Renal

Question 1

Nephritic syndrome characterized by…?

Answer 1

Hypertension, mild proteinuria and hematuria with red blood cells casts in the urine sediment

Question 2

Poststreptococcal glomerulonephritis related to exposure to group…?

Answer 2

Group “A beta-hemolytic Streptococcus species”
(eg pharyngitis, skin infection - impetigo)

III Hypersensitivity reaction (immune complexes)

Question 3

Cardiorenal syndrome: activation of the RAAS with low urine sodium and fractionated excretion of sodium. Why does it lead to an elevated blood urea nitrogen?

Answer 3

Urea is passively reabsorbed following sodium in the proximal tubule

Question 4

Thiazides … uric acid levels in the blood and … calcium reabsorption

Answer 4

Increase and increase.

They also cause mild hypovolemia. Kidneys respond by reabsorbing more sodium and water in the proximal convoluted tubule

Question 5

Thiazides side effects?

Answer 5

Hyperglycemia and increased serum cholesterol and LDL. Hypercalcemia and hyperuricemia.

Question 6

Potter sequence: why does it happen?

Answer 6

Caused by low urine = oligohydramnios

Urine is the major source of amniotic liquid

P ulmonary hipoplasia 
O ligohydramnios
T wisted skin (wrinkles)
T wisted face
E xtremity deformities
R enal agenesis

P (amniotic fluid is crucial for the development of the fetal lungs by both helping the airways phisically stretch out as well as contributing aminoacids)

Question 7

Nephrogenic diabetes insipidus: what is it?

Answer 7

Kidneys don’t respond to ADH

x Deficient ADH production = central diabetes insipidus

ADH decreases serum sodium

Question 8

Treatment central diabetes insipidus vs nephrogenic DI?

Answer 8

CDI = desmopressin (synthetic ADH analog)
NDI = thiazide diuretics or NSAIDs

Question 9

_fferent arterioles more receptive to angiotensin II than _fferent arterioles

Answer 9

E / A

When there are low levels of angiotensin II, only efferent arterioles constricts (GFR preserved). With high levels, GFR decreases.

Question 10

Angiotensin II action on the proximal convoluted tubule?

Answer 10

Na+ reabsorption (and H20 by osmosis)

ps. It also stimulates ADH secretion (on the hypothalamus) and aldosterone (acts on the Na+/K+ pump, increasing Na+ reabsorption)

Question 11

Hypovolemia … uric acid reabsorption in the proximal tubules

Answer 11

Stimulates

Question 12

Why does rhabdomyolysis cause kidney injury?

Answer 12

[ Myocyte injury releases intracellular muscle contents (eg myoglobin) ]

It results from myoglobin filtration and degradation within the glomeruli. Heme pigment is released, which causes acute tubular necrosis by direct cytotoxicity and renal vasoconstriction.

Question 13

Damage to the renal epithelium … glomerular permeability and allows for … of large molecules

Answer 13

Increases

Leakage