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S1 First aid > Renal > Flashcards

Renal Flashcards

1
Q

Faconi Syndrome

A

generalized reabsorption defect in PCT

may lead to met acidosis due to increased excretion of hco3 po43 and all substances reabsorbed by the pct

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2
Q

bartter syndrome

A

reabsorption defect in thick ascending loop of henle affects na+/K+/2cl- cotransporter

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3
Q

gittelmann syndrome

A

reapsorption defect of nacl in dct

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4
Q

little syndrome

A

gain function mutation, increases the activity of na+ channels causing met alkalosis, hypokalemia,

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5
Q

Rapid progressive (crescentic) gemerulonephrits
LM? IF? antibodies?
disease associ?

A

poor prognosis, crescent on LM which contain fibrin and plasma proteins.

Linear IF due to antibodies in the basement membrane and aveolar basement membrane
: goodpastures syndrome: hematuria/ hemoptysis; type 2 hypersensitivity reaction.

Treatment is plasmaphoresis

Negative IF/ pauci- immune: Granolomatosis with polyangiitis (Wegner) PR3-Anca/cAnca

or microscopic polyangitis MPO-ANCA/p-ANCA

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6
Q

Acute poststreptocococal glomerulonephritis

A

more in children, poststrep (pharynx or skin) type 3 hypersensitivity,
LM: hypercellular enlarged glomeruli
IF: starry sky lumpy bumpy due IgG, IgM, C3 deposition along GBM and mesangium
EM: subepithel IC humps

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7
Q

Nephrotic syndrome

A

damage GBM, massive proteinurea: >3,5, hypoalbuminemia, edema, hyperlipidemia. Dysruption of glumerolar filtration charge barriar by 1° direct eg slerosis of pedocytes, 2° sytemic process eg diabetes

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8
Q

MCD, minimal chage disease (liopoid nephrosis)

A

Nephrotic syndrome in children, often triggered by recent infection, vaccination
LM: Normal glomeruli
IF: -
EM:-effacement of podocyte foot processes

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9
Q

FSG, focal segmental glomerulosclerosis

A

Nephrotic syndrome in african and hispanics. idiopathic, HIV; SS,herion, obesity, does not respond to steroids, progress CKD
LM- segmantal sclerosis and hyanlinosis
IF-often- but may be + for non specific focal deposits like IgM, C3, C1
EM:- effacement of foot processes similar to minimal change disease

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10
Q

Membranous nephropathy

is due to? is most common in? LM, IF, EM?

A

Nephrotic syndrome, also called membranous glumerolonephritits, Can be 1° eg antibodies to phospholipase A2 receptor or 2° to drugs eg NSAIDS, infections eg HPV, HCV, SLE or sloid tumors, does not repond to steroids
LM: diffuse cap. and GBM thickining
IF:- granular due immune complex IC deposition
EM- “Spike and dome” appearance of subepithelial deposits

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11
Q

Amyloidosis

A

kidney most commonly involved organ. chronic condition prediposis the deposition.
LM: Congo red stain shows apple green birefringence under polarized light due amoyloid deposition in mesagium

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12
Q

diabetic glomerulonephopathy

A

most common cause in the US, hyperglycemia, glycation of tissue, mesangial expasion, GBM thickining—-> increase in permeability, GFR increases, HTN—–> glumerolusclerosis
LM: -mesangial expasion, GMB thickining, eosinophilic nodular glomerulosclerosis (kimmelstil-Wilson lesion)

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13
Q

Nephritic syndrome

A

Inflammatory process. involves glomeruli, leads to hematuria and RBC casts in urine. Associated with Azotemia, oliguria, hypertension (due to salt retention), porteinuria, hypercellular/ inflamed glomeruli on biobsy

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14
Q

diffuse proliferative glomerulonephritis

A

often SLE. DPGN and MPGN often presnt as nephrotic syndrome and nephritc syndrome concurrently
LM- wire lupes of capillaries
IF granular, EM-subendothlial and sometimes intramembranous IgG based IC often with C3 deposition

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15
Q

alport syndrome

A

mutation in type 4 collagen, thikining of the GBM—> eye problems etc

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16
Q

membranoproliferative glumeronephrits

A

MPGN in a nephritic syndrome that often co-presents with nephrotic syndrome.

Type 1 may be 2° to hepatitis B/C, iodiopathic, suendothelial IC deposits with granular IF

Type 2 is assc. with C3 nephritic factor (IgG autoantibody that stabilizes C3 convertase—> persistent complement activation—> decrease in C3

Intramembranous deposits, also called dense deposit disease, mesangial ingrowth—-> GBM splitting—> “tram-track”

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17
Q

BGA ph, co2

A

ph: acid.<7,4> alca.
Co2: “< 40>”

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18
Q

when we have met. alkalosis we need to look at?

A

Anion GAP: AG acidosis>12< NON Gap

Def of Anion GAP: Na-CL-CO2

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19
Q

What causes an AG acidosis?

A

MUD PILES

Methanol, Uremia, DKA, Pro, Isopropyl, Lactic acid, Ethylene salicylates

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20
Q

what needs to be checked if there is a NON GAP?

A

Urine Anion Gap

If UAG is negative, it will be due to dirrhea: loss of bicarbs and volume

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21
Q

what is the UAG?

A

Urine Anion Gap: Na+-K-CL

if it is positive, it means there is RTA (renal tubular acidosis)

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22
Q

what needs to be checked if you have met. acidosis

A

UCL >10<
>10 not volume resposive—->HTN in present—> hyperaldosteron, if no HTN then barter or gittleman

if <10 it is due to dehydration

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23
Q

RBC casts

A

glomerulonephritis

24
Q

WBC casts

A

pyelonephritis, transplant rejection, tubulointeristial inflammation

25
Q

Fatty casts

A

nephrotic syndrome

26
Q

granular casts

A

acute tubular necrosis “muddy casts”

27
Q

waxy casts

A

end-stage renal disease/chronic kidney disease

28
Q

hyline casts

A

nonspecific

29
Q

acute tubular necrosis

A

3 stages: inciting, maintenance: oligiuric, recovery: polyuric, electrolyte wasting

divided by into: ischemic and nephrotoxic

30
Q

renal papillary necrosis

A

SS and gross hematuria

31
Q

acute interstitial necrosis

A

also called tubulointerstial nephritis. AIT inflammation. Pyruria: eosinophils and azotmia 2° eg Sjörgen, SLE

remember the Pś 
Pee: diurecis
Pain: NSAIDS
Penicillins and cephalosporins
PPI
RifamPin
32
Q

Polycystic kidney d.

A

dominant: above 45, recessive in infancy

33
Q

supply of the ureter

A

prox. -renal artery,
middle-gonadel artery, aorta,common internal iliac
distal- internal iliac and sup.vesical

34
Q

horseshoe kidney

A

trapped under the inferior mesenteric

35
Q

renal oncytoma

A

Benign epithelial tumor arises from the collecting duct, large eosinophilic cells with abundant mitochondria

36
Q

renal cell carcinoma

A

originates from th PCT, polygonal clear calls, lipids and carbohydrate accumulation- flank pain, painless hematuria, VHL, RCC Chromosome3 delition

PEAR= PTHrP, Ectopic EPO, ACTH, Renin

37
Q

Nephroblastoma

A

aka Wilms tumor, children2-4, flank mass, hematuria and poss. HTN. WT1 or WT2 gene on chromosome 11
Denys-Drash and Bechwith-Wiedemann syndrme

38
Q

Oxybutynin

A

for the overactve bladder

39
Q

overflow incontinence

A

incomplete emtying, outlow obtrction alpha-blocker for prostate

40
Q

Mannitol

A

pulmonary edema, containdicated in HF and anuria

41
Q

Acetazomide= ACIDazolamide

A

CA inhibitor, decreases HCO3. Use: glaucome, metabolic alkalosis, altitude sickness

works on PCT

42
Q

Loop diuretis

A

Sulf. diuretics inhibit cotransport sytem NA+/K+/CL-, of the thick acending limb of loop of H.

43
Q

Ethacrynic acid

A

Non-sulf. inhibitor of co.trans. sys. NA+/K+/CL-thick acending limb

44
Q

Thiazid

A

inhibit Nacl reaption in DCT and decresase the Ca excretion

45
Q

postassium sparing -one

A

SEAT, Spiro-, Elpranone, Amiloride, Triamtere work on the cortical collecting tubule

46
Q

ACEI

A

-pril, decreases ATll, dereases GFR

47
Q

ARBs

A

-sartan, blocks ATll rezeptor, can cause hyperkalimia, decrease GFR

48
Q

Alikiren

A

Alikiren kills renin, therefor blos angiotensinogen to ATl conversion, use is hypertension

49
Q

FF=

A

GFR/RBF

50
Q

calcium stones shape

A

calcium oxalat: hypocitraturia, shaped like a dumbbell or envelope, Crohn, treat with thiazides

51
Q

Ammonium magnesium phosphate stones

A

looks like a coffin, caused urease producing bacteria: proteus, staph sapro. and kelbsiella

52
Q

Uric acid stones

A

rhomboid or resettes, assoc. with hyperuricemia, tret with allopurinol

53
Q

Cystine stone

A

hexagonal, auto. ress. cystine-reab. PCT transporter defect, causing cytinuria causing and COLA urine= Orinitine, Lysine, Arginine

54
Q

the vessel palpable in the pelvis next to the ureter?

A

is the internal pelvic artery

55
Q

clearence is calculate by?

A

c=urine concentration X urine flow I/ plasma concentration

C= UC X I/ PC

56
Q

what is a derivative of methanephric blastoma

A

PCT

S1 First aid (20 decks)

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