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Undeleted > Renal > Flashcards

Renal Flashcards

1
Q

Hydronephrosis in fetus

A

failure of utereopelvic junction to canalize

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2
Q

Potter’s syndrome

A

oligohydramnios
compression of fetus
pulmonary hypoplasia
death

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3
Q

Horseshoe kidney

A

ascension blocked by IMA

assc with Turner syndrome

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4
Q

What can cross ureters and cause urine backup?

A

accessory renal artery

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5
Q

Characteristics of Glc renal clearance

A

threshold-past where you see Glc in urine (160mg/dL)
splay-gradual appearance of Glc in urine
full saturation of Glc transporters at 250mg/dL

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6
Q

Pellegra sx

Not B3 deficiency

A

Hartnup’s disease
deficiency of neutral AA transport
Tryptophan important loss

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7
Q

Impact of fluid by adrenal insufficiency

A 
increased ICF (pulls ECF out)
decreased ECF
decreased osmolarity (lose salt)
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8
Q

Impact of fluid by SIADH

A

increased ICF
increased ECF
decreased osmolarity

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9
Q

Impact of fluid by diabetes insipidus

A 
decreased ICF/ECF
increased osmolarity (loss of water)
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10
Q

Impact of fluid by primary aldosteronism

A

decreased ICF (pulled out by salt)
increased ECF
increased osmolarity

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11
Q

PTH on proximal tubule

A

inhibits Na+/phosphate cotransport

decreased phosphate resorption

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12
Q

AT II on proximal tubule

A

increased Na+/H+ exchange

increased Na+/HCO3- resorption

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13
Q

PTH on distal convoluted tubule

A

increased Ca2+/Na+ exchange

increased Ca2+ resorption

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14
Q

Aldosterone on collecting tubule

A

increased Na+ channels on luminal side

increased Na+ resorption

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15
Q

Renal BP control

A 
myogenic response (stretch constricts-Ca2+ mediated)
tubuloglomerular feedback (macula densa)
PGE/NO (vasodilate)
epi/NE/endothelin (vasoconstrict)
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16
Q

Beta1 receptors on kidney action

A

increase renin secretion by juxtaglomerular cells

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17
Q

Alpha1 receptors on kidney action

A

increase Na+/K+ pump in proximal tubule

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18
Q

Central Diabetes insipidus

A

lack of ADH secretion
responds to desmopressin
chromosome 20 defect

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19
Q

Nephrogenic diabetes insipidus

A

genetic loss of V2R/AQP-2 or lithium toxicity

no desmopressin response

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20
Q

EPO production

A

made by peritubular capillary bed
in response to hypoxia
increases RBC production

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21
Q

VIt D and kidneys

A

converts 25-OH Vit D to 1,25-(OH)2 Vit D (active form)

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22
Q

NSAIDs impact on kidneys

A

decrease PGE which dilate arterioles

can cause acute renal failure

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23
Q

Insulins impact on K+

A

shifts K+ into cells

causing hypokalemia

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24
Q

Hyperkalemia impact on heart

A

wide QRS complex

peaked T waves

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25
Q

ABG for metabolic acidosis

A

decreased bicarb
decreased PCO2
decreased pH

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26
Q

ABG for respiratory acidosis

A

increased bicarb
increased PCO2
decreased pH

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27
Q

Type 1 renal tubular acidosis

A

defect in H+ excretion

increased risk for Ca2+/phosphate stones

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28
Q

Type 2 renal tubular acidosis

A

defect in tubule bicarb resorption

29
Q

Sign of azotemia

A

increased BUN and creatinine

decreased GFR

30
Q

Fatty casts in urine

A

nephrotic syndrome

31
Q

granular casts in urine

A

acute tubular necrosis

32
Q

waxy casts in urine

A

chronic renal failure

33
Q

Focal segmental glomerulosclerosis

A

collapse of glomeruli (HIV/blacks/heroin assc)
hyalinosis
effacement of foot processes
IgM and C3

34
Q

Membranous nephropathy

A

adult caucasian males
GBM thickening
spike and dome (immune complex deposits)
granular immunofluorescence

35
Q

Minimal change disease

A

2-6 y/o post infection and Hodgkin lymphoma assc
foot process effacement
selective loss of albumin
responds to corticosteriods

36
Q

Amyloidosis

A

congo red stain
apple green birefringence
assc with multiple myeloma

37
Q

Membranoproliferative GN

A

type 1:tram track due to GBM splitting
C3/C4/IgG
type 2:ribbon like, only C3
assc with HBV/HCV

38
Q

Diabetic glomerulonephropathy

A

nonenzymatic glycosylation
nodular glomerulosclerosis
Kimmelstiel-Wilson lesion
hyaline arteriosclerosis

39
Q

Acute poststrep GN

A

lumpy bumpy appearance (immune complex deposition)
child post URT infection
periorbital edema
IgG/IgM/C3

40
Q

Rapidly progressive GN

A

crescent moon shape
seen in Goodpasture’s (linear IF)/Wegeners’s (c-ANCA)/microscopic polyangiitis (p-ANCA)
petechial hemorrhage on cortical surfaces

41
Q

Diffuse proliferative GN

A

SLE or PMGN
wire looping of capillaries
IgG and C3 deposition
granular on IF

42
Q

Berger’s disease

A

related to Henoch-Schoenlein purpura
mesangial proliferation
IgA in mesangium
aka IgA nephropathy

43
Q

Alport syndrome

A

mutation of type IV collagen, X linked
split basement membrane
deafness/eye problems

44
Q

Ca2+ kidney stones

A

acid-oxalate/basic-phosphate
can result from ethylene glycol/Vit C
hypercalciuria/normocalcemia

45
Q

Struvite kidney stones

A

Mg2+/NH4+/phosphate
caused by infection (urease (+))
acidify urine to tx

46
Q

Uric acid kidney stones

A

radiolucent
assc with hyperuricemia
seen in diseases with increased cell turnover (leukemia)

47
Q

Cystine kidney stones

A

hexagonal crystals

congenital defect in cysteine resorption

48
Q

Renal cell carcinoma

A

yellow color/upper pole of kidney
assc with Von Hippel-Lindau (chromosome 3 deletion) and tuberous sclerosis
mets to lung/bone

49
Q

Wilm’s tumor

A

2-4 y/o
deletion of suppressor gene WT1 chromosome 11
embryonic glomerular structures
Anirida/GI malformation/MR (Beckwith Wiedemann syndrome)

50
Q

Transitional cell carcinoma

A

painless hematuria

assc with aniline dyes/cyclophosphamide

51
Q

Acute pyelonephritis

A

WBC casts
neutrophils
affects cortex (not glomeruli)
tubular necrosis

52
Q

Chronic pyelonephritis

A

Eosinophilic casts
vesicoureteral reflux
corticomedullary scarring
thyroidization of kidney

53
Q

Drug induced interstitial nephritis

A

eosinophils/azotemia
1-2 wks after drug use (but months with NSAIDs)
hypersensitivity rxn

54
Q

Acute tubular necrosis

A

HgCl/CCl4/ethylene glycol all cause
metabolic acidosis and oliguria
granular casts
assc with renal ischemia

55
Q

Renal papillary neccrosis

A

sloughing off of renal papillae
hematuria/proteinuria
DM/sickle cell/acute pyelonephritis/chronic phenacetin use

56
Q

Prerenal azotemia labs

A

increased BUN/creatinine ratio

decreased GFR

57
Q

Intrinsic renal azotemia labs

A

due to acute tubular necrosis
decreased BUN/creatinine ratio
fluid backflow

58
Q

Postrenal azotemia labs

A

normal BUN/creatinine ratio

outflow obstruction

59
Q

Renal osteodystrophy

A

failure of Vit D hydroxylation
increased PTH (secondary to increased phosphate)
subperiosteal thinning of bone

60
Q

Chromophobe renal carcinoma

A

(+) Hale’s colloidal iron stain
halo around nucleus
tan-brown color

61
Q

ADPKD

A

multiple lg bilateral cysts
mutation of PKD1/PKD2
assc with berrry aneurysms
destroys kidney parenchyma

62
Q

ARPKD

A

infantile PKD
sponge like appearance of medulla/cortex
hepatic fibrosis
assc with Potter’s syndrome (oligohydramnios)

63
Q

Medullary sponge kidney

A

assc with Marfan’s/Ehler’s Danlos
dilations of collecting ducts
adult onset

64
Q

Acetazolamide use

A

glaucoma
altitude sickness
pseudotumor cerebri (increased ICP)

65
Q

Furosemide adverse effects

A

loop diuretic
ototoxicity/gout
sulfa allergy

66
Q

Use of ethacrynic acid

A

for pts with sulfa allergy who cannot use furosemide

67
Q

HCT adverse effect

A

hyperlipidemia
sulfa allergy
hyperglycemia

68
Q

Spironolactone adverse effects

A

gynecomastia

hyperkalemia

69
Q

ACE-I’s contraindication

A

bilateral renal artery stenosis

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