Renal Flashcards
0
Q
What is goldblatt’s kidney?
A
Flea-bitten kidney (blown capillaries)
1
Q
Which part of the nephron concentrates urine?
A
Medulla
2
Q
What is uremia?
A
Azotemia (increase BUN and creatinine)
Plus symptoms: bleeding, encephalopathy and pericardins
3
Q
What is azotemia?
A
Renal failure
Increase BUN and creatinine
4
Q
What is nephritic kidney disease?
A
Cause: *Vasculitis *Hematuria *Proteinuria *Hipoalbuminemia *Edema Lead to glomerulonephritis
5
Q
What is nephrotic kidney disease?
A
Cause:
- Proteinuria
- Lipiduria
- Hipoalbuminemia
- Edema
- Usually have retention of water and sodium
6
Q
What is seen in RPGN (rapidly progressive glomerulinephritis)?
A
Crescents
7
Q
What is post-streptococcal glomerulonephritis?
A
Cause by streptococcus
Subepithelial (skin, throat)
IgG/C3/C4 deposition
Aso ab
8
Q
What is interstitial nephritis?
A
Urine eosinophils
9
Q
What is lupus nephritis?
A
Subepithelial
10
Q
What is MGN (membranoglomerulonephritis)?
A
Deposition
11
Q
What is MPGN (membranoproliferative glomerulonephritis)?
A
Tram-tracks (Type II has low C3)
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
13
Q
What is FSGS (focal segmental glomerulosclerosis)?
A
AA (african american)
HIV pts
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
15
Q
What is the most common cause of kidney stones?
A
Dehydration
16
Q
What are the most common type of kidney stone?
A
Calcium pyrophosphate
17
Q
What type of kidney stone have coffin-lid crystals?
A
Triple phosphate
18
Q
What type of kidney stones have rosette crystals?
A
Uric acid
19
Q
What type of kidney stones have hexagonal crystals?
A
Cystine
20
Q
What type of kidney stone have envelope or dumbbell shape crystals?
A
Oxalate
21
Q
What disease has aniridia (absence of iris)?
A
Wilm’s tumor
22
Q
What disease has iridocyclitis (inflammation of the iris and ciliary body)?
A
Juvenile rheumatoid arthritis (still’s disease)
23
Q
What is phimosis?
A
Foreskin scarred at penis head
24
What is paraphimosis?
Foreskin scarred at penis base (retraction of foreskin= strangulates penis)
25
What is urge incontinence?
Urgency leads to complete voiding (small bladder vol.)
26
What is stress incontinence?
Weak pelvic floor muscles (estrogen effect)
27
What is overflow incontinence?
Runs down leg but can't complete empty bladder
28
What structures have one-way valves?
Urethra
| Ejaculatory duct
29
What structures have fake sphincters?
Ureters
LES
Ileocecal valve
30
What has WBC casts?
Nephritis
31
What has WBC casts only?
Pyelonephritis (sepsis)
32
What has WBC casts + eosinophils?
Interstitial nephritis (allergies)
33
What has WBC casts + RBC casts?
Glomerulonephritis
34
What has fat casts?
Nephrotic syndrome
35
What has waxy casts?
Chronic renal failure
36
What has tubular casts?
ATN (acute tubular necrosis)
37
What has muddy brown casts?
ATN (acute tubular necrosis)
38
What has hyaline casts?
Normal sloughing
39
What has epithelial casts?
Normal sloughing
40
What has crescents?
RPGN (rapid progressive glomerulonephritis)
41
How do you measure afferent renal function?
Creatinine or inulin
42
What is the normal amount of urine in 24hrs?
800-2,000 ml
| 1.5 L
43
What is the amount of kidney filtration per minute?
125 ml
44
How do you measure efferent renal function?
BUN or PAH
45
What is the afferent arteriole's job?
Filter
46
What is the efferent arteriole's job?
Secrete
47
How do you test afferent arteriole function?
GFR
48
How do you test efferent arteriole function?
RPF
49
What is pre-renal failure?
Low flow to kidney (BUN:Cr>20)
50
What is renal failure?
Damage glomerulus (BUN:Cr<20)
51
What is post-renal failure?
Obstruction (haven't peed in last 4 days)
52
What is the job of the proximal tubule?
Reabsorb glucose, aa, salt and bicarbonate
53
What is the job of the thin ascending limb?
Reabsorbs water
54
What is the job of the thick ascending limb?
Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water
55
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl (hypotonic)
56
What is the job of the late distal tubule and collecting duct?
Final concentration of urine by reabsorbing water, excretion of acid (isotonic)
57
What does the macula densa do?
Measures osmolarity
58
What does the J-G apparatus do?
Measures volume
59
What is fanconi's syndrome?
Old tetracycline use= urine phosphates, glucose, aa
60
What is bartter's syndrome?
Baby w/ defective triple transporter (low Na, Cl, K w/ normal BP)
61
What is psychogenic polydipsia?
No concentrating ability= cerebral edema
62
What is hepatorenal syndrome?
High urea from liver= increase glutaminase= NH4+= GABA= kidney stops working
63
What is type 1 RTA?
Distal renal tubular acidosis: H/K in CD is broken= high urine pH (UTI, stones, Li)
64
What is type 2 RTA?
Proximal RTA: bad CA (carbonic anhydrase)= lost all bicarb= high urine pH (multiple myeloma)
65
What is type 3 RTA?
RTA I + II= normal urine pH (5-6)
66
What is type 4 RTA?
Infart J-G= no renin= no aldo= high K (DM, NSAIDs, ACE-I, Heparin)
67
What is central pontine myelinolysis?
Due to correcting Na faster than 0.5 mEq/hr
68
What is MetHb?
Hb w/ Fe 3+ (ferric ion)
69
What is acute intermittent porphyria?
Increase porphyrin, urine alpha-ALA, porphobilinogen= abdominal pain, neuropathy, red urine
70
What is porphyria cutanea tarda?
Sunlight= skin blister w/ porphyrin deposits,
| wood's lamp= orange-pink
71
What is erythrocytic protoporphyria?
Porphyria cutanea tarda in a baby
72
What is sickle cell disease?
Homozygous HbS: (beta glu6-val)= vaso-occlusion, necrosis, dactyliti (painful fingers/toes) at 6mo, protects against malaria
73
What is sickle cell trait?
Heterozygous HbS= painless hematuria, sickle with extreme hypoxia
74
What is HbC disease?
(Beta glu6-Lys), still charged= no sickling
75
What is alpha-thalassemia?
* 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
What is beta-thalassemia?
*1 deletion "beta minor": increase HbA2 and HbF
*2 deletions "trait/intermedia/major": only HbA2 and HbF
= hypoxia at 6 months
77
What is cooley's anemia?
See w/beta thalassemia major (no HbA= excess RBC production), baby making blood from everywhere= frontal bossing, hepatosplenomegaly and long extremities.
78
What is virchow's triad?
Thrombosis risk factors:
1. Turbulent blood flow "slow"
2. Hypercoagulable "sticky"
3. Vessel wall damage "escapes"
79
What does acute hypoxia cause?
Shortness of breath
80
What does chronic hypoxia cause?
Clubbing of fingers/ toes
81
What is intravascular hemolysis?
RBC destroyed in blood- low haptoglobin (binds free floating Hb)
82
What is extravascular hemolysis?
RBC destroyed in spleen (problem w/ RBC membrane)= splenomegaly
83
What enzymes need lead (Pb)?
Gamma-ALA dehydrase
| Ferrochelatase
84
What does EDTA bind?
X2+
85
What disease has a smooth philthrum?
Fetal alcohol syndrome
86
What disease has a long philthrum?
William's disease
87
What disease has sausage digits?
Pseudo-hypoparathyroidism, psoriatic arthritis
88
What disease has 6 fingers?
Trisomy 13 (Patau syndrome)
89
What disease has 2-jointed thumbs?
Diamond-blackfan
90
What disease has painful fingers?
Sickle cell disease
91
What are the microcytic hypochromic anemias?
"FAST Lead":
* Fe deficiency
* Anemia of chronic disease
* Sideroblastic anemia
* Alpha-thalassemia
* Beta-thalassemia
* Pb poisoning
