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Renal Flashcards

0
Q

What is goldblatt’s kidney?

A

Flea-bitten kidney (blown capillaries)

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1
Q

Which part of the nephron concentrates urine?

A

Medulla

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2
Q

What is uremia?

A

Azotemia (increase BUN and creatinine)

Plus symptoms: bleeding, encephalopathy and pericardins

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3
Q

What is azotemia?

A

Renal failure

Increase BUN and creatinine

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4
Q

What is nephritic kidney disease?

A 
Cause:
*Vasculitis
*Hematuria
*Proteinuria
*Hipoalbuminemia
*Edema
Lead to glomerulonephritis
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5
Q

What is nephrotic kidney disease?

A

Cause:

  • Proteinuria
  • Lipiduria
  • Hipoalbuminemia
  • Edema
  • Usually have retention of water and sodium
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6
Q

What is seen in RPGN (rapidly progressive glomerulinephritis)?

A

Crescents

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7
Q

What is post-streptococcal glomerulonephritis?

A

Cause by streptococcus
Subepithelial (skin, throat)
IgG/C3/C4 deposition
Aso ab

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8
Q

What is interstitial nephritis?

A

Urine eosinophils

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9
Q

What is lupus nephritis?

A

Subepithelial

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10
Q

What is MGN (membranoglomerulonephritis)?

A

Deposition

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11
Q

What is MPGN (membranoproliferative glomerulonephritis)?

A

Tram-tracks (Type II has low C3)

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12
Q

What is MCD (minimal change disease)?

A 
Kids
Fused foot processes
No renal failure
Loss of charge barrier
Protein mainly albumin leaks into interstitial space causing edema
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13
Q

What is FSGS (focal segmental glomerulosclerosis)?

A

AA (african american)

HIV pts

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14
Q

What are the vasculitis w/low C3?

A 
"PMS in Salt Lake City"
Post-strep GN
MPGN type II
SBE (subacute bacterial endocarditis)
Serum sickness
Lupus
Cryoglobulinemia
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15
Q

What is the most common cause of kidney stones?

A

Dehydration

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16
Q

What are the most common type of kidney stone?

A

Calcium pyrophosphate

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17
Q

What type of kidney stone have coffin-lid crystals?

A

Triple phosphate

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18
Q

What type of kidney stones have rosette crystals?

A

Uric acid

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19
Q

What type of kidney stones have hexagonal crystals?

A

Cystine

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20
Q

What type of kidney stone have envelope or dumbbell shape crystals?

A

Oxalate

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21
Q

What disease has aniridia (absence of iris)?

A

Wilm’s tumor

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22
Q

What disease has iridocyclitis (inflammation of the iris and ciliary body)?

A

Juvenile rheumatoid arthritis (still’s disease)

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23
Q

What is phimosis?

A

Foreskin scarred at penis head

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24
Q

What is paraphimosis?

A

Foreskin scarred at penis base (retraction of foreskin= strangulates penis)

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25
Q

What is urge incontinence?

A

Urgency leads to complete voiding (small bladder vol.)

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26
Q

What is stress incontinence?

A

Weak pelvic floor muscles (estrogen effect)

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27
Q

What is overflow incontinence?

A

Runs down leg but can’t complete empty bladder

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28
Q

What structures have one-way valves?

A

Urethra

Ejaculatory duct

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29
Q

What structures have fake sphincters?

A

Ureters
LES
Ileocecal valve

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30
Q

What has WBC casts?

A

Nephritis

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31
Q

What has WBC casts only?

A

Pyelonephritis (sepsis)

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32
Q

What has WBC casts + eosinophils?

A

Interstitial nephritis (allergies)

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33
Q

What has WBC casts + RBC casts?

A

Glomerulonephritis

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34
Q

What has fat casts?

A

Nephrotic syndrome

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35
Q

What has waxy casts?

A

Chronic renal failure

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36
Q

What has tubular casts?

A

ATN (acute tubular necrosis)

37
Q

What has muddy brown casts?

A

ATN (acute tubular necrosis)

38
Q

What has hyaline casts?

A

Normal sloughing

39
Q

What has epithelial casts?

A

Normal sloughing

40
Q

What has crescents?

A

RPGN (rapid progressive glomerulonephritis)

41
Q

How do you measure afferent renal function?

A

Creatinine or inulin

42
Q

What is the normal amount of urine in 24hrs?

A

800-2,000 ml

1.5 L

43
Q

What is the amount of kidney filtration per minute?

44
Q

How do you measure efferent renal function?

A

BUN or PAH

45
Q

What is the afferent arteriole’s job?

46
Q

What is the efferent arteriole’s job?

47
Q

How do you test afferent arteriole function?

48
Q

How do you test efferent arteriole function?

49
Q

What is pre-renal failure?

A

Low flow to kidney (BUN:Cr>20)

50
Q

What is renal failure?

A

Damage glomerulus (BUN:Cr<20)

51
Q

What is post-renal failure?

A

Obstruction (haven’t peed in last 4 days)

52
Q

What is the job of the proximal tubule?

A

Reabsorb glucose, aa, salt and bicarbonate

53
Q

What is the job of the thin ascending limb?

A

Reabsorbs water

54
Q

What is the job of the thick ascending limb?

A

Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water

55
Q

What is the job of the early distal tubule?

A

Concentrate urine by reabsorbing NaCl (hypotonic)

56
Q

What is the job of the late distal tubule and collecting duct?

A

Final concentration of urine by reabsorbing water, excretion of acid (isotonic)

57
Q

What does the macula densa do?

A

Measures osmolarity

58
Q

What does the J-G apparatus do?

A

Measures volume

59
Q

What is fanconi’s syndrome?

A

Old tetracycline use= urine phosphates, glucose, aa

60
Q

What is bartter’s syndrome?

A

Baby w/ defective triple transporter (low Na, Cl, K w/ normal BP)

61
Q

What is psychogenic polydipsia?

A

No concentrating ability= cerebral edema

62
Q

What is hepatorenal syndrome?

A

High urea from liver= increase glutaminase= NH4+= GABA= kidney stops working

63
Q

What is type 1 RTA?

A

Distal renal tubular acidosis: H/K in CD is broken= high urine pH (UTI, stones, Li)

64
Q

What is type 2 RTA?

A

Proximal RTA: bad CA (carbonic anhydrase)= lost all bicarb= high urine pH (multiple myeloma)

65
Q

What is type 3 RTA?

A

RTA I + II= normal urine pH (5-6)

66
Q

What is type 4 RTA?

A

Infart J-G= no renin= no aldo= high K (DM, NSAIDs, ACE-I, Heparin)

67
Q

What is central pontine myelinolysis?

A

Due to correcting Na faster than 0.5 mEq/hr

68
Q

What is MetHb?

A

Hb w/ Fe 3+ (ferric ion)

69
Q

What is acute intermittent porphyria?

A

Increase porphyrin, urine alpha-ALA, porphobilinogen= abdominal pain, neuropathy, red urine

70
Q

What is porphyria cutanea tarda?

A

Sunlight= skin blister w/ porphyrin deposits,

wood’s lamp= orange-pink

71
Q

What is erythrocytic protoporphyria?

A

Porphyria cutanea tarda in a baby

72
Q

What is sickle cell disease?

A

Homozygous HbS: (beta glu6-val)= vaso-occlusion, necrosis, dactyliti (painful fingers/toes) at 6mo, protects against malaria

73
Q

What is sickle cell trait?

A

Heterozygous HbS= painless hematuria, sickle with extreme hypoxia

74
Q

What is HbC disease?

A

(Beta glu6-Lys), still charged= no sickling

75
Q

What is alpha-thalassemia?

A
  • Chromosome 16 deletion
  • Most common mendelian recessive

1 deletion: normal
2 deletions “trait”: microcytic anemia
3 deletions: hemolytic anemia, Hb H=beta 4
4 deletions: hydrops fetalis (cause edema in the fetus)

76
Q

What is beta-thalassemia?

A

*1 deletion “beta minor”: increase HbA2 and HbF
*2 deletions “trait/intermedia/major”: only HbA2 and HbF
= hypoxia at 6 months

77
Q

What is cooley’s anemia?

A

See w/beta thalassemia major (no HbA= excess RBC production), baby making blood from everywhere= frontal bossing, hepatosplenomegaly and long extremities.

78
Q

What is virchow’s triad?

A

Thrombosis risk factors:

  1. Turbulent blood flow “slow”
  2. Hypercoagulable “sticky”
  3. Vessel wall damage “escapes”
79
Q

What does acute hypoxia cause?

A

Shortness of breath

80
Q

What does chronic hypoxia cause?

A

Clubbing of fingers/ toes

81
Q

What is intravascular hemolysis?

A

RBC destroyed in blood- low haptoglobin (binds free floating Hb)

82
Q

What is extravascular hemolysis?

A

RBC destroyed in spleen (problem w/ RBC membrane)= splenomegaly

83
Q

What enzymes need lead (Pb)?

A

Gamma-ALA dehydrase

Ferrochelatase

84
Q

What does EDTA bind?

85
Q

What disease has a smooth philthrum?

A

Fetal alcohol syndrome

86
Q

What disease has a long philthrum?

A

William’s disease

87
Q

What disease has sausage digits?

A

Pseudo-hypoparathyroidism, psoriatic arthritis

88
Q

What disease has 6 fingers?

A

Trisomy 13 (Patau syndrome)

89
Q

What disease has 2-jointed thumbs?

A

Diamond-blackfan

90
Q

What disease has painful fingers?

A

Sickle cell disease

91
Q

What are the microcytic hypochromic anemias?

A

“FAST Lead”:

  • Fe deficiency
  • Anemia of chronic disease
  • Sideroblastic anemia
  • Alpha-thalassemia
  • Beta-thalassemia
  • Pb poisoning

PP Clues (6 decks)

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