membrane.
Can be AD and AR - less severe forms
What are the extra-renal features of alport syndrome?
Anterior lenticonus, hearing loss, macular abnormalities
What is linear IgG staining pathognomonic for on renal biopsy?
Anti-GDM
Definition of nephrotic syndrome?
Nephrotic range proteinuria and hypoalbuminaemia or oedema where serum albumin can’t be measured.
What is nephrotic range
> 40mg/m2/hr (>1000mg/m2/day)
Urine protein to creatinine ratio >200mg/mmol
Which autoantibody is associated with idiopathic membranous nephropathy?
PLA2R- Targets the M type phospholipase A2 receptor (surface of podocyte cell membranes)
What is the gene mutation in Gitelman syndrome?
SLA12A3 (NCCT) - Autosomal recessive
What test can measure GFR in the hospital?
Plasma disappearance of radio-isotope study - Cr-EDTA
What is the Schwartz equation for eGFR
eGFR = 36.5 x height (cm) = serum creatinine (umol/L)
What can overestimate your creatinine clearance?
Low muscle mass
Tubular secretion of creatinine (eg.nephrotic syndrome/CKD)
What gene and inheritance is related to nephropnopthisis?
NPHP - Autosomal recessive
Nephrocystin gene
What is the classical presentation of nephropnopthisis?
Polyuria
Polydipsia
Enuresis
Bland urine
Disproportionate anaemia for degree of CKD
Short stature
Small kidneys with poor CM differentiation
Extra-renal manifestations - Retinitis pigmentosa, visual and developmental delay, cerebellar abnormalities, obesity, polydactyly
What is the most common organism involved in spontaneous peritonitis in a nephrotic patient?
Strep. Pneumoniae
What electrolyte disturbance can Tacrolimus cause?
hypomagnesaemia, hyperkalaemia
Best study modality to look for ectopic ureters or duplex collecting system?
IVU
What is the treatment for children on PD who present with suspected peritonitis?
Cefazolin and Ceftazidime (need to cover for gram negative and gram positive organisms until culture returns)
If MRSA known vancomycin and ceftazidime
What is the gene mutation for congenital nephrotic syndrome?
NPHS1 and NPHS2
