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DIT > Renal > Flashcards

Renal Flashcards

1
Q

stimuli that induce renin release

A

B-adrenergic stimulation (sympathetic tone)
low Na in DCT (macula densa)
low pressure in afferent arteriole

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2
Q

body water

A

60% body weight

1/3 extracellular, 1/4 of that is plasma

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3
Q

glomerular filtration barrier

A

fenestrated capillary epithelium
BM with heparan sulfate (- charge)
podocyte foot processes

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4
Q

Renal formulas

A 
CL=UV/P
GFR=UV/P (inulin or creatinine)
RPF=UP/V (PAH)
Filtration fraction=GFR/RPF
Filtered load=GFR*Px
Excretion rate=V*Ux
Reabsorption=filtered-excreted
Secretion=excreted-filtered
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5
Q

effect of NSAIDS on kidney

A 
inhibit PG (normally dilate afferent arterioles)
so constrict afferent arteriole:
decreases RBF and GFR, so FF stays the same
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6
Q

site of excretion of organic anions and cations

A

PCT

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7
Q

site of isotonic fluid reabsorption

A

PCT

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8
Q

gout+intellectual disability+lip-biting

A

Lesch-Nyhan syndrome

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9
Q

Psammoma bodies

A

Papillary adenocarcinoma of thyroid
serous cystadenocarcinoma of ovary
meningioma
mesothelioma

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10
Q

function of distal tubule

A

Principal cells: reabsorb H2O and Na
secrete K
Intercalated: secrete H or HCO
reabsorb K

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11
Q

two types of intercalated cells

A

alpha (a cells): secrete H ions

beta (B cells): secrete HCO3

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12
Q

effect of aldosterone on collecting duct

A

principal cells: increase reabsorption of Na and secretion of K
intercalated: increases secretion of H

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13
Q

acute pulmonary edema

A

loop diuretic

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14
Q

idiopathic hypercalciuria (calcium stones)

A 
thiazide
avoid loop (increase Ca excretion)
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15
Q

glaucoma

A

mannitol or acetazolamide

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16
Q

mild to moderate CHF with expanded ECV

A

loop

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17
Q

conjunction with loop or thiazide to spare K

A

K sparing

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18
Q

edema associated with nephrotic syndrome

A

loop

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19
Q

increased intracranial pressure

A

mannitol

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20
Q

mild to moderate HTN

A

thiazide

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21
Q

hypercalcemia

A

loop

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22
Q

hyperaldosteronism

A

spironolactone or eplerenone (ald antagonists)

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23
Q

heart failure pt with sulfa allergy

A

ethacrynic acid

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24
Q

peaked t waves

A

hyperkalemia

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25
tetany
hypocalcemia, hypomagnesia
26
arrythmias
hypo/hyper K, hypomagnesia
27
decreased deep tendon reflexes
hypermagnesia
28
flattened T waves, U waves on EKG
hypokalemia
29
diagnostic features of DI
polyuria decreased SG and osmolarity of urine water deprivation test: no increase in urine osmolarity desmopressin: central if urine osmolarity increases nephrogenic if urine osmolarity stays the same
30
factors cause hyperkalemia
``` Digitalis B antagonists acidoses decreased insulin hyperosmolariy cell lysis ACE inhibitors and K sparing ```
31
factors cause hypokalemia
``` increased insulin B agonists alkalosis hyposmolarity cell proliferation loop ```
32
emergency treatment of hyperkalemia
B agonist IV dextrose then IV insulin IV bicarb
33
treatment for central DI
desmopressin
34
treatment for nephrogenic DI
HCTZ, indomethacin, amiloride
35
treatment for lithium-induced nephrogenic DI
amiloride
36
high anion gap metabolic acidosis
``` MUDPILES methanol uremia diabetic ketoacidosis propylene glycol iron tablets or INH lactic acidosis ethylene glycol salicylates (late) ```
37
Renal tubular acidosis
``` type 1 (distal): decreased H excretion, pH>5.5 and increased Ca stones, hypokalemia type 2 (proximal): decreased HCOs reabsorption, pH5.5, decreased aldo response ```
38
determining acid base problems
bicarb follows pH in metabolic causes | pCO2 is opposite pH in respiratory causes
39
CSF changes in Guillain-Barre
albumino-cytologic dissociation | increased protein with normal cell counts
40
rash on palms and soles
secondary syphilis rocky mountain spotted fever coxsackie A virus kawasaki disease
41
features of nephrotic syndrome
proteinuria > 3.5 g/day hypoalbuminemia peripheral edema
42
glomerular histology reveals multiple mesangial nodules
diabetic nephropathy
43
linear patterns of IgG deposition on IF
Goodpasture syndrome
44
lumpy-bumpy deposits of IgG, IgM, and C3 in the mesangium
poststreptococcal glomerulonephritis
45
deposits of IgA in the mesangium
IgA nephropathy (Berger's)
46
anti-GBM antibodies, hematuria, hemoptysis
Goodpasture syndrome
47
nephritis, deafness, cataracts
Alport syndrome
48
crescent formation in glomeuli
rapidly progressive glomerulonephritis
49
wire-loop appearance on EM
lupus nephritis
50
most common nephrotic syndrome in children
minimal change disease
51
most common nephrotic syndrome in adults
focal segmental glomerulosclerosis (FSGS)
52
Kimmelstiel-Wilson lesions (nodular glomerulosclerosis)
diabetic nephropathy
53
EM: effacement of epithelial foot processes
minimal change disease
54
nephrotic syndrome associated with hepatitis B
membrano-proliferative glomerulonephritis (MPGN)
55
nephrotic syndrome associated with HIV
FSGS
56
EM: subendothelial humps and tram-track appearance
membrano-proliferative glomerulonephritis (MPGN)
57
LM: segmental sclerosis and hyalinosis
FSGS
58
purpura on back of arms and legs, abdominal pain, IgA nephropathy
Henoch-Schonlein purpura
59
apple-green birefringence with Congo-red stain
Amyloidosis
60
EM: spiking of the GBM due to electron dense subepithelial deposits
membranous nephropathy
61
nodular hyaline deposits in the glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
62
glomerulonephritis plus pulmonary vasculitis
granulomatosis with polyangitis (Wegener's) | or Goodpasture Syndrome
63
WAGR complex
Wilm's tumor aniridia (no iris) genitourinary malformation mental/motor retardation
64
risk factors for transitional cell carcinoma
smoking, aniline dyes, cyclophosphamide
65
classic features of drug-induced acute interstitial nephritis
fever, rash, hematuria, CVA tenderness eosinophilia azotemia
66
what changes will be seen in a BMP in a pt with renal failure
hyperkalemia hypocalcemia increased BUN and Cr
67
most common tumor of the urinary tract
transitional cell carcinoma
68
most common renal malignancy of early childhood
Wilm's tumor
69
fever, rash, hematuria and eosinophilia
acute interstitial nephritis
70
red cell casts
acute glomerulonephritis
71
waxy casts
chronic renal failure
72
thyroid-like appearance of kidney
chronic pyelonephritis
73
most common renal tumor
renal cell carcinoma
74
most common type of renal stone
calcium
75
type of renal stone associated with Proteus vulgaris (also Klebsiella)
struvite stones (staghorn calculi)
76
drugs that cause acute tubular necrosis
aminoglycosides, cephalosporins, polymyxins
77
BUN/Cr >20 with decreased RBF
prerenal azotemia

DIT (28 decks)

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