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ID/LC Step Review > Renal 2 > Flashcards

Renal 2 Flashcards

1
Q

Concentrations of which substances increase as you move along the proximal tubule?

A
  • PAH
  • Cr
  • Inulin
  • Urea
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2
Q

Concentrations of which substances decrease as you move along the proximal tubule?

A
  • Bicarb
  • Glucose
  • AAs
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3
Q

Grapefruit is a what?

A

P450 inhibitor

Increases nephrotoxicity by raising circulating drug levels

Slows breakdown of drugs metabolized by this pathway

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4
Q

Cyclosporine and ^ed levels of serum Cr?

A

Calcineurin inhibitor nephrotoxicity

via P450 pathway

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5
Q

Beta-blockers function

A
  • Decrease renin production

- Decrease sympathetic stimulation

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6
Q

Indication of diabetic nephropathy?

A

Increased albumin excretin

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7
Q

Appropriate tx for diabetic pt w/ diabetic nephropathy

A
  • Anti-glycemic drugs

- ACEIs (have anti-proteinuric effects)

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8
Q

Athroembolic renal disease

A
  • Occur post-invasive vascular procedures
  • Needle-shaped cholesterol clefts within the atheromatous thrombus
  • Emboli found in kidneys (most common), GI tract, CNS, skin
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9
Q

DKA emergent tx

A

IV NS and insulin

Increase serum bicarb, Na

Decrease glucose, osmolality, and K

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10
Q

Urinalysis of PSGN

A

RBC cast, mild proteinuria, ^ serum Cr

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11
Q

PSGN clinical presentation

A
  • Commonly in kids
  • Hematuria
  • HTN
  • Periorbital edem
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12
Q

Genetics of ARPKD

A

AR duh

Mutation in PKHD1 gene

Codes for fibrocystin (present in kidney and liver)

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13
Q

Clinical findings of ARPKD

A
  • Renal insufficiency
  • Nephromegaly
  • HTN

Dx: bilateral enlarged, echogenic kidneys on US

Associated w/ Potter sequence

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14
Q

Potter sequence

A
  • Flattened facies
  • Limb deformities
  • Pulm hypoplasia
  • Oligohydramnios

HIGH mortality

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15
Q

Pyelonephritis histo characteristics

A
  • Massive interstitial infiltration
  • PMNs in interstitium and tubular lamina
  • Fever, hematuria
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16
Q

Adverse rxn associated w/ Beta-lactam antibiotics?

A
  • Fever
  • Rash
  • ARF

Drug-induced acute interstitial nephritis

Also - NSAIDs, sulfonamides, rifampin, diuretics

17
Q

Acute interstitial nephritis

A
  • Peripheral eosinophilia and eosinophiluria

- Hypersensitivity

18
Q

Ramipril

A

ACEI

19
Q

Primase

A

DNA-dependent RNA poly

Incorporates short RNA primers into replicating DNA

20
Q

Frothy/foamy urine?

A

Caused by proteinuria => nephrotic syndrome

21
Q

Pts w/ MS and urinary issues

A
  • Spastic bladder after developing acute lesion on spinal cord
  • Increased urinary freq and urge incontinence
  • Bladder hypertonia (UMN!!!)
22
Q

Where does majority of water reabsorption occur?

A

Proximal tubule

Passively w/ reabsorption of solutes

23
Q

Crescents in RPGN consist of which materials?

A
  • Glomerular parietal cells
  • Monocytes
  • Macros
  • ABUNDANT fibrin

Eventually become sclerotic, disrupting glomerular function => irreversible renal injury

24
Q

In acute transplant rejection, what is the humoral response?

A
  • C4d deposition
  • PMN infiltrate
  • Necrotizing vasculitis
25
Q

In acute transplant rejection, what is the cellular response?

A
  • Lymphocytic interstitial infiltrate

- Endotheliitis

26
Q

Acute hemolytic transfusion reaction

A
  • Fever & chills
  • Hypotension
  • Dyspnea
  • Chest/back pain
  • Hemoglobinuria (red- to brown-colored urine)

Occur w/in minutes/hours of starting a blood transfusion — ABO incompatibility

Ab-mediated (Type III) hypersensitivity reaction

27
Q

Type III hypersensivity

A
  • IgM bind to Ag => complement activation
  • C3a and C5a cause vasodilation and sx of shock
  • Complement mediated cell lysis
28
Q

Urachus

A
  • Yolk sac forms the allantois => extends into urogenital sinus => becomes bladder (5th-7th week)
  • Allantois becomes urachus after bladder formation => now duct between bladder and yolk sac
29
Q

Patent urachus

A
  • Aka persistent allantois remnant
  • Connects umbilicus and bladder
  • Pts present w/ urine discharge from umbilicus
  • Exacerbated w/ crying, straining, voiding, prone position
30
Q

Vesicourachal diverticulum

A
  • Failure to close part of urachus
  • commonly asymptomatic
  • Outpouching of bladder apex
31
Q

Urachial sinus

A
  • Failure to close distal part of urachus
  • Presents w/ periumbilical tenderness and purulent discharge from persistent/recurrent infections
  • Adjacent to umbilicus
32
Q

Urachal cyst

A
  • Failure of central portion of urachus to obliterate

- Fluid filled structure located between the two obliterated ends of urachus

33
Q

Vitelline duct

A
  • Persistent yolk stalk
  • Connects small intestine w/ skin
  • Presents w/ meconium discharge from umbilicus
  • Incomplete obliteration => meckel diverticulum
34
Q

Proximal ureter blood supply

A

Renal artery

35
Q

Distal ureter blood supply

A

Superior vesical artery

36
Q

Urinary incontinence in pts w/ MS

A
  • Develop urge incontinence due to loss of CNS inhibition of detrusor contraction in the bladder
  • Bladder can become atonic, dilated => overflow incontinence

ID/LC Step Review (19 decks)

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