Nephrology

Question 1

At what week does the PRONEPHROS degenerate?

Answer 1

4 weeks

Question 2

What structure is the “permanent” kidney?

Answer 2

Metanephros

appears at week 5

Question 3

What structures are derived from the ureteric bud?

Answer 3

Ureters
Pelvises
Calyces
Collecting ducts

Question 4

The metanephric mesenchyme/ blastema gives rise to

Answer 4

glomerulus –> DCT

Question 5

Obstruction of this structure is the most common cause of prenatal hydronephrosis

Answer 5

Ureteropelvic junction

Question 6

Compression of the developing fetus caused by oligohydramnios –> limb deformities

Answer 6

Potter sequence (syndrome)

Question 7

What conditions are associated with Potter sequence?

Answer 7

POTTER:

Pulmonary hypoplasia
Oligohydramnios
Twisted face
Twisted skin
Extremity defects
Renal failure

Question 8

A condition in which the inferior poles of the kidneys fuse and are trapped under the INFERIOR MESENTERIC ARTERY. Associated with hydronephrosis.

Answer 8

Horshoe kidney

Question 9

This is the most common cause of bladder outlet obstruction. Presents with bilateral hydronephrosis and oligohydramnios

Answer 9

posterior urethral membrane

Question 10

Why is the left kidney used for living donor transplant?

Answer 10

because it has a longer renal vein.

The left renal vein receives 2 additional veins: left suprarenal an left gonadal

Question 11

3 most common points of ureteral obstruction

Answer 11

ureteropelvic junction
pelvic inlet
ureterovesical junction

Question 12

What is the effect of prostaglandin in the kidneys

Answer 12

preferentially dilates AFFERENT arteriole
(increase RPF and GFR, no change in FF)

Prostaglandin is inhibited by by NSAIDS –> constriction

Question 13

What is the effect of ANGIOTENSIN II in the kidneys

Answer 13

Preferentially constricts EFFERENT arteriole
(decreased RPF, increased GFR and FF)

inhibited by ACE inhibs

Question 14

Site where all glucose and amino acids, most HCO3, Na, Cl, PO4, K, H2O, and uric acid are reabsorbed. generation and secretion of NH3

Answer 14

PCT

Question 15

Effect of PTH in PCT

Answer 15

increase PO4 EXCRETION

Question 16

Effect of angiotensin II in PCT

Answer 16

increase Na, H2O, and HCO3 reabsorption

Question 17

This is a reabsorption defect in PCT causing proximal RTA –> hypophosphatemia, osteopenia (excretes everything PCT reabsorbs)

Answer 17

Fanconi syndrome

Question 18

This is where passive reabsorption of H2O happens. Concentrating segment –> hypertonic urine.

Answer 18

Thin descending loop of Henle

Question 19

Site of Na, K, Cl reabsorption and paracellular reabsorption of Mg and Ca

Answer 19

Thick ascending loop of Henle

Question 20

What condition affects the Na/K/2Cl cotransport in the thick ascending loop of Henle causing metabolic acidosis, hypoK, hyperCa

Answer 20

Barter syndrome

Question 21

Diluting segment of the nephron. Reabsorption of Na, Cl, Ca

Answer 21

DCT

Question 22

What is the effect of PTH in the DCT?

Answer 22

increase Na/Ca exchange –> increased Ca reabsorption

Question 23

This part of the nephron is regulated by aldosterone causing reabsorption of Na in exchange for K and H2O

Answer 23

Collecting tubules

Question 24

This is a reabsorption defect of NaCl in DCT causing metabolic alkalosis, hypoMg, hypoK, hypoCa

Answer 24

Gitelman syndrome

Question 25

Gain of function mutation causing increase Na reabsorption in collecting tubules

Answer 25

Liddle syndrome

Met alk, hypoK, HPN

Question 26

Hereditary 11B-HSD deficiency –> increase in cortisol –> increase mineralocorticoid receptor activity

Answer 26

Syndrome of apparent mineralocorticoid excess

Question 27

What activates RAAS?

Answer 27

decrease BP and NaCl delivery (macula densa)

increase sympathetic tone (B1-receptors)