Nephrology Flashcards
What are the 6 low complement nephritic syndromes?
SBE SLE serum sickeness cryoglobulinemia PSGN MPGN II
What are the hormones with disulfide bonds?
PIGI prolactin inhibin GH insulin
What do you see psammoma bodies in?
meningioma
mesothelioma
papillary carcinoma of thyroid
serous cystadenoma of ovary
What are the Jones criteria for Acute Rheumatic Fever?
J: joints O: carditis N: subcutaneous nodules E: erythema marginatum S: sydenham chorea
What are the IgA nephropathies?
HSP (Henoch Schlonein Purpura)
Berger’s
Alport’s
What causes renal induced acidosis?
plasma RTA
metabolic acidosis
glutaminase
ammonia production in CD (10% of urea cycle)
What hormones are produced by small cell lung carcinoma?
ACTH ADH PTH TSH ANP
What are the 4 causes of SIADH?
small cell carcinoma
increased intracranial pressure
drugs
hypoxia
What are the low volume states with acidosis?
diarrhea and RTA
What are the types of kidney stones?
calcium oxalate
struvite
uric acid
cysteine
What are the clues for pseudogout?
positively birefringent rhomboid crystals
calcium pyrophosphate
elderly pts
men=women
What are the bladder cancer risk factors?
smoking aniline dyes aflatoxine benzenes cyclophosphamide Von Hippel Lindau Tuberos Sclerosis Schistosoma haematobium
What are the causes of papillary necrosis?
AIDS and vasculitides
What are the 3 narrowings of ureter?
pelvic brim
hilum
entrance to the bladder
What is nephritic syndrome?
hematuria
protein loss
What is nephrotic syndrome?
protein loss >3.5 g/dL edema hyperlipidemia (VLDL) hypercoagulable (2,7,9,10,C,S) dec serum albumin inc urine albumin loss of basement membrane charge due to deposition on heparin sulfate leading to massive proteinuria and lipiduria
What are the most common causes of UTIs?
#1 E. coli #2 Proteus #3 Klebsiella
What is the most frequent cause of UTI in females 5-10yrs and 18-24 yrs?
staph saprophyticus
What is pre-renal failure?
low vol state BUN:Cr>20:1 low flow to kidneys lao Na in urin low FeNa concentrated urine
What is intra-renal failure?
BUN:Cr
What is the vasculitic pattern for renal artery stenosis?
clot in front of renal artery
What is glomerulonephritis?
inflamed glomeruli
What is vasculitic pattern for interstitial nephritis?
clot off the medulla
What is the vasculitic pattern for focal segmental glomerulonephritiis?
clot off part of nephron
What do yo see in rapidly progressive glomerulonephritis?
crescents
composed of glomeruler parietal cells, monocytes, macrophage and abundant fibrin
What is the MC nephritic disease in adults?
membranous glomerulonephritis (MGN)
What is the MC renal disease in blacks/Hispanics?
FSGN
What is the MC renal disease in HIV/IV drug users?
FSGN
What is the MC renal mass?
cyst
What is the MC malignant renal tumor in adults?
adenocarcinoma
What is the MC malignant renal tumor in kids?
Wilm’s tumor
What nephrotic syndrome can progress to RPGN?
Goodpastures
What is the MC nephrotic syndrome in kids?
miminal change disease
What is seen in Type I Renal Tubular Acidosis?
metabolic acidosis distal collecting duct H/K exchange defect hypokalemia high urine pH frequent UTIs stones
What is seen in Type II Renal Tubular Acidosis?
no carbonic anhydrase in PCT
hgh urine pH early but low late (b/c use up bicarb)
Which part of nephron concentrates urine?
medulla
What is Goldblatt’s kidney?
contralateral flea-bitten kidney
What is uremia?
azotemia + symptoms
What is azotemia?
renal failure (inc BUN/Cr)
What is seen in post strep glomerulonephritis?
subepithelial humps
IgG/C3/C4 deposition
ASO Ab
What is seen in interstitial nephritis?
urine eosinophils (drugs), toxins
what is seen in lupus nephritis?
glomerular destruction
subeptihelial immune complex deposition
anti-ds-DNA
What is seen in membranoglomerulonephritis?
deposition
What is membranoproliferative glomerulonephritis?
tram tracking (type II has low C3)
What is seen in minimal change disease?
fused foot processes
no renal failure
loss of charge barrier
What is the most common cause of kidney stones?
dehydration
what type of kidney stones have coffin-lid crystals?
triple phosphate
What type of kidney stones have rosette crystals?
uric acid
What type of kidney stones have hexagonal crystals?
cysteine
What type of kidney stones envelop or dumbbell-shaped crystals?
calcium oxalate
what disease has aniridia?
Wilm’s tumor
What is phimosis?
foreskin scarred to head of penis
What is paraphimosis?
foreskin retracted and scarred to base of penis
risk of strangulation
What is urge incontinence?
overactive detrusor muscle
small bladder volume
What is stress incontinence?
weak UG diaphragm muscles
estrogen connection
What is overflow incontinence?
cannot fully empty
What structures have a one way valves?
urethra and ejaculatory duct
What has WBC casts?
nephritis
What has WBC casts only?
pylonephritis
What has WBC cast + eosinophils?
interstitial nephritis (allergies)
What has WBC casts + RBC casts?
glomerulonephritis
What has fat casts?
nephrotic syndrome
What has waxy casts?
chronic renal disease
What has tubular casts?
RTA
What has hyaline casts?
normal
What has epithelial cells?
normal
What has crescents?
RPGN
How do you measure afferent renal function?
creatinine or inulin
How do you measure efferent renal function?
BUN or PAH
How do you test afferent renal function?
GFR or inulin
How do you test efferent renal function?
RPF or PAH
What is post-renal failure?
obstruction
What is the job of proximal convoluted tubule?
reabsorb 60-80% of everything filtered
What is the job of the thick descending limb?
reabsorb water
What is the job of the thick ascending limb?
make concentration gradient by reabsorbing solutes (Na, Cl, K, Mg, Ca) without water
What is the job of the early distal tubule?
concentrate urine by reabsorbing NaCl(hypotonic)
What is the job of the late distal tubule and collecting duct?
concentrate urine by reabsorbing water
excretion of uric acid
make new bicarb
What does macula densa do?
measures osmolarity in beginning of DCT
What does JG apparatus do?
measure volume
What is Fanconi’s syndrome?
old tetracycline use destroys PCT
phosphates, glucose, and amino acids in urine
What is Bartter’s syndrome?
baby with defective triple transporter
dec Na, Cl, and K
normal Bp
What is psychogenic polydipsia?
dilute urine due to excess water intake
What is central pontine myelinosis?
due to correcting Na faster than 0.5 mEg/hr