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FA organs HY > Renal > Flashcards

Renal Flashcards

1
Q

What gives rise to the glomerulus-> DCT?

CD-> pelvis?

A

Metanephric mesenchyme = glomerulus

Ureteric bud= CD-> pelvis

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2
Q

Horseshoe kidney is associated with?

A

Turners syndrome

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3
Q

Total body water: ICF vs ECF? How do you measure ECV & plasma volume?
ECF: Plasma vs Interstitial volumes?

A 
ICF= 2/3 
ECF= 1/3 --> INULIN 
Plasma = 1/3 of ECF --> Albumin 
Interstitial = 2/3 ECF
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4
Q

If you give a pt 9L of Hypotonic saline how many enter the plasma? 9L of isotonic saline?

A 
Hypotonic= 3 L into ECF --> 1 L into plasma 
Isotonic = 9L into ECF --> 3 L into Plasma
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5
Q

What is the glomerular basement membrane gives it a negative charge?

A

Heparan Sulfate

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6
Q

Renal Clearance equation?

Cl < GFR vs Cl > GFR?

A 
C= UV/P = Urine [a] x urinve flow rate / plasma [a] 
< = Absorbed 
> = Secreted
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7
Q

What is used to calculate GFR?

GFR equation?

A

Inulin Clearance / Creatinine (slightly secreted)

GFR= U x V / P = Cl of Inulin

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8
Q

What is used to calculate RPF?

RBF calculation?

A

PAH clearance

RBF = RPF / (1-Hct)

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9
Q

Calculate FF? normal FF?

A

FF = GFR / RPF = 20%

Filtered load = GFR x plasma [a]

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10
Q

How do NSAIDs affect RPF + GFR + FF?

A

NSAIDs block PGs = Constriction of Afferent

dec GFR/ dec RPF = FF SAME

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11
Q

How does ACEi affect RPF + GFR + FF ?

A

AngII constricts Efferent = Dilation of Efferent w/ ACEi

dec GFR/ inc RPF = Dec FF

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12
Q

Constriction of Efferent arteriole (FF= GFR/ RPF)?

A 
FF= Inc
GFR = inc
RPF = dec
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13
Q

Increase in plasma protein concentration (FF=GFR/RPF)?

A

FF = dec
GFR = dec (High oncotic pressure)
RPF = NC
**low protein = Inc FF= Inc GFR/ RPF NC

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14
Q

Constriction of ureter affect on FF= GFR/RPF?

A 
FF = dec 
GFR = dec 
RPF = NC
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15
Q

Filtered load calculation? Excretion rate?

A 
FL = GFR x P 
Ex= V x U
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16
Q

Hartnup’s disease?

A

Na dependent AA transporter def in PT

**def in Trp = Niacin def = Pellagra

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17
Q

What part of the tubule does ang II act on?

A

PT = activates Na/ H+ exchanger

** Causes Contraction Alkalosis

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18
Q

The concentration of what substances increase along the PT? highest –> lowest

A

PAH-> Cr–> Inulin -> Urea -> Cl –> K -> Na

  • *Note only PAH & Cr are secreted/ not absorbed W
  • *inulin is Not secreted or absorbed
  • *Na/K/urea/Cl are ALL absorbed But less than H2O so Concentrations Increase
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19
Q

Concentration of what substances dec along PT? Lowest –> highest

A

Glucose (ALL absorbed)
AAs (all absorbed but slower than Glucose)
HCO3
Phosphate
**the Concentration of these substances Dec because they are Reabsorbed Faster than H2O

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20
Q

What stimulates Renin release?

A

B1 agonist
dec Na @ MD
dec BP

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21
Q

Function of ANP?

A

Relax vascular smooth muscle (cGMP)
increase GFR
dec Renin

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22
Q

In response to Hypoxia what releases Epo in the kidney?

A

Interstitial cells in peritubular capillaries

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23
Q

What are some causes of HYPERkalemia?

A 
Digitalis 
Acidosis 
B-antagonists 
Cell lysis 
Hyperosmolarity
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24
Q

Causes of HYPOkalemia?

A

Insulin
Beta agonists (inc Na/K ATPase activity)
Alkalosis
Hypo-osmolarity

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25
Q

U waves and flattened T waves on ECG, arrhythmias, and weakness?

A

Hypokalemia

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26
Q

dec DTR, lethargy, bradycardia, hypotension, Cardiac arrest?

A

Hyper Mg+

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27
Q

Wide QRS and peaked T waves on ECG, weakness and arrhythmias?

A

Hyperkalemia

Peaked T = High K

28
Q

What things can cause Peaked T waves and Wide QRS?

A

Digitalis
Beta-antagonist
Acidosis
**HEART BLOCK

29
Q

What things can cause flattened T waves and U wave?

A

Insulin
Alkalosis
B-agonists

30
Q

What is the calculation for the predicted respiratory response to metabolic acidosis?

A

Winters formula = Pco2 = 1.5 (HCO3) + 8

**HCO3 12 –> Pco2 should= 26

31
Q

What are the causes of anion gap metabolic acidosis?

A 
Methanol
Uremia
DKA
Propylene glycol (anti-freeze)
Iron or INH
Lactic acidosis
Ethylene glycol (oxalic acid)
Salicylates
32
Q

Defect in Distal (CD) tubule H excretion
Hypokalemia + urine pH > 5.5
Ca/PO4 stones?

A

Type 1 RTA (distal)

33
Q

Hypoaldosteroneism or No CD response
Hyperkalemia and xammoniagenesis
Dec urine pH due to Dec buffers?

A

Type 4 RTA (Hyperkalemic)

34
Q

Defect in PT HCO3 reabsorption
urine pH<5.5 + hypokalemia
Hypophosphatemic rickets?

A

Type 2 RTA (proximal)

35
Q

Waxy casts vs WBC vs RBC casts?

A 
Waxy= CRF
WBC = pyelonephritis or Transplant rejection
RBC= nephritis, ischemia, malignant HTN
36
Q

Features of nephrotic syndrome?

A

Hyperlipidemia
Fatty casts
ATIII loss = Hypercoagulable state

37
Q

Diffuse GBM thickening due to granular IC deposits (“Spike and dome”) associated with HBV, SLE nephrotic?

A

Membranous

38
Q

Child with recent infection (days ago) and not has puffy eyes. What is seen on biopsy? Rx?

A

Minimal change=
LM= NC
EM = Podocyte effacement
**STEROIDS

39
Q

Subendothelial IC deposits leading to “tram tracks” due to Mesangial ingrowth?

A

Type 1 MPGN

40
Q

What is associated with Continuous C3 activation and Very LOW C3 in serum?

A

Type 2 MPGN (dense deposits dz)

**C3 nephritic factor

41
Q

Associated with HCV?

Intramembranous dense deposits?

A

HCV= T1 MPGN

dense deposits = T2 MPGN

42
Q

IC deposits:
Subepithelial
Intramembranous
Subendothelial

A 
Subepi = Membranous
Intramem = T2 MPGN
Subendo = T1 MPGN
43
Q

Nephritic syndromes?

A 
PSGN
RPGN 
DPGN 
bergers dz
Alports
44
Q

What is in the “lumpy bumpy” subepithelial deposits?

A

PSGN = IgM + IgG + C3

45
Q

What is in Crescentic formation?

A

FIBRIN
plasma proteins
parietal cells, macs

46
Q

MCC of death in SLE pts?

A

DPGN= wire loop subendothelial deposits

47
Q

Pt with recent hx of GI/URT infection and now has hematuria and red palpable lesions on buttocks?

A

Bergers disease = IgA nephropathy

  • *Henoch-schonlein purpura
  • *IgA in Mesangium
48
Q

pt with GN, deafness, and visual issues have a defect in?

A

Type IV collagen (BM) = Alports

49
Q

Pt with recurrent Calcium stones. Rx?

A

HCTZ or CITRATE

50
Q

What stones form due to High pH by Proteus infection?

A

Ammonium Mg phosphate = Struvite

51
Q

What is the only stone visible on CT and not X-ray?

A

Uric acid stone = radiolUcent

52
Q

Form in CD due to dec pH and causes Hexagonal crystal formation in children?

A

Cysteine stones

53
Q

Renal cell carcinoma descriptions?

A

PT origination
Lipid/ carb accumulation
Invades Renal vein–> Lung/bone mets
BL in VHL

54
Q

Pt with a mass containing Embryonic glomerular structures, no iris, mental retardation?

A

WAGR (Wilms, Aniridia, GU malformations, Retardation)

55
Q

What are associated with cancers of renal calyces, pelvis, and bladder?

A

Transitional cell = Smoking, Aniline dyes, Phenacetin, Cyclophosphamide

56
Q

Pt with fever, CVA tenderness, vomiting, and WBC casts. What part of kidney is affected?

A

Acute pyelonephritis == CORTEX

57
Q

What is seen with Chronic Pyelonephritis?

A

Corticomedullary scarring
Blunted calyx
Eosinophilic casts (Thyroidization of kidney)

58
Q

Thyroidization and Blunted calyces?

A

Chronic Pyelonephritis

59
Q

Pt with fever, rash, hematuria, CVA tenderness, and eosinophils in urine?

A

Drug induced Interstitial nephritis

60
Q

Kidneys with “Cirrhosis like” fine cortical granulations due to fibrosis and sclerosis?

A

HTN nephrosclerosis

61
Q

Pt with DM/SCD/ pyelonephritis/ chronic Phenacetin use with Gross hematuria?

A

Renal papillary necrosis

62
Q

MCC of acute pyelonephritis and Rx?

A 
MCC = VUR + ascending infection 
Rx = CIPROFLOXACIN
63
Q

What are consequences of Renal failure?

A 
Anemia (low Retic count)
Fibrinous pericarditis (uremia)
Encephalopathy 
Platelet dysfunction
Osteodystrophy
Dyslipidemia (high TGs)
64
Q

What is seen with renal osteodystrophy?

A

Subperiosteal thinning of bones

65
Q

ADPKD associations?

A

Berry-aneurysms
MVP
Benign hepatic cysts

66
Q

Associations with ARPKD?

A

Congenital Hepatic Fibrosis
HTN + Portal HTN
Pottter’s syndrome if In utero failure

67
Q

Two causes of Shrunken kidneys on US?

A 
Adults = CRF 
Child = medullary cystic disease

FA organs HY (11 decks)

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