Renal Flashcards
Patient has cyanotic toe discoloration and renal failure following invasive procedure? What do you think about?
Atheroembolic disease of renal arteries. Cholesterol-containing debris get pushes from larger arteries to basically kidneys or smaller one. Light microscopy will show cholesterol emboli.
Sodium nitroprusside added to urine with kid having multiple kidney stones. What abnormality will you likely see?
aminoaciduria. cysteine problem. the sodium cyanide-nitroprusside tests checks for cystine’s sulfhydrl groups.
What does the L kidney lie immediately left up rib wise?
12th
Where does potassium absorption happen?
2/3 in proximal, a little more in loop of Henle. collecting duct is primary site of K regulation
In tumor lysis syndrome, where does urin acid precipitate? How do you prevent it?
In the collecting duct. Low pH. High urine flow and high pH prevents it. So alkalinize the urine.
What diuretic do you give to CHF patients?
Spironolactone
In the recovery phase of ATN, patients can become dehydrated and develop what severe electrolyte imbalance?
Hypokalemia due to high volume, hypotonic urine. Hyperkalemia during maintenance phase.
Patient with alpha3-chain of collagen type IV has abx against it? Dx?
Goodpasture. Hemoptysis and oliguria.
What are some causes of membraneous glomerulonephropathy?
Spike and dome stain on methenamine silver stain. Systemic - cancer, DM, SLE
Hep B, C, syphilis
gold, penicillamine, NSAIDs
Patient has hemoptysis, HTN, and hematuria with some NE induced indirect IM
Likely diagnosis? Wegener’s.Has sinus + hematuria + hemoptysis. No deposits, C-ANCA.
Patient has BP 200/100. Low K. High renin and aldosterone. Muscle weakness and headaches.
Consider reninomas. Benign juxtaglomerular cell neoplasm. In secondary hyperaldosteronism, both renin and aldosterone are elevated.
What is the #1 prognostic factor in PSGN
Age
What is paradoxical aciduria?
In low K states, H+ instead of K is exchanged for Na in CCT, leading to alkalosis
Timing of IgA nephropathy vs PSGN?
PSGN is usually several weeks afterwards.
How can you get tubular proteinuria and overload proteinuria?
Overload: MM. Tubular: B2 microglobulin and Ig light chains that are not absorbed say in tubulointerstitial nephritis.
Why are glycogen and lipids usually clear on slides?
Tissue fixation and staining usually dissolve them
What are some risks to bladder cancer?
Phenacetin, Smoking, Cyclophosphamide, rubber, aniline dyes, textiles, leather, any occupational exposure
What are symptoms and histological hallmarks of ethylene glycol poisoning?
Oliguria, anorexia, flank pain. Ballooning and vacuolar degeneration of proximal tubule. Obv, Ca oxalate crystals.
If you clip a renal artery, what part would you expect to go up?
Secondary renin increase. So macula densa cells in afferent arteriole would go hyperplasia.
