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Elliot Step 1 > Renal > Flashcards

Renal Flashcards

1
Q

Plasma volume measured by?

A

Albumin

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2
Q

Extracellular volume measured by?

A

Inulin

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3
Q

Negative charge on glomerular bm?

A

Heparan sulfate (lost in nephrotic syndrome)

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4
Q

Sodium correction for glucose?

A

(glucose-100)/100) *1.6= +sodium

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5
Q

Filtration fraction?

A

GFR/RPF

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6
Q

Normal FF?

A

20%

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7
Q

Renal plasma flow is best estimated using?

A

PAH (measures renal plasma flow)

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8
Q

Deficiency in neutral amino acid (tryptophan) transporter?

A

Hartnup’s disease– results in pellagra

Should never see amino acids in urine– amino acids are absorbed by sodium dependent transporters in proximal tubule

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9
Q

Causes of pellagra?

A

Dec niacin or tryptophan– why tryptophan? because the body converts tryptophan into niacin

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10
Q

Sodium is absorbed with…….in the early PCT? and …… in the late PCT?

A

Bicarb

Cl-

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11
Q

Describe AII and contraction alkalosis?

A

AII acts on the PCT to absorb Na– which in turn secretes H+– Bicarb is absorbed when H+ is secreted–>metabolic alkalosis (i.e. contraction alkalosis)

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12
Q

Part of nephron that is impermeable to water?

A

Thick ascending limb– absorbs 10-20%

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13
Q

Difference between thiazide and loop diuretics with regard to calcium?

A

Thiazides increase calcium

Loops decrease calcium

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14
Q

Tetany and arrhythmia caused by which electrolyte imbalance?

A

Low serum Magnesium

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15
Q

opioids? alk or acid?

A

Respiratory acidosis

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16
Q

Spironolactone– acidemia or alkalosis?

A

Metabolic acidosis

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17
Q

Salicylates– alk or acid?

A

Respiratory alkalosis

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18
Q

Loop diuretics– alk or acid?

A

Metabolic alkalosis

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19
Q

Hyperaldosteronism– alk or acid?

A

Metabolic alkalosis

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20
Q

RBC cast ddx?

A

Glomerulonephritis; ischemia or malignant htn

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21
Q

WBC casts?

A

Tubulointerstitial inflammation; acute pyelonpehritis; transplant rejection

i.e. infection or inflammation

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22
Q

RBC casts may have which protein?

A

Tamm horsefall protein

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23
Q

Fatty casts (oval fat bodies)

A

Nephrotic syndrome

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24
Q

Granular/muddy brown casts?

A

Acute tubular necrosis

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25
Q

Waxy casts?

A

Advanced renal disease/chronic renal failure

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26
Q

Hyaline casts?

A

Nonspecific– can be normal finding

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27
Q

Common to see what type of cells in urine?

A

Epithelial cells

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28
Q

Pt. presents with proteinuria, fatty casts and edema– what would you expect on blood labs?

A

Hypoaggamablobulinemia and hyperlipidemia and hypoalbuminemia

Increased risk of infection due to hypoagammaglobulinemia

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29
Q

MCC of nephrotic syndrome in adults?

A

Focal segmental glomerulosclerosis– no immune complexes

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30
Q

EM shows effacement of foot processes; poor response to steroids?

A

Focal segmental glomerulosclerosis

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31
Q

Spike and dome appearance with subepithelial deposits of IgG and C3? causes?

A

Membranous nephropathy (nephrotic)
Granular on IF
Drugs, infection, sle, idiopathic

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32
Q

Foot process effacement; loss of albumin but not globulins?

A

Minimal change disease– usually follows infection. Responds well to corticosteroids
Dec IgG and inc IgM

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33
Q

DDX of amyloidosis?

A

Multiple myeloma; TB; RA

34
Q

Subendothelial IC deposits with granular IF; tramtrack appearance due to splitting of mesangial ingrowth? What is this associated with?

A

Membranoproliferative glomerulonephritis type 1– associated with HBV and HCV

35
Q

Intramembranous IC deposits; dense deposits; dec C3?

A

Membranoproliferative glomerulonephritis type 2

36
Q

Resorptive defect in PCT assoc with increased excretion of all amino acids?

A

Fanconi– metabolic acidosis

37
Q

Resorptive defect in TAL?

A

Barterr syndrome–hypokalemia; met alkalosis and hypercalceuria

38
Q

Subepithelial humps?

A

Acute poststrep– neutrophils in humps

39
Q

Granular appearance ddx?

A

Acute strep; diffuse proliferative; membranous

40
Q

LM wire looping of capillaries?

A

Diffuse proliferative

41
Q

Staghorn caliculi?

A

Ammonium magnesium phosphate aka struvite crystals

42
Q

Radiolucent crystals on xray?

A

Uric acid– lemon drop shape

43
Q

Lemon drop shape crystals?

A

Uric acid– seen with diseases of high cell turnover

44
Q

Hexagonal crystals?

45
Q

Painless hematuria with no casts for male?

A

suggests bladder cancer

46
Q

Transitional cell carcinoma assoc with?

A

Pee SAC

Phenacetin; smoking; aniline dyes; and cyclophosphamide

47
Q

Subendothelial humps?

A

Lupus nephritis (diffuse progressive)( and membranoproliferative

48
Q

Where are IgA deposits in kidney?

49
Q

Brown granular casts– dead epithelial cells?

A

Acute tubular necrosis

50
Q

Rash, fever, kidney disease?

A

Acute interstitial nephritis– inflammatory infiltrate– eosinophils in urine, may lead to papillary necrosis

51
Q

Fatty casts?

A

Nephrotic syndrome

52
Q

FSGS– IF?

A

Nothing– NO immune complexes

53
Q

Spike and dome?

A

Membranous– thick glomerular BM dt immune complexes

54
Q

Granular IF?

A

Immune complexes eg Membranous, membranoproliferative; Post streptococcul; diffuse proliferative

55
Q

Tram tracks?

A

Membranoproliferative

56
Q

What do you see in nephritic syndrome (glomerulus?)

A

Hypercellular inflamed glomerulus

57
Q

Difference between Wegeners and Good pastures?

A

Nasopharynx involvement in Wegeners and no IF because no immune complexes

58
Q

Pathology of chronic pyelonephritis?

A

Cortical scarring and blunted calyces

59
Q

Pyuria with negative urine cultures?

A

urithritis dt chlamydia and neisseria

60
Q

Contraction alkalosis

A

ATII stimulates Na/H exchange–>inc Na and HCO3

61
Q

PTH acts proximally and distally– what does it do in each instance?

A

Proximally it inhibits Na/phosphate

Distally it enhances Ca/Na exchange–>Ca reabsorption

62
Q

Distal tubule is impermeable to urea

63
Q

principal cells

A

enhances Na/K pump— i.e. secretes K and H

64
Q

erythropoietin released by

A

interstitial cells in peritugbular capillary bed in response to hypoxia

65
Q

Low K?

66
Q

High K?

A

wide QRS and peaked T waves

67
Q

stones bones groans and psychiatric overtones

A

HYPERCALCEMIA

68
Q

Electrolye that will cause Decreased DTR in excess?

69
Q

Renal tubular acidosis are associated with

A

Hypokalemia except 4 which causes hyperkalemia dt decreased aldosterone or lack of response to aldosterone

Remember: type 2 has decreased urine despite being a tubular acidosis

70
Q

Eosinophilic nodular glomerulosclerosis

A

kimmelstiel wilson lesions

71
Q

Upper respiratory tract infection; IgA deposition; gastroenteritis

A

henoch schonlein or bergers disease

72
Q

treatment for calcium stones

A

HCTZ and CITRATES

73
Q

RCC spread to?

A

lung and bone

74
Q

common bugs of pyelonephritis?

A

Enterobacter faecalis; kleb; ecoli

75
Q

eosinophilic casts (thyroidization of kidney)

A

chronic pyelonephritis

76
Q

3 stages of ATN

A

1) inciting event
2) Maintenance phase– oliguric 1-3 weeks; risk of hyperkalemia
3) Recovery phase– polyuric, bun and creatinine fall; risk of hypokalemia

77
Q

Used to treat pseudotumor cerebri

A

acetazolamide

78
Q

Furosemide effect on afferent arteriole?

A

stimulates PGE release

79
Q

toxicity of furosemide

A

OH DANG

ototoxic; hypokalemic; dehydration; allergy; nephritis; GOUT

80
Q

Side effects of Ace inhibitors

A

CATCHH

cough, angioedema, Teratogen, Creatinine increase; HYPERkalemia; hypotension

Elliot Step 1 (32 decks)

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