Renal

Question 1

kidney embryo - 3 phases and final fate

Answer 1

pronephros - degenerates
mesonephros - interim kidney in 1st TM > male genital system
metanephros - permanent, becomes kidneys

Question 2

Potter’s syndrome - causes and effects

Answer 2

caused by ARPKD, post urethral valve, bilat renal agenesis
results in oligohydramnios > compression of fetus > limb deformities, facial deformity, pulmonary hypoplasia (can cause death)

Question 3

horseshoe kidney assoc w/

Answer 3

Turner syndrome

Question 4

relationship of ureters to uterine artery / ductus deferens

Answer 4

“water under the bridge” - ureters go under both structures

Question 5

what makes the charge barrier in the glomerular filtration barrier?

Answer 5

heparan sulfate in the BM

Question 6

clearance formula

Answer 6

C = U*V/P

Question 7

normal filtration fraction

Answer 7

20%

Question 8

at what glucose level does glucosuria begin, and at what level do the transporters reach there maximum?

Answer 8

160 mg/dl it begins, at 350 mg/dl its at Tm

Question 9

Hartnup’s disease

Answer 9

def of neutral AA transporter
results in pellagra

Question 10

3 stimuli for renin release

Answer 10

dec BP (JG cells)
dec Na delivery (macula densa cells)
inc sympathetic tone (beta 1 receptors)

Question 11

what cells secrete renin

Answer 11

juxtaglomerular cells

Question 12

6 things that shift K out of cells / cause hyperkalemia

Answer 12

digitalis
hyperosmolarity
insulin def
lysis of cells
acidosis
beta adrenergic antagonist

Question 13

U waves on ECG

Answer 13

hypoK

Question 14

peaked T waves on ECG

Answer 14

hyperK

Question 15

Henderson Hasselbach Eqn

Answer 15

pH = 6.1 + log (bicarb/(0.03PCO2))

Question 16

Winter’s formula

Answer 16

predicts resp compensation for primary metab acid/base disturbance
PCO2 = 1.5bicarb + 8 +/- 2

Question 17

type 1 RTA

Answer 17

distal - defect in CD’s excretion of H. assoc w/ hypoK and inc risk of Ca kidney stones and bone resorption

Question 18

type 2 RTA

Answer 18

proximal - defect in PCT bicarb reabs. assoc w/ hypoK and inc risk for hypophosphatemic rickets. does not respond to tx w/ bicarb

Question 19

type 4 RTA

Answer 19

hypoaldosteronism / reduced response to aldosterone. causes hyperK > impairs ammoniagenesis in PCT > acidosis

Question 20

granular muddy brown casts in urine

Answer 20

ATN

Question 21

fatty casts “ oval fat bodies” in urine

Answer 21

nephrotic syndrome

Question 22

2 MCC nephrotic synd in adults

Answer 22

1 - focal segmental glomerulosclerosis

2 - membranous nephropathy

Question 23

causes of focal segmental glomerulosclerosis

Answer 23

HIV, heroin, obesity, interferon, CKD due to congenital absence or surgical removal

Question 24

EM kidney biopsy - “spike and dome” w/ subepithelial deposits

Answer 24

membranous nephropathy

Question 25

causes of membranous nephropathy

Answer 25

idiopathic, drugs, infxns, SLE, solid tumors

Question 26

MCC nephrotic synd in kids

Answer 26

minimal change dz

Question 27

membranoproliferative glomerulonephritis is assoc w/

Answer 27

HBV, HCV

Question 28

"tram track" appearance

Answer 28

membranoproliferative glomerulonephritis

Question 29

Kimmelstiel Wilson lesions

Answer 29

diabetic glomerulonephropathy

Question 30

"lumpy bumpy" glomeruli

Answer 30

acute post strep glomerulonephritis

Question 31

conditions that can cause crescentic glomerulonephritis

Answer 31

Goodpasture's Wegener's (granulomatosis w/ polyangiitis) microscopic polyangiitis

Question 32

MCC death in SLE

Answer 32

diffuse proliferative glomerulonephritis

Question 33

"wire looping" of capillaries in glomeruli

Answer 33

diffuse proliferative glomerulonephritis

Question 34

Berger's dz (IgA nephropathy) - related to what condition, what appearance on LM

Answer 34

Henoch-Schonlein purpura | mesangial proliferation

Question 35

high pH vs low pH calcium kidney stones

Answer 35

high pH > Ca phos | low pH > Ca oxalate

Question 36

hexagonal crystals (kidney stone type)

Answer 36

cystine stone

Question 37

clear cell RCC originates from what cell

Answer 37

proximal tubule cell

Question 38

genetic cause of RCC

Answer 38

gene deletion on chromosome 3 (can be sporadic or part of von Hippel Lindau)

Question 39

paraneoplastic synd assoc w/ RCC

Answer 39

ectopic EPO, ACTH, PTHrp

Question 40

Wilm's tumor assoc w/ (2 things)

Answer 40

``` Beckwith-Wiedemann synd WAGR complex (Wilm's, Aniridia, Genitourinary malformation, mental Retardation) ```

Question 41

MC tumor of urinary tract system

Answer 41

transitional cell CA (urothelial tumor)

Question 42

diffuse cortical necrosis - causes

Answer 42

vasospasm and DIC - occurs after obstetric catastrophes and septic shock

Question 43

MCC intrinsic renal failure

Answer 43

ATN

Question 44

phases of ATN

Answer 44

inciting event maintenance phase - oliguric for 1-3 wks, risk of hyperK recovery phase - polyuric, BUN and Cr fall, risk of hypoK

Question 45

renal papillary necrosis is assoc w/

Answer 45

DM acute pyelonephritis chronic phenacetin use sickle cell anemia and trait

Question 46

dec BUN/Cr ratio

Answer 46

intrinsic renal failure

Question 47

renal osteodystrophy

Answer 47

failure of vit D hydroxylation > hypoCa and hyperPhos > 2ndary hyperPTH > subperiosteal thinning of bones

Question 48

assoc conditions w/ ADPKD

Answer 48

berry aneurysms, mitral valve prolapse, benign hepatic cysts

Question 49

effect of loop diuretics and thiazides on Ca

Answer 49

loops inc Ca excretion | thiazides dec Ca excretion

Question 50

tox of furosemide

Answer 50

``` OH DANG ototox hypoK dehydration allergy (sulfa) nephritis (interstitial) gout ```

Question 51

non-sulfa drug version of furosemide

Answer 51

ethacrynic acid

Question 52

tox of thiazides

Answer 52

hypokalemic metab alkalosis hyponatremia sulfa allergy hyperGLUC (glycemia, lipidemia, uricemia, calcemia)

Question 53

ACEi tox

Answer 53

``` CATCHH cough angioedema teratogen (renal abnlties) Cr increase (dec GFR) hyperK hypoTN ```