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USMLE Step1 > Renal > Flashcards

Renal Flashcards

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USMLE® Step 1 flashcards
1
Q

donor renal A and V anastamosed to

A

external iliac A and V

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2
Q

hartnup disease mech

A

neutral aminoacidura (also decreased absorption by enterocytes) eg. tryptophan

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3
Q

tryptophan gives rise to

A

nicotinic acid, serotonin, melatonin

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4
Q

Fanconi syndrome mech

A

generalized reabsorptive defect in PCT (involves all AA)

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5
Q

Thin descending and thick ascending loop of Henle (water and solutes)

A

descending permeable to water but not solutes : ascending permeable to solutes but not water

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6
Q

In nephon, all glucose and AA absorbed in

A

PCT

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7
Q

In nephon, most dilute urine in

A

DCT

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8
Q

ADH action on nephron and which cell

A

principal cell, V2 receptor, more aquaporins on the membrane (water hormone)

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9
Q

aldosterone on nephron, which cell

A 
Principal cell (Na+ & water reabsorption, K+ secretion)
a-intercalated cell (K+ absorption; H+ secretion)
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10
Q

Juxta glomerular cells on

A

Afferent arteriole (secrete renin)

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11
Q

macula densa on

A

DCT (sense NaCl)

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12
Q

trigger for renin secretion

A

decrease renal arterial pressure and increased renal sympathetic discharge (beta 1)

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13
Q

erythropoetin secreted by

A

interstitial cells in the peritubular capillary bed

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14
Q

primary disturbance in metabolic A/A

A

HCO3

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15
Q

Primary disturbance in respiratory A/A is

A

pCO2

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16
Q

All (pCO2, HCO3 and pH) decreased in

A

metabolic acidosis

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17
Q

IF of PSGN two terms

A

starry sky or lumpy-bumpy

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18
Q

what deposits in PSGN

A

IgG, IgM and C3 (note: type III)

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19
Q

crescentic GN

A

RPGN

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20
Q

Goodpasture syndrome leads to what type of GN

A

RPGN

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21
Q

two types of pauci immune RPGN

A

wegners G and microscopic polyangitis

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22
Q

what type of HS in Goodpastures syndrome

A

type II

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23
Q

what type of GN SLE leads to

A

DPGN (membranous nephropathy is the nephrotic version of SLE)

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24
Q

race and nephrotic syndrome

A 
FSG Sclerosis (african american and hispanic)
membranous nephropathy (caucasian)
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25
Q

urease + bugs cause what type of stone

A

AMP, struvite, staghorn (due to alkalinization of urine)

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26
Q

clear cell ca originate from

A

PCT

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27
Q

eosinophiluria with rash

A

drug induced interstitial nephritis

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28
Q

acetazolamide MOA

A

Carbonic anhydrase inhibitor (NaHCO3 diuresis)

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29
Q

loop diuretic MOA

A

inhibit Na+/K+/2Cl- cotransporter of thick ascending LOH

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30
Q

what drug inhibits loop diuretics fn

A

NSAIDS

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31
Q

Thiazides MOA

A

Inhibit NaCl reabsorption

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32
Q

Thiazides SE is exploited in

A

osteoporosis and renal calcium stones

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33
Q

aldosterone receptor antagonist in kidney

A

spironolactone and eplerenone

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34
Q

triamterene and amiloride MOA

A

block Na+ channels

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35
Q

aliskiren MOA

A

direct renin inhibitor, used in hyper tension

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36
Q

ACE I and bradykinin

A

ACE I increases bradykinin (bradykinin is a vasodilator)

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37
Q

useless promises, not totally

A

cadual mesonephric duct= ureteric bud

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38
Q

blastema (m mesenchyme)

A

glomeruli to DCT

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39
Q

most common site hydronephrosis

A

ureteropelvic junction

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40
Q

potter sequence cause of death

A

pulmonary hypoplasia

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41
Q

cause of potter sequence

A

BIL RENAL AGENES

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42
Q

foot finding in potter

A

clubbed foot

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43
Q

ACE 1 CI in preg

A

renala genesis

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44
Q

donor kidney art connected to

A

ext iliac art (on right side)

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45
Q

horse shoe kidney which a, risk and syndrome

A

IMA, turner, risk wilms tumor

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46
Q

multicystic dysplastic kidney

A

no connection between bud and mesemcnyme

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47
Q

duplex collecting system risk

A

reflux, UTI

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48
Q

kidney ribs

A

11, 12

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49
Q

during transplantation, lt kidney

A

goes to rt iliac fossa (longer vein)

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50
Q

kidney wedge necrosis

A

segmental art

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51
Q

kidney why emboli

A

3-5 times more perfused

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52
Q

uterine vessels and ureter damage which ligament

A

cardinal

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53
Q

plasma vol is measured by

A

radiolabelled albumin

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54
Q

60% what happens

A

40% 20%

5% and 15%

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55
Q

ECF vol measured by

A

inulin (also GFR)

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56
Q

size barrier

A

fenestrated capillary endothelium

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57
Q

charge barrier

A

basement memb- heparan sulfate- negative charge barrier

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58
Q

C=UV/P, V is

A

urine flow rate ml/min

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59
Q

when creatine level is normal

A

graph is flat

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60
Q

why creatinine clearance overestiamte GFR

A

moderately excreted

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61
Q

RBF

A

RPF/1-ht

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62
Q

FF=

A

GFR/RPF = 20%

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63
Q

filtered load+ excretion rate

A

GFRXplasma conc (same as UV)

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64
Q

why FF increase with angiotensin

A

efferent constant

GFR increase, RPF dec, FF incre

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65
Q

neutral aminoaciduria (tryptophan)

A

hartnups disease

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66
Q

inulinis grouped with

A

mannitol

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67
Q

glucose, Na grouped with

A

urea

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68
Q

PAH grouped with

A

creatinine

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69
Q

PCT_ hormones

A

PTH_phosphate

angiotensin 11 Na

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70
Q

descending loop

A

permeable to water (not solute)

at end becomes hypertonic

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71
Q

ascending loop

A

Na, K,Cl reabsorbed

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72
Q

PCT

A

na and cl- symporter
PTH-ca
most dilute (hypotonic)

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73
Q

Hormones in collecting duct

A

aldosterone and ADH

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74
Q

for AA absorption in PCT, need

A

Na

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75
Q

fanconi syndrome and metabolic defect

A

generalized defect
renal tubular acidosis
sir general fanconi

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76
Q

Bartter syndrome is lik

A

loop

77
Q

gitelman syndrome is like

A

thiazide (T.G Ravi)

78
Q

liddle syndrome features

A

inc na, dec K, metabolic alkalosis and decrease aldosterone

79
Q

liddle syndrome problem

A

increased na reabsorption

80
Q

SAME defect

A

11 b HSD def

81
Q

Acquired SAME

A

licorice (glycyrrhetic acid)

82
Q

things absorbed more quickly than water

A

glucose, AA, bicarb and Pi

83
Q

JG cells location

A

afferent

84
Q

macual densa location and sensor

A

DCT,Nacl

85
Q

Role of b blockers in kidney

A

block b1 in JGA and decrease renin

86
Q

angiotensionogen from

A

liver

87
Q

function of angiotension 11 on baroreceptor

A

limit reflex bradycardia

88
Q

K+ regulation happen at

A

DCT adn collecting duct (H,K+ ATPase)

89
Q

erythropoetin secreted by

A

interstitial cells in peritubular capillary bed

90
Q

1 a hydroxylase location

A

PCT

91
Q

2 metabolic conditions causing hyperkalemia

A

acidosis hyperosmolarity

92
Q

electrolyte complications after nebulizer use

A

hypokalemia (note b blockers cause hyerkalemia)

93
Q

hypokalemia ECG

A

flattened T,U wave

94
Q

hyperkalemia ECG

A

widened QRS, peak T

95
Q

Mg low and high

A

torsades de pointes and decreased DTR

96
Q

ECG and low ca

A

QT prolongation

97
Q

anion gap diarrhea and salin infusion

A

normal (HARD ASS)

98
Q

winter formula

A

pco2= 1.5 (Hco3)+8 +/_ 2

99
Q

in metabolic acidosis

A

all up

100
Q

in compensation

A

think how to make the opposite

101
Q

high altitude and acid base

A

resp alkalosis

102
Q

cause of metabolic alkalosis

A

diuretics
vomiting
antacids
hyperaldosteronism

103
Q

3 types of RTA

A

1,11 and 1V

104
Q

type 1 RTA

A

distal, decreased H+ secretion

105
Q

type 11 RTA

A

proxima, increased bicarbonae secretion

106
Q

type 1V RTA

A

hypoaldosteronism (hyperkalemia)

107
Q

cause of type 1 RTA

A

amphotericin B, analgesic nephropathy

108
Q

type !! RTA cause

A

fanconis synd, acetazolamide

109
Q

RBC casts

A

g nephritis and malignant HT

110
Q

granular casts (muddy brown)

A

acute tubular necrosis

111
Q

waxy cast

A

end stage renal disease

112
Q

GN code

A

ARDIAM

113
Q

APSGN histology

A

LM- hypercellular
IF_ starry sky lumpy bumpy
EM- IC humps

114
Q

APSGN deposits

A

IgG IgM C3

115
Q

lab findings in APSGN

A

increase antiDNAse B

Increase ASO, decrease C3

116
Q

crescent in RPGN made up of

A

fibrin, C3b, IgG

117
Q

RPGN types

A

anti GBM- good pastures

paucimmune- wegener adn microscopic

118
Q

diffusely proliferating wires are seen un

A

SLE

119
Q

IgA nephropathy (2 names)

A

buergers disease, HSP

120
Q

IgA nephropathy microscopy

A

mesangial proliferation and mesangial deposits

121
Q

alport syndrome

A

can’t see, can’t pee, cant hear a buzzing bee

122
Q

basket- weave

A

marfan adn alport EM

123
Q

alport synd mechanism

A

mutation in type IV colagen X linked

124
Q

MPGN is easy

A

proliferation inside the GBM

tram track

125
Q

MPGN associated

A

HBV

126
Q

nephrotic syndrome code

A

FM MAD

127
Q

NS pneumococcal infection

A

loosing IgG in urine

128
Q

NS hypercoagulability

A

loosing antithrombin 111

129
Q

FSGS associated

A

HIV and african american

conditions

130
Q

selective protenuria

A

lipod nephrosis (M change D)

131
Q

Antibodies to phospholipase A2

A

membranous

132
Q

associated with membranous

A

caucasian, SLE, HBV, solid tumors

133
Q

thrombosis and nephrotic synd

A

membranous

134
Q

spike adn dome appearance in

A

methanamine silver

membranous

135
Q

most common cause od nodular glomerlosclerosis

A

DM

136
Q

dont forget in DM kidney

A

GBM thickening

137
Q

most commom kidney stone

A

calcium oxalate

138
Q

chemistry of kidney stone

A

hypercalciuria, normocalcemia

139
Q

alkaline urine stone

A

calcium phosphae and AMP

both are phosphate

140
Q

vitamin for calcium oxalate stone

A

pyridoxine

141
Q

microscopy of calcium stones

A

calcium- envelope
AMP- coffin lid(death)
uric acid- rhomboid (like pseudo gout)
cystine- hexagonal (sixtine)

142
Q

radioluscent stones

A

uric acid- cystine

143
Q

sodium cyanide nitroprusside test and renal stone

A

cystine

144
Q

stone associated wth reflux

A

AMP

145
Q

RCC origiante from

A

PCT

146
Q

RCC silent cancer

A

lung metastasis

147
Q

renal oncocytoma origin

A

collecting duct

148
Q

2 differentiating feature of renal oncocytoma

A

central scar and eosinophilic

RCC_ yellow and clear cell

149
Q

embryonic glomerular structure in a tumor

A

nephroblastoma (wilms tumor)

150
Q

beckwith weiderman synd

A

beck very muscular

macroglossia, organomegaly, hemihypertrophy

151
Q

wilm tumor association

A

beckwith weiderman

WAGR

152
Q

diabetes - bladder

A 
overflow incontinence
(detrussor muscle dysfunction and inability to sense bladder)
153
Q

aniline dyes which cancer

A

transitional CC

154
Q

nitrite test + in urine

A

E coli

155
Q

sterile pyuria with neg culture

A

gonococci and chlamydia

156
Q

thyroidization of kidney

A

c/c pyelonephritis (eosinophilic cast)

157
Q

CT in pyelonephritis

A

striated parencymal enhancement

158
Q

rash and costvertebral angle tenderness

A

drug induced interstitial nephritis

159
Q

immunology of drug induced

A

eosinophils and IgE (takes 2 wks0

160
Q

abruptio placenta and renal complication

A

diffuse cortical necrosis (vasospasm and DIC related)

161
Q

ATN sites

A

PCT and thick ascending loop

162
Q

sickle cell disease and kidney

A

renal papillary necrosis (also NSAIDS)

163
Q

in prerenal azotemia kidney preserve NA and absorb BUN

A

FENA 20, osm > 500

164
Q

renal azotemai

A

cant conserve

osm 40, Fena>2%, BUN/cr

165
Q

anemai in CRF

A

normocytic normochromic
retic cunt normal
platelet, WNC normal

166
Q

ARPKD is associated with

A

congenital hepatic fibrosis, portal HT

167
Q

ADPKD is associated with

A

berry aneurysm, hepatic cyst, MVP

168
Q

medullary cystic disease

A

shrunken kidney (poor prognosis)

169
Q

complex cyst risk

A

RCC

170
Q

compensation of diuretcis (lop and thiazide)

A

aldosterone- hypokalemia and alkalosis

ADH_ free water and hyponatermia

171
Q

toxicity of mannitol

A

pulmonary edema

172
Q

acetazolamide MOA

A

NaHCo3 losing

173
Q

uses of acetazolamide

A

metabolic alkalosis, altitude sickness, urianry alkalization

174
Q

SE of acetazolamide

A

acidosis and sulfa allergy

175
Q

loop diuretics and NSAIDS

A

loop diuretics cause PGE release (dil of afferent)

176
Q

loop diuretic MOA

A

na,K,2 cl cotransport

177
Q

ethacrynic acid indications

A

sulfa allergy, (loop, thiazide, acetazolamide are sulfa drugs)

178
Q

loop diuretic and uric acid

A

increased, cause gout

179
Q

thiazide is good for people with

A

osteoporosis and renal stones

180
Q

aldosterone antagonsit

A

spiranolactone, eplerenone

triamterene and amiloride are Na channel blockers

181
Q

CHF and spiranolactone

A

decreased ventricualr remodelling and fibrosis

182
Q

gynaecomastia and diuretic

A

spiranolactone

183
Q

serum Nacl and diuretics

A

decerase in all except acetazolamide

184
Q

hot summer day id equivalent to

A

loop diuretics (contraction alkalosis)

185
Q

ACE inhibitor 1st SE

A

first dose hypotension (severe in RAS, C/c kidney disease and diuretics

186
Q

what happens to GFR In ACEI

A

eff dil, decrease GFR, increase creatinine

187
Q

aliskiren

A

direct renin inhibitor for HT

188
Q

micturition reflex

A

sacral center- bladder contraction
pontine center- co ordinate relaxation of ext urethral sphincter
cerebral corted- inhibit sacral center

189
Q

entire urinary tract from pelvis to urethra covering

A

transitional cell epithelium

USMLE Step1 (19 decks)

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