Renal Flashcards
Which part of the nephron concentrates urine?
Medulla
What is the course of the ureter?
The ureter passes under the uterine artery and under the deferens
What is the 60/40/20 rule?
60% total body water
40% ICF
20% ECF
What is Goldblatt’s kidney?
File-bitten kidney (blown capillaries)
What is uremia?
Azotemia + symptoms
What is azotemia?
Elevated BUN/Cr ratio
What is Nephritic kidney disease?
Increased size of fenestrations
=> vasculitis
What is Nephrotic kidney disease?
Lost basement membrane charge d/t deposition on heparin sulfate
=> massive proteinuria and lipiduria
What is seen in rapidly progressive glomerulonephritis (RPGN)?
Crescents
What is post-strep GN?
Subepithelial, IgG/C3/C4 deposition
ASO Ab
What is interstitial nephritis?
Urine eosinophils or eosinophilic casts
What is Lupus nephritis?
Subepithelial
“Wire loops”
What is membranoglomerulonephritis (MGN)?
Deposition of “something”
What is Membranoproliferative glomerulonephritis (MPGN)?
Tram-tracks
(Type II has low C3)
What is minimal change disease (MCD)?
Kids
Fused foot processes
No renal failure
Loss of charge barrier
What is Focal Segmental Glomerulosclerosis (FSGS)?
AA - amyloid
HIV patients
What are the vasculitides with low C3?
PMS in Salt Lake City
- Post-strep GN
- MPGN type II
- SBE
- serum sickness
- lupus
- cryoglobulinemia
What is the most common cause of kidney stones?
Dehydration
What are the most common type of kidney stones?
Calcium phosphate
What type of kidney stones have coffin-lid crystals?
Triple phosphate
What type of kidney stones have rosette crystals?
Uric acid
What type of kidney stones have hexagonal crystals?
Cystine
What type of kidney stones have envelopes or dumbbell-shaped crystals?
Oxalate
What disease has aniridia?
Wilm’s tumor
What disease has iridocyclitis?
Juvenile RA
What is phimosis?
Foreskin scarred at penis head
(= foreskin stuck smooshed up)
What is paraphimosis?
Foreskin scarred at penis base
(= retraction of foreskin => strangulates penis)
What is urge incontinence?
Urgency leads to complete voiding
(Detrusor spasticity -> small bladder volume)
What is stress incontinence?
Weak pelvic floor muscles
(Estrogen effect)
What is overflow incontinence?
Runs down leg but cannot complete emptying of bladder
What structures have one-way valves?
Urethra
Ejaculatory duct
What structures have fake sphincters?
Ureters
LES
Ileocecal valve
What has WBC casts?
Nephritis
What has WBC casts only?
Pyelonephritis (sepsis)
What has WBC casts + eosinophils?
Interstitial nephritis (allergies)
What has WBC casts + RBC casts?
Glomerulonephritis
What has fat casts?
Nephrotic syndrome
What has waxy casts?
Chronic renal failure
What has tubular casts?
ATN
What has muddy brown casts?
ATN
What has hyaline casts?
Normal sloughing
What has epithelial casts?
Normal sloughing
How do you measure afferent renal function?
Creatinine
(Or inulin)
How do you measure efferent renal function?
BUN
(Or PAH)
What is the afferent arteriole’s job?
Filter
What happens if you constrict the afferent arteriole?
RPF - goes down
GFR - goes down
FF (GFR/RPF) stays unchanged
What is the efferent arteriole’s job?
Secrete
What happens if you constrict the efferent arteriole?
RPF - goes down
GFR - goes up
FF (GFR/RPF) goes up
How do you test afferent arteriole function?
GFR
What is normal GFR?
100 mL/min
How do you test efferent arteriole function?
RPF
What happens if you increase plasma protein concentration?
RPF - stays unchanged
GFR - goes down
FF (GFR/RPF) - goes down
What happens if you decrease plasma protein concentration?
RPF - stays unchanged
GFR - goes up
FF (GFR/RPF) - goes up
What is pre-renal failure?
Low flow to kidney (BUN/Cr >20)
What is renal failure?
Damaged glomerulus (BUN/Cr ratio <20)
What is post-renal failure?
Obstruction (have not peed in last 4 days)
What is the job of the proximal tubule?
Reabsorb glucose, amino acids, salt, and bicarbonate
What is the job of the thin ascending limb?
Reabsorbs water
What is the job of the thick ascending limb?
Make the concentration gradient by reabsorbing Na, Cl, K, Mg, Ca without water
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl (hypotonic)
What is the job of the lat distal tubule and collecting duct?
Final concentration of urine by reabsorbing water and excreting acid
What does the macula densa do?
Measures osmolarity
What does the J-G apparatus do?
Measures volume
What is Fanconi’s syndrome?
Old tetracycline use
=> urine phosphates, glucose, amino acids
What is Bartter’s syndrome?
Baby w/ defective triple transporter
(Low Na, Cl, K w/ normal BP)
What is psychogenic polydipsia?
No concentrating ability
-> cerebral edema
What is hepatorenal syndrome?
High urea from the liver
-> increase activity of glutaminase
-> incr NH4
-> incr GABA
-> kidney stops working
What is type 1 RTA?
Distal renal tubular acidosis
- H/K exchange in collecting duct is broken
-> high urine pH
d/t UTI, stones, Lithium
What is type 2 RTA?
Proximal RTA
- bad carbonic anhydrase
-> lose all bicarb
-> low urine pH
Associated w/ multiple myeloma
What is type 3 RTA?
RTA I + II
W/ normal urine pH (pH = 5-6)
What is type 4 RTA?
Infarct J-G
-> no renin
-> no aldosterone
-> high K
d/t DM, NSAIDs, ACEi, heparin
What is central pontine myelinolysis?
Due to correcting Na faster than 0.5 mEq/hr
