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Step 1 Clues > Pp Clues Renal > Flashcards

Pp Clues Renal Flashcards

1
Q

Which part of the nephron concentrates urine?

A

Medulla

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2
Q

What is the course of the ureter?

A

The ureter passes under the uterine artery, and under the deferens.

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3
Q

What is the 60/40/20 rule?

A

60% total body water
40% ICF
20% ECF

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4
Q

What is Goldblatt’s kidney?

A

HTN:Flea-bitten kidney (blown capillaries)

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5
Q

What is Uremia?

A

Azotemia + symptoms

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6
Q

What is Azotemia?

A

↑BUN/Cr

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7
Q

What is Nephritic kidney disease?

A

↑Size of fenestrations => vasculitis

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8
Q

What is Nephrotic kidney disease?

A

Lost BM charge due to deposition on heparin sulfate => massive proteinuria and lipiduria

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9
Q

What is seen in RPGN (Rapidly Progressive Glomerulonephritis)?

A

Crescents

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10
Q

What is Post-Strep GN?

MCC in children

A

Subepithelial, IgG/C3/C4 deposition, ASO Ab

impetigo/pharyngitis

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11
Q

What is Interstitial Nephritis findings ?

focal segmental necrotizing GN

A

Urine eosinophils or eosinophilic casts

asthma/ panca/

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12
Q

What is Lupus Nephritis?

A

Subepithelial
diffuse proliferative GN

decrease complement

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13
Q

What is MGN?
(Membranoglomerulonephrits)

A

Deposition of “something”

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14
Q

What is MPGN findings (Membranoproliferative Glomerulonephritis)?

A

Tram-tracks (type II has low C3)

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15
Q

What is MCD (Minimal Change Disease)?

A

Kids, fused foot processes, no renal failure, loss of charge barrier

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16
Q

which conditions shows FSGS (Focal Segmental Glomerulosclerosis)?

A

AA, HIV pts, HTN, Diabetes

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17
Q

What are the vasculitis w/ low C3?

A

“PMS in Salt Lake City”*
Post-strep GN
MPGN Type II
SBE
Serum sickness
Lupus
Cryoglobulinemia

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18
Q

What is the most common cause of kidney stones?

A

Dehydration

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19
Q

What are the most common
type of kidney stones?

A

Calcium phosphate

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20
Q

What type of kidney stones have coffin- lid crystals?

A

Triple phosphate

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21
Q

What type of kidney stones have rosette crystals?

A

Uric acid

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22
Q

What type of kidney stones
have hexagonal crystals?

A

Cystine
COLA

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23
Q

Enveloped-shaped stones or dumbbell-shaped crystals?

A

Oxalate

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24
Q

What disease has Aniridia?
Absent partial or complete of iris

A

Wilm’s tumor

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25
Q

What disease has Iridocyclitis?

A

Juvenile rheumatoid arthritis

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26
Q

What is Phimosis?

A

Foreskin scarred at penis head
(foreskin stuck smooshed up)

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27
Q

What is Paraphimosis?

A

Foreskin scarred at penis base (retraction of foreskin => strangulates penis)

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28
Q

What is Urge incontinence?

A

Urgency leads to complete voiding (detrustorspasticity → small bladder vol)

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29
Q

What is Stress incontinence?

A

Weak pelvic floor muscles (estrogen effect)

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30
Q

What is Overflow incontinence?

A

Runs down leg but can’t complete
empty of bladder

spastic/tight sphinter

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31
Q

What structures have one-way valves?

A

Urethra, ejaculatory duct

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32
Q

What structures have fake sphincters?

A

Ureters, LES, Ileocecal valve

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33
Q

What has WBC casts?

A

Nephritis

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34
Q

What has WBC casts only?

A

Pyelonephritis (sepsis)

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35
Q

What has WBC casts + eosinophils?

A

Interstitial nephritis (allergies)

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36
Q

What has WBC casts + RBC casts?

A

Glomerulonephritis

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37
Q

What has Fat casts?

A

Nephrotic syndrome

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38
Q

What has Waxy casts?

A

Chronic renal failure

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39
Q

What has Tubular casts?

A

ATN

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40
Q

What has Muddy brown casts?

A

ATN

41
Q

What has Hyaline casts?

A

Normal sloughing

42
Q

What has Epithelial casts?

A

Normal sloughing

43
Q

What has Crescents?

A

RPGN

44
Q

How do you measure afferent
renal function?

A

Creatinine (or inulin)

45
Q

How do you measure efferent
renal function?

A

BUN (or PAH)

46
Q

What is the afferent arteriole’s job?

A

Filter

47
Q

What happens if you constrict the afferent arteriole?

A

RPF goes down
GFR goes down
FF (GFR/RPF) stays unchanged

48
Q

What is the efferent arteriole’s job?

A

Secrete

49
Q

What happens if you constrict the efferent arteriole?

A

RPF goes down
GFR goes up
FF (GFR/RPF) goes up

50
Q

How do you test afferent arteriole function?

A

GFR

51
Q

What is normal GFR?

A

100 mL/min

52
Q

How do you test efferent arteriole function?

A

RPF

53
Q

What happens if you increase plasma protein concentration?

A

RPF stays unchanged
GFR goes down
FF (GFR/RPF) goes down

54
Q

What is pre-renal failure?

A

Low flow to kidney (BUN:Cr >20)

55
Q

What is renal failure?

A

Damage glomerulus (BUN:Cr <20)

56
Q

What is post-renal failure?

A

Obstruction (haven’t peed in last 4 days)

57
Q

What is the job of the proximal tubule?

A

Reabsorb glucose, amino acids, salt, and bicarb

58
Q

What is the job of the thin ascending limb?

A

Reabsorbs water

59
Q

What is the job of the thick ascending limb?

A

Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water

60
Q

What is the job of the early distal tubule?

A

reabsorbing NaCl (hypotonic)

61
Q

What is the job of the late distal tubule and collecting duct?

A

Final concentration of urine by reabsorbing water, excretion of acid

62
Q

What does the macula densa do?

A

Measures osmolarity

63
Q

What does the J-G apparatus do?

A

Measures volume

64
Q

What is Fanconi’s syndrome?

A

Old tetracycline use => urine phosphates, glucose, amino acids

severe electrolite inbalance

65
Q

What is Bartter’s syndrome?

A

Baby w/ defective triple transporter (low Na, Cl, K w/ normal BP)

66
Q

What is Psychogenic polydipsia?

A

No concentrating ability →cerebral edema

67
Q

What is Hepatorenal syndrome?

A

High urea from liver →increase activity of glutaminase→NH4+→GABA→ kidney stops working

68
Q

What is Type 1 RTA?

A

Distal renal tubular acidosis: H/K in CD is broken→high urine pH (UTI, stones, Li)

69
Q

What is Type 2 RTA?

A

Proximal RTA: bad CA →lost all bicarb → low urine pH (multiple myeloma)

70
Q

What is Type 3 RTA?

A

RTA I + II → normal urine pH (5-6)

71
Q

What is Type 4 RTA?

A

Infarct J-G → no renin → no Aldo → high K (DM,NSAIDS, ACE-I, Heparin)

72
Q

What is Central Pontine Myelinolysis?

A

Due to correcting Na faster than 0.5mEq/hr

73
Q

Urachal cyst

A

Urine drains from umbilicus

74
Q

Exstrophy of bladder risk

A

Bladder cancer persists

75
Q

To pee

A

M3 agonist. Bethanecol
B2 Antig: non selective B blocker
A1 antagonist:zozin

76
Q

Not to pee

A

M3 antagonist :oxybutyine
B2 agonist albutorol, terbutaline
A1 agonist Ephedrine
B3 agonist: mirabegran

77
Q

Urge incontinence

drug

A

Oxybutyine
Mirabegram

78
Q

WBC cast

A
79
Q

RBC cast

A
80
Q

Eosinophil cast
Fatty cast

A
81
Q

Waxy cast
Hyaline cast

A
82
Q

Metanephros give rise to

A

adult kidney

83
Q

2 barriers that prevent protein from leaking out vessel

A

heparin sulphate
small fenestrations

84
Q

Proteinuria with nephrotic syndrome

A

basement membrane loss neg charge
protein leaks out freely
All protein low

85
Q

mcc of nephrotic syndrom in children

A

minimal change dz

86
Q

mcc nephritic syndrome in adult

A

HTN and DM

87
Q

MCC of nephritic syn in children

A

Berger’s
PSGN

88
Q

Nephrotic syn in adult

A

FSGN
membranous nephropathy

89
Q

Ig-A nephropathies

A

Berger’s
HSP
Alport’s

90
Q

mcc of membranous nephropathy

A

deposition in the membrane
amyloid
drugs
immune complex(MPGN)

91
Q

Lipoid nephrosis: Minimal change disease mcc

A

2 weeks post URI
autoimmune: T cells and macrophages and fat deposition
effacement of foot

92
Q

RTA 1

A

distal H/K defective: high urine PH

93
Q

RTA II

A

Proximal CA
urine pH is very low 3-4 (distal HK)

94
Q

Acidosis with hypokalemia, look at

A

RTA

95
Q

RTA 3

A

combination of 1 and 2 so the pH is normal with acidic plasma

96
Q

RTA 4 is associated with

A

diabetes: infarction of JG apparatus
low renin and Aldo

97
Q

crescents in the kidney

A

RPGN
granulomatosis with polyangiitis(Wegener)
Goodpasture’s

98
Q

use to treat ADH by sensitizing receptor

A

Thiazides
hypercalcemia

99
Q
A

Step 1 Clues (27 decks)

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