Renal 2b

Question 1

What is the primary cause of hypercalcemia in outpatients? Inpatients?

Answer 1

Hyperparathyroidism.

Malignancy (multiple myeloma)

Question 2

What is the pneumonic for hypercalcemia symptoms?

Answer 2

Stones, Groans, Thrones and Psychic Overtones.

Question 3

What drug can treat hypercalcemia?

Answer 3

Loop diuretics (lasix) and IVF.

“Loops Lose Calcium”

Question 4

What are 3 signs of hypocalcemia?

Answer 4

a. perioral numbness
b. tetany
c. Chvostek sign (abnormal reaction to facial stimulation)

Question 5

What are 3 causes of hypocalcemia?

Answer 5

a. thyroidectomy… the parathyroid is removed by accident.
b. post-transfusion: citrate and Ca++ bind, effective low Ca++
c. low D = low Ca++

Question 6

What can be a cause of low D?

Answer 6

renal failure.

Question 7

What can be a cause of low D?

Answer 7

renal failure.

Question 8

How does spironolactone work?

Answer 8

It competitively binds to aldosterone receptors knocking them out.

Question 9

How does spironolactone work?

Answer 9

It competitively binds to aldosterone receptors knocking them out.

Question 10

Where do the kidneys and ureters come from?

Answer 10

intermediate mesoderm

Question 11

Where does the bladder come from?

Answer 11

endoderm (cloaca)

Question 12

What does metanephric kidney development begin/end?

Answer 12

Week 4 to week 36.

Question 13

What is the metanephric kidney rudiment composed?

Answer 13

the ureteric bud and metanephric mesenchyme.

Question 14

What two things have a very important reciprocal relationship that is essential for their development?

Answer 14

a. ureteric bud

b. metanephric mesenchyme

Question 15

What ureteric bud gives rise to what?

Answer 15

a. renal collecting system
b. renal pelvis
c. calyces
d. ureter

Question 16

The metanephric mesenchyme gives rise to what?

Answer 16

a. nephron segments
b. renal corpuscle
c. DCT

Question 17

What is the definition of CAKUT?

Answer 17

correlation of UT defects with stages of UT development.

Question 18

How can thiazide help with kidney stones?

Answer 18

It reduces the amount of Ca++ in the urine.

Question 19

What are the consequences of renal failure?

Answer 19

MAD HUNGER
-Metabolic 
Acidosis
-Dyslipidemia (especially triglycerides)
-Hyperkalemia
-Uremia (nausea, anorexia, pericarditis, encephalopathy)
-Na/H2O retention
-Growth retardation
-Erythropoietin failure
-Renal osteodystrophy

Question 20

How do Ca and Mg get into the cell in the proximal tubule?

Answer 20

paracellular

Question 21

How do Ca and Mg get into the cell in the TALH?

Answer 21

paracellular

Question 22

How do Ca and Mg get into the cell in the distal nephron?

Answer 22

Apical side: channels

Basolateral: Na/Ca exchang (ATP), Ca-ATPase, and unknown Mg transporter.