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Eagle Prep Review > Renal > Flashcards

Renal Flashcards

1
Q

Where in the kidney is glucose, bicarb, AA and metabolites reabsorbed?

A

PCT

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2
Q

What does the MeSonephros become?

A

CRUMS
(urinary system OUT of kidney)
- collecting duct
- renal pelvis
- ureters
-major/minor calyces

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3
Q

What does the MeTanephros become?

A

“Renal Parenchyma” or “Kidney Proper”
- glomerulus
- PCT
- Loop of Henle
- DCT
- Collecting Tubule

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4
Q

What structure can connect the umbilicus and the bladder; sometimes has discharge leaking from it in children?

A

patent urachus

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5
Q

What structure is due to a failure to close the distal part of the urachus; leads to periumbilical tenderness and purulent discharge?

A

urachal sinus

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6
Q

Formula and Indicators for TBW

A

TBW= ICF + ECF

Indicators: D2O

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7
Q

Formula and Indicators for ECF

A

ECF = plasma + interstitial fluid

Indicators: Mannitol and Inulin

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8
Q

What type of channels does ADH act on?

A

aquaporin channels in the collecting duct

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9
Q

MOA of ADH

A
  • Increase H2O reabsorption in CT
  • Decrease Urine Volume
  • Increase Urine Specific Gravity
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10
Q

What is Angiotensin II’s affect on GFR?

A

increases GFR

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11
Q

MOA of aldosterone

A

Acts on the Na+/K+ pumps in the DCT
- Increases Na+ absorption (water follows)

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12
Q

Describe what happens in SIADH (urine vs. plasma)

A
  • too much ADH
  • very concentrated urine
  • dilute plasma (hyponatremia)
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13
Q

Describe what happens in Aldosterone deficiency (urine vs. plasma)

A
  • no aldosterone; hyponatremia
  • lots of urine with Na+ following
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14
Q

What is the affect of B-blockers and Digoxin on Potassium?

A

Increased K+

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15
Q

What is the affect of B-agonists on K+?

A

Decreased K+

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16
Q

Hyper_____ can cause muscle cramps or rhabdomyolysis.

A

Hyperkalemia (if K+ too high)

*also can cause muscle weakness if K+ too low

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17
Q

_____ in the urine, can bind to Ca2+ and help to decrease the risk for calcium kidney stones.

A

Citrate

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18
Q

Formula for Renal Clearance

A

Concentration = [Urine Osm x Urine Flow Rate] / Plasma Osm

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19
Q

Name the indicator used for GFR

A

Inulin or Creatinine clearance

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20
Q

Constriction of Afferent Arteriole does what to GFR?

A
  • decreased GFR

due to activation of renal sympathetic nerves

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21
Q

What affect does ANP have on GFR?

A
  • increased GFR
  • DECREASES
    Renin, AT II, Aldo, NaCL, and ADH
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22
Q

Describe the Changes in RPF, GFR and FF

  • NSAIDS
A

Increases Prostaglandins Dilate the Afferent Arteriole
- Increase RPF
- Increase GFR
- FF remains Constant

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23
Q

Describe the Changes in RPF, GFR and FF

  • ACE Inhibitor
A

Angiotensin II Constricts the Efferent Arteriole
- Decrease RPF
- Increase GFR
- Increase FF

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24
Q

Describe the Changes in RPF, GFR and FF

Afferent Arteriole Constriction

A
  • Decrease RPF
  • Decrease GFR
  • FF remains constant
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25
Q

Formula for Filtration Fraction

A

GFR/RPF

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26
Q

Name the 6 types of Nephrotic Syndrome

A

MMFANS
- Minimal Change Dz
- Membranous
- Focal Segmental Glomerular Nephropathy
- Amyloidosis
- Nodular Sclerosing (Diabetes)
- SLE (Lupus!)

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27
Q

What are the 4 main characteristics of Nephrotic Syndrome?

A

PALE

  • Proteinuria > 3.5
  • Albuminuria
  • Lipidemia
  • Edema
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28
Q

Name the 5 types of Nephritic Syndrome.

A

PRIMA

  • Post-streptococcal glomerulonephritis
  • Rapidly Progressive Glomerulonephritis
  • IgA Nephropathy
  • Membranoproliferative Glomerulonephropathy
  • Alports
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29
Q

What are the 4 main characteristics of Nephritic Syndrome?

A

HOAR

  • Hypertension
  • Oliguria
  • Azotemia
  • RBC cast
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30
Q

Does Nephrotic Syndrome have blood in the urine (hematuria)?

A

NO

31
Q

Waxy Cast in Urine?

A

End Stage Kidney Disease

32
Q

Granular Cast/Muddy Brown Cast in Urine?

A

ATN

33
Q

Fatty Cast in Urine?

A

Nephrotic Syndrome

34
Q

RBC Cast in Urine?

A

Nephritic Syndrome

35
Q

WBC Cast in Urine?

A

Pyelonephritis

36
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

Lumpy bumpy
Mimics SLE Type 4
Type III Hypersensitivity
Look for Periorbital Edema!

A

Nephritis

Post Streptococcal Glomerulonephritis

37
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

  • NO immunofluorescence
    • c-ANCA
  • involves Upper [sinus] and Lower Respiratory
A

Nephritic

Wegner’s
- Rapidly Progressive Glomerulonephritis

38
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

(Type II Hypersensitivity)
Lower Respiratory
Anti-glomerular BM antibodies (Type IV collagen)

A

Nephritic

Goodpasture’s Syndrome
- Rapidly Progressive Glomerulonephritis

39
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

HS Purpura
Berger’s
- Mesangial

A

Nephritic

IgA nephropathy

40
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

S/S: Facial Swelling
Tram-Track Appearance on immunofluorescence
Subendothelial deposits (Type 1)

A

Nephritic

Membranoproliferative glomerulonephritis

41
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

Involves Basement Membrane (Type IV collagen)
S/S: blindness, deafness
Hint: “basket weave appearance”

A

Nephritic

Alports!

42
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

Podocyte Effacement/Foot process
Infection/Immune Issues can cause this.

A

Nephrotic

Minimal Change Disease
treat with prednisone

43
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

Anti-Phospholipase A2
Mimics SLE Type 5
Spike and Dome Appearance

A

Nephrotic

Membranous…

44
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

  • IV drug use, HIV, Sickle Cell
  • Most common in AA and Hispanics
A

Nephrotic

Focal Segmental Glomerulonephritis

45
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

Multiple Myeloma, Sarcoidosis, TB
Bence Jones Proteins
Apple Green Birefringence

A

Nephrotic

Amyloidosis

46
Q

Name the Disease.
(+ Nephritic vs. Nephrotic)

BM thickening
Kimmelstein Wilson Nodules (wire loop)

A

Nephrotic

Nodular Sclerosing (Diabetes)

47
Q

Name the Vasculitis
- most common form of childhood vasculitis
- Skin Rash (palpable purpura)
- Follows Upper Respiratory Infections

A

Henoch-Schonlein Purpura

48
Q

Name the Vasculitis
- Heavy Smokers
- Intermittent Claudication

A

Buerger’s Disease (thromboangiitis obliterans)

49
Q

Name the Vasculitis
- Fever > 5 days
- Conjunctivitis (red eyes)
- Strawberry Tongue

A

Kawasaki Disease
causes acute necrotizing vasculitis of small/medium vessels

50
Q

Name the Vasculitis
- necrotizing immune complex inflammation
- seen in Hep. B patients

A

Polyarteritis Nodosa
treat with corticosteroids

51
Q

Name the Vasculitis
+ p-ANCA
- granulomatous vasculitis with eosinophilia

A

Churg-Strauss Syndrome

52
Q
A
53
Q

If BUN/Cr ratio is > 15, what type of azotemia is it?

A

PRERENAL
- anything under 15 is either intrarenal or post renal

54
Q

What are the 4 causes of ischemia ATN?

A

MESH

  • major surgery
  • extensive blood loss
  • severe burns
  • hemorrhage
55
Q

What is the main cause of toxic ATN?

A

NSAIDS

56
Q

Primary treatment for Cystitis (UTI)?

A

TMP-SMX (Bactrim)

57
Q

What are the 4 drugs that can cause Drug Induced Interstitial Nephritis?

A

PCNS

  • Penicillin
  • Cephalosporins
  • NSAIDS
  • Sulfonamides
58
Q

What bacteria is the most common cause of a UTI?

A

E. coli

59
Q

Name the Kidney Disorder

  • acute severe colicky flank pain
  • hematuria
  • Dx: CT scan
A

Nephrolithiasis (kidney stone)

60
Q

Name the Kidney Disorder

  • dilation of the renal calyces
A

Hydronephrosis

Tx: treat the obstruction causing the back up of flow

61
Q

What drug can be used to treat calcium kidney stones?

A

Hydroclorothiazide

62
Q

Kidney stone: hexagonal shape

A

Cysteine stone

63
Q

Kidney stone: Coffin lid appearance

A

Struvite stone

64
Q

Kidney Stone:
- rhomboid shape
- radiolucent

A

Uric Acid Kidney Stones

65
Q

What are the 4 AA that can cause Cysteine Kidney Stones?

A

COLA
- cysteine
- ornithine
- lysine
- arginine

66
Q

Name the Incontinence

  • Laugh/cough and pee comes out
  • Due to increased abnormal pressure
  • Treatment:
    Pessary
    Kegel exercise
A

Stress Incontinence

67
Q

Name the Incontinence

  • Urge that you have to go at random times
  • Treatment:
    Timed Voiding (timer)
    Antimuscarinic
A

Urge Incontinence

68
Q

Name the Incontinence

  • Cause: inability for nerves to empty the bladder
  • Diabetics can get this!!
  • Treatment:
    Catheterization to empty the bladder
A

Overflow Incontinence

69
Q

What are the various causes of High Anion Gap Metabolic Acidosis?

A

MUDPILES
Methanol,
Uremia,
Diabetic ketoacidosis,
Propylene glycol,
Isoniazid/Iron
Lactic acidosis,
Ethylene glycol,
Salicylates (aspirin)

70
Q

What are the various causes of Normal Anion Gap Metabolic Acidosis?

A

HARDASS
hyperalimentation,
Addison’s disease,
renal tubular acidosis, diarrhea,
acetazolamide,
spironolactone,
saline infusion.

71
Q

Metabolic Acidosis vs. Metabolic Alkalosis

  • Vomitting
A

Hypokalemic
Hypochloremic
Metabolic Alkalosis

72
Q

Name the Urinary Incontinence Type and its Etiology.
- S/S: leakage with coughing, sneezing, lifting

A

Stress
- due to decreases urethral sphincter tone

73
Q

Name the Urinary Incontinence Type and its Etiology.
- S/S: Overwhelming urge to urinate

A

Urge Incontinence
- Detrusor Muscle Overactivity

74
Q

Name the Urinary Incontinence Type and its Etiology.
- S/S: incomplete emptying and persistent involuntary dribbling

A

Overflow Incontinence
- impaired detrusor muscle contractility
- bladder outlet obstruction

Eagle Prep Review (23 decks)

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