Renal 1.5 Flashcards
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
Conn
Kalemia, alkalosis, renin
Na, Water, K/H+
surgery, spironolactone/epleronone
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
coliform
introitus
urethra
E coli, S saprophyctis
fluoro, TMP/SMX
pyelonephritis
girls
obstruction/reflux
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
uremia
hyaline arteriosclerosis
HTN/DM
smooth muscle, ECM
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 __
catheter
cholesterol clefts
malignant HTN
fibrinoid, arteriosclerosis
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
nephritic syndrome
C3, streptococcal
hypercellular
C3, IgG, IgM
humps
disruption of __ in PSGN leads to leakage of __ into urine
results in dec __ and edema
subendothelial C1q deposits seen in type 1 __ GN
GBM, albumin
oncotic pressure
membranopoliferative
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 __
hydrostatic pressure
efflux
oncotic pressure
albumin
capillaries
Pc-Pi - Oc-Oi
positive
capillaries
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 __
extraperitoneal
anterior
aponeurosis
superficial/transversalis, fat
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__
DC, Na/Cl/Water
apical
Na/K, Cl
Na/Cl
Na/Ca
less
HCTZ, chlorothiazide
indapamide, metolazone
HF, renal/hepatic
K/Mg/Na, Ca
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__
loop
Na/Ca/K, ototoxic
K sparing
Kalemia, gynecomastia
CA
met acid
osmotic
Na, pulm edema
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
upward
secretion, reabsorption
downward
filtered, reabsorbed
Creatinine, PAH, inulin
filtered, greater
urea
Na/K
reabsorbed
bicarb
avidly
Glucose, aa
__ 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
enlapril
AT2
VC
constriction
aldosterone
efferent arteriole
inc
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
Cl, volume
HCO3
hypoTN, dec
saline
Cl, volume
Na/Cl
aldosterone
high, low
isotonic
GC, Conn
high
not
_ 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
JG macula densa, JG distal tubule affarent arteriole smooth muscle
renin
hyperplasia
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
RCC
vHL
3p
hemangioblastoa, RCC, pheo
RB
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
dec
Kalemia, cough, angioedema
Mtoprolol, renin
prazosin
__ = GFR/RPF
GFR calculated w __/__ clearance
RPF calculated via __ clearance
Clearance eq
urine conc of S x urine __
Plasma conc of S
FF
creatinine, inulin
PAH
flow rate
__ 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
Fabry
Gb3
neuro, hidrosis
hot/cold
exercise, stress
angiokeratomas, telangectasias
CV, cardiac, renal
glomeruli, distal
proteinuria/poluria
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
Metachromatic leukodystrophy
seizure, PN
neurofibromatosis
Krabbe, galactocerebrosidase
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 ___
nephritogenic, Strep
immune complexes
3
Henoch Schonlein, IgA antigen
3
small, mesangium
supportive
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
PCT, loop of henle
Distal/collecting
reabsorb
normal/high
K, aldosterone, Alkalosis, flow
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
hydroneprhosis
uretopelvic
renal parenchyma
pelvis/ureter
canalize
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
urethral valves
stricture, obstrution
vesicoureteral
ureter/pelvis
polydipsia, polyuria, low urine SG indicate __ as dx
can be due to L__ by antagonizing ADH on collecting duct
resolves upon __
Diabetes Insipidus
ithium
discontinuation
Carbonic anhydrase inhibs act on __
osmotic diuretics act on __/__ limb of LoH
loop diuretics act on __
early __ is site of action for thiazides
proximal tubule
PT, descending lmb
thick ascending limb
DCT
