Renal 1.5 Flashcards

1
Q

Hyperaldosteronism aka __ syndrome
see HTN, hypo__, metabolic __ and dec plasma __

aldosterone causes retention of __/__ wasting __/__

tx w ___ or therapy w aldosterone antags like S/E

A

Conn
Kalemia, alkalosis, renin

Na, Water, K/H+

surgery, spironolactone/epleronone

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2
Q

UTI/pyelonephritis usually due to invasion by enteric __ bacteria inhabiting the periurethral vaginal __

ascend to bladder via the ___
most common orgs are E/S

tx w F or T

fever, chills, flank pain leads to __

most common in __
in boys, think O/R

A

coliform
introitus

urethra
E coli, S saprophyctis

fluoro, TMP/SMX

pyelonephritis

girls
obstruction/reflux

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3
Q

fatigue, weakness, itching may be due to accumulation of __in CKD

renal biopsy w eosinophilic hyaline material in intima/media of small arteries/arterioles indicates __

usually seen in pt w /
plasma constituents leak across vasc endothelium, leading to __ prolif and excessive __ formation

A

uremia

hyaline arteriosclerosis

HTN/DM
smooth muscle, ECM

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4
Q

atheroembolic renal disease occurs after __ manipulation of aorta in pt w severe atherosclerosis
see __ in arterial lumen

onion like, concentric thickening of walls of arterioles seen in __
shows __ necrosis and hyperplastic __

A

catheter
cholesterol clefts

malignant HTN
fibrinoid, arteriosclerosis

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5
Q

child w recent skin infection and __ sx w periorbital edema, dark urine, oliguria, RBC casts, mild proteinuria

labs show dec __, inc titers of __ antibodies

LM is __ glomeruli due to PMN/monocyte infiltration

IF shows deposits of __/__/__ in GBM/mesangium

EM shows subepithelial __ w depostion of ag-ab complexes

A

nephritic syndrome

C3, streptococcal

hypercellular

C3, IgG, IgM

humps

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6
Q

disruption of __ in PSGN leads to leakage of __ into urine
results in dec __ and edema

subendothelial C1q deposits seen in type 1 __ GN

A

GBM, albumin
oncotic pressure
membranopoliferative

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7
Q

Pc-Pi is the __ gradient
main driving force of fluid __ from capillary

Oc-Oi is __ gradient
primarily depends on large proteins like __
thus, higher in __ to dec net fluid efflux

total equation is __ - __
when __, fluid moves into interstitum

when neg, fluid moves to __

A

hydrostatic pressure
efflux

oncotic pressure
albumin
capillaries

Pc-Pi - Oc-Oi

positive

capillaries

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8
Q

bladder is located __
as it fills, it comes into contact w the ___ ab wall

in suprapubic cystostomy, piercing of __ on ab wall will occur
also __ fascia, __ fascia, and extraperitoneal __

A

extraperitoneal
anterior

aponeurosis
superficial/transversalis, fat

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9
Q

Thiazide diuretcis work on the __ tubule, enhancing __/__/__ excretion
Na/Cl symporter found on __ membrane
__/__ atpase and _ channel found on basolateral side

thiazides inhibit __ symporter
thus, Ca inc due to inc activity of __ exchanger
this leads to __ Ca being absorbed

ex of drugs H/C, I, M
not as efficacous as __
used for edema from _, __/_disease
SE: hypo__/__/__ hyper__

A

DC, Na/Cl/Water
apical
Na/K, Cl

Na/Cl
Na/Ca
less

HCTZ, chlorothiazide
indapamide, metolazone
HF, renal/hepatic
K/Mg/Na, Ca

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10
Q

Furosemide/bumetanide/torsemide are __ diuretics
SE: hypo_// and o

Triamteren/spironolactone are __ diuretics
SE: hyper__, G

Acetazolamide is a __ inhib
SE is M

Mannitol is an __ diuretc
SE hyper___ and P__

A

loop
Na/Ca/K, ototoxic

K sparing
Kalemia, gynecomastia

CA
met acid

osmotic
Na, pulm edema

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11
Q

tubular fluid/plasma filtrate graph
__ slope seen w products that inc as fluid moves distally
result of S/non-__

__ slope indicates reabsorption is occurring

Top most line- freely __ and minimal __
C/I/P

mid upper line- freely __ and absorbed to a slightly _ degree
thnk U

even w 1 is __/__ similar to water

slightly below is actively __ in proximal tubule
think B

line 5 is __ absorbed in PCT
think G/A

A

upward
secretion, reabsorption

downward

filtered, reabsorbed
Creatinine, PAH, inulin

filtered, greater
urea

Na/K

reabsorbed
bicarb

avidly
Glucose, aa

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12
Q

__ is ace inhibitor
dec levels of __

AT2 leads to systemic __
__ of efferent arteriole in Glomerulus
inc __secretion

thus, ACEI dec __ resistance by dilating efferent arteriole
leads to __ GFR

A

enlapril
AT2

VC
constriction
aldosterone

efferent arteriole
inc

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13
Q

Met alkalosis causes
first step: check urine __ and _ status

Vomiting/NG suction
lose H/Cl causes rise in __
pt will have __TN and _ urine Cl
__ responive in that pt improves w __/_ correction

Thiazide/loop diuretics- dec absorption of __/__
release of __ forms MA
pt has __ urine Cl w use, __ urine Cl when stopped
will respond to _ saline

MC excess
use of __ or __ syndrome
hyperTN and __ urine Cl
will __ respond to saline

A

Cl, volume

HCO3
hypoTN, dec
saline
Cl, volume

Na/Cl
aldosterone
high, low
isotonic

GC, Conn
high
not

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14
Q
_ apparatus senses renal blood flow
made of M/\_\_ cells
MD cells located in \_\_ and monitor salt/tubular flow rate
info taken to JC cells in wall of \_\_
these are modified \_\_ cells

w hypoperfusion, JC cells release __
activates cascade, and __ occurs overtime

A
JG
macula densa, JG
distal tubule
affarent arteriole
smooth muscle

renin
hyperplasia

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15
Q

hematuria, renal mass, malignant cells on pathology indicate __
closely assc w __ disease
AD caused by mutation/deletion to chromo __
see cerebellar H_, clear cell __ and p

__ is located on chromo 13 assc w retinoblastoma/osteosarcoma

A

RCC
vHL
3p
hemangioblastoa, RCC, pheo

RB

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16
Q

ACE inhibs initially __ GFR
SE include hyper__ and C, A

Beta blocker like M act on B1 R in JG cells to dec ___

A1 adrenergic antag to tx htn P

A

dec
Kalemia, cough, angioedema

Mtoprolol, renin

prazosin

17
Q

__ = GFR/RPF

GFR calculated w __/__ clearance
RPF calculated via __ clearance

Clearance eq
urine conc of S x urine __
Plasma conc of S

A

FF

creatinine, inulin
PAH

flow rate

18
Q

__ is XL recessive def of a galatosiase A
__ accumulates

sx include __ pain/hypo__ in adolescense
loss distal __/__ distinction
worse w E/S

in late adolescence, A/T develop

death via C/C/R failures
GB3 found in G/__ tubule leading to P/P

A

Fabry
Gb3

neuro, hidrosis
hot/cold
exercise, stress

angiokeratomas, telangectasias

CV, cardiac, renal
glomeruli, distal
proteinuria/poluria

19
Q

accumulation of Cerebroside sulfate occurs in M__
see ataxia, s/PN

Neurofibromasarcomas can arise in __

Optic atrophy, dev dely, seizure occur in __ due to __ def

A

Metachromatic leukodystrophy
seizure, PN

neurofibromatosis

Krabbe, galactocerebrosidase

20
Q

In PSGN, antibodies form against __ strains of Group A beta hemolytic __
eventually form __ and deposit in GBM, a __ HS rxn

systemic vasculitis following URI in kids dx __
formed by circulating __ immune complexes, type __ HS rxn
deposit in __ vessels and renal ___
tx is ___

A

nephritogenic, Strep
immune complexes
3

Henoch Schonlein, IgA antigen
3
small, mesangium
supportive

21
Q

majority of K filtered by glomeruli occurs in the __ and L__
late __/__ tubules regulate K concentration
K depletion stimulates A intercalated cells to __ potassium

principal cells secrete K with __/__ load

high extracellular __, inc __, A and inc __ can result in inc K excretion
aldosterone stimulates __ cells of collecting tubule

A

PCT, loop of henle
Distal/collecting
reabsorb

normal/high

K, aldosterone, Alkalosis, flow

22
Q

Fetal __ is detected via US
usually asx, but w narrowing of __ jxn can lead to palpable ab mass and large kindney

metanephric blastema gives rise to the fxning __
ureteric bud froms the renal __/__
UPJ is last to __ and may be failed

A

hydroneprhosis
uretopelvic

renal parenchyma
pelvis/ureter
canalize

23
Q

Posterior __ is most common cause of bilateral hydronephrosis
may also have urethral __, or bladder neck __

vesicoureteral reflux occurs from incomplete closure at the __ jxn
can lead to dilated U/P

A

urethral valves
stricture, obstrution

vesicoureteral
ureter/pelvis

24
Q

polydipsia, polyuria, low urine SG indicate __ as dx
can be due to L__ by antagonizing ADH on collecting duct

resolves upon __

A

Diabetes Insipidus
ithium

discontinuation

25
Q

Carbonic anhydrase inhibs act on __

osmotic diuretics act on __/__ limb of LoH

loop diuretics act on __

early __ is site of action for thiazides

A

proximal tubule

PT, descending lmb

thick ascending limb

DCT