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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
Q

tetany

A

hypocalcemia, hypomagnesia

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26
Q

arrythmias

A

hypo/hyper K, hypomagnesia

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27
Q

decreased deep tendon reflexes

A

hypermagnesia

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28
Q

flattened T waves, U waves on EKG

A

hypokalemia

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29
Q

diagnostic features of DI

A

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

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30
Q

factors cause hyperkalemia

A 
Digitalis
B antagonists
acidoses
decreased insulin
hyperosmolariy
cell lysis
ACE inhibitors and K sparing
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31
Q

factors cause hypokalemia

A 
increased insulin
B agonists
alkalosis
hyposmolarity
cell proliferation
loop
32
Q

emergency treatment of hyperkalemia

A

B agonist
IV dextrose then IV insulin
IV bicarb

33
Q

treatment for central DI

A

desmopressin

34
Q

treatment for nephrogenic DI

A

HCTZ, indomethacin, amiloride

35
Q

treatment for lithium-induced nephrogenic DI

A

amiloride

36
Q

high anion gap metabolic acidosis

A 
MUDPILES
methanol
uremia
diabetic ketoacidosis
propylene glycol
iron tablets or INH
lactic acidosis
ethylene glycol
salicylates (late)
37
Q

Renal tubular acidosis

A 
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
Q

determining acid base problems

A

bicarb follows pH in metabolic causes

pCO2 is opposite pH in respiratory causes

39
Q

CSF changes in Guillain-Barre

A

albumino-cytologic dissociation

increased protein with normal cell counts

40
Q

rash on palms and soles

A

secondary syphilis
rocky mountain spotted fever
coxsackie A virus
kawasaki disease

41
Q

features of nephrotic syndrome

A

proteinuria > 3.5 g/day
hypoalbuminemia
peripheral edema

42
Q

glomerular histology reveals multiple mesangial nodules

A

diabetic nephropathy

43
Q

linear patterns of IgG deposition on IF

A

Goodpasture syndrome

44
Q

lumpy-bumpy deposits of IgG, IgM, and C3 in the mesangium

A

poststreptococcal glomerulonephritis

45
Q

deposits of IgA in the mesangium

A

IgA nephropathy (Berger’s)

46
Q

anti-GBM antibodies, hematuria, hemoptysis

A

Goodpasture syndrome

47
Q

nephritis, deafness, cataracts

A

Alport syndrome

48
Q

crescent formation in glomeuli

A

rapidly progressive glomerulonephritis

49
Q

wire-loop appearance on EM

A

lupus nephritis

50
Q

most common nephrotic syndrome in children

A

minimal change disease

51
Q

most common nephrotic syndrome in adults

A

focal segmental glomerulosclerosis (FSGS)

52
Q

Kimmelstiel-Wilson lesions (nodular glomerulosclerosis)

A

diabetic nephropathy

53
Q

EM: effacement of epithelial foot processes

A

minimal change disease

54
Q

nephrotic syndrome associated with hepatitis B

A

membrano-proliferative glomerulonephritis (MPGN)

55
Q

nephrotic syndrome associated with HIV

A

FSGS

56
Q

EM: subendothelial humps and tram-track appearance

A

membrano-proliferative glomerulonephritis (MPGN)

57
Q

LM: segmental sclerosis and hyalinosis

A

FSGS

58
Q

purpura on back of arms and legs, abdominal pain, IgA nephropathy

A

Henoch-Schonlein purpura

59
Q

apple-green birefringence with Congo-red stain

A

Amyloidosis

60
Q

EM: spiking of the GBM due to electron dense subepithelial deposits

A

membranous nephropathy

61
Q

nodular hyaline deposits in the glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

62
Q

glomerulonephritis plus pulmonary vasculitis

A

granulomatosis with polyangitis (Wegener’s)

or Goodpasture Syndrome

63
Q

WAGR complex

A

Wilm’s tumor
aniridia (no iris)
genitourinary malformation
mental/motor retardation

64
Q

risk factors for transitional cell carcinoma

A

smoking, aniline dyes, cyclophosphamide

65
Q

classic features of drug-induced acute interstitial nephritis

A

fever, rash, hematuria, CVA tenderness
eosinophilia
azotemia

66
Q

what changes will be seen in a BMP in a pt with renal failure

A

hyperkalemia
hypocalcemia
increased BUN and Cr

67
Q

most common tumor of the urinary tract

A

transitional cell carcinoma

68
Q

most common renal malignancy of early childhood

A

Wilm’s tumor

69
Q

fever, rash, hematuria and eosinophilia

A

acute interstitial nephritis

70
Q

red cell casts

A

acute glomerulonephritis

71
Q

waxy casts

A

chronic renal failure

72
Q

thyroid-like appearance of kidney

A

chronic pyelonephritis

73
Q

most common renal tumor

A

renal cell carcinoma

74
Q

most common type of renal stone

A

calcium

75
Q

type of renal stone associated with Proteus vulgaris (also Klebsiella)

A

struvite stones (staghorn calculi)

76
Q

drugs that cause acute tubular necrosis

A

aminoglycosides, cephalosporins, polymyxins

77
Q

BUN/Cr >20 with decreased RBF

A

prerenal azotemia

DIT (28 decks)

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