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Pathology > Renal > Flashcards

Renal Flashcards

1
Q

PLA2R antibodies

A

membranous nephropathy, usually IgG4

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2
Q

Renal angiomyolipoma

A

BL in tuberous sclerosis

AD disease, get brain hamartomas, seizures, retardation, cardiac rhabdomyoma, skin angiofibroma, ash leaf spots with no pigment

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3
Q

VHL syndrome

A

BL renal cell carcinoma
cerebellar hemangioblastomas
retinal hemangiomas
liver cysts

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4
Q

descending loop

ascending loop

A

water permeable

water impermeable –> dilute DCT

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5
Q

death in Potter sequence

A

lung immaturity - pulmonary hypoplasia

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6
Q

hemophilia C

A

factor 11 deficiency

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7
Q

spike and dome

A

membranous nephropathy

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8
Q

Berger disease

A

after URI
IgA nephropathy

Henoch-Schonlein has…
GI pain, migratory arthralgias

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9
Q

ATII site of action

A

efferent arteriole

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10
Q

tumor lysis syndrome

A

uric acid precipitates in CD from low pH

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11
Q

non lactose fermenting gram negative rod

A

Pseudomonas

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12
Q

lactose fermenting gram negative rod

A

E coli
Enterobacter cloacae (Abx resistance)
Klebsiella

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13
Q

Gram positive coccus

A

Enterococcus faecalis

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14
Q

struvite

A

magnesium aluminum phosphate

“coffin lids” pH > 7

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15
Q

uric acid stone

A

rhombus

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16
Q

primary aldosteronism

A

low renin, high aldosterone

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17
Q

V2 receptor

A

water and urea (medullary CD) permeability

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18
Q

mesonephros

metanephros

A

male Wolffian ducts, female Gartner ducts

true kidney
ureteric bud - CD forward
metanephric blastema/mesoderm - rest

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19
Q

loop diuretics also…

A

cause renal PG release

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20
Q

Fabry disease

A

alpha galactosidase deficiency
ceramide trihexoside accumulation

hypohidrosis, acroparesthesia, angiokeratomas on abdomen, progressive renal insufficiency!

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21
Q

Diabetic autonomic neuropathy

A

Type 1 DM, overflow incontinance, incomplete emptying

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22
Q

nephrotic syndrome

A

activates RAAS

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23
Q

FF

A

GFR/RPF

=20%

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24
Q

c-ANCA

A

Wegeners
type 3 pauci-immune RPGN

cough, dyspnea, hemoptysis, epistaxis, chronic sinusitis, mucosal ulceration

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25
Q

acute hemorrhagic cystitis

A

adenovirus in children

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26
Q

ethylene glycol ingestion

A

calcium oxalate crystals

anion gap metabolic acidosis

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27
Q

linear IgG and C3 deposits

A

Goodpastures

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28
Q

Lactate dehydrogenase

A

Pyruvate to lactate

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29
Q

Prevent Ca stones

A

give citrate
restrict protein and Na
don’t restrict Ca

acid – calcium oxalate
basic – calcium phosphate

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30
Q

metabolic alkalosis

A

loss of H or Cl

vomiting, diuretics, Conn, Cushing

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31
Q

K regulation

A

a-intercalated save

principal cells secrete

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32
Q

ATN

A

lose K, Ca, P, Mg in recovery phase

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33
Q

ESRD

A

osteodystrophy

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34
Q

Selective proteinuria

A

albumin mostly

in minimal change disease

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35
Q

easy fatiguability
constipation
bone pain
renal failure

A

multiple myeloma

see eosinophilic casts of light chain

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36
Q

outer medulla

A

PCT and Thick AL

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37
Q

Clearance

A

UV/P

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38
Q

PSGN

A

60% full recovery in adults

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39
Q

cystenuria

A

sodium-cyanide nitroprusside test
turns red purple

treat with acetazolamide

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40
Q

NSAID use

A

chronic interstitial nephritis

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41
Q

Fanconi syndrome

A

aminoaciduria
glycosuria
low phosphate
hypouricemia

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42
Q

treat nephrogenic diabetes insipidus

A

HCTZ
amiloride (if lithium induced?)
indomethacin to increase blood flow

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43
Q

relationship to ureters

A

vas deferens and uterine artery run above

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44
Q

plasma volume

A

1/4 of 1/3

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45
Q

renal clearance

A

CL = UV/P

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46
Q

renal plasma flow

A

P(PAH)

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47
Q

estimate GFR

A

inulin or Cr clearance

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48
Q

excretion rate

A

UV

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49
Q

filtered load

A

GFR*P

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50
Q

FF

A

GFR/RPF

~20%

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51
Q

HUS

A

thrombocytopenia
renal failure
and hemolytic anemia

from E coli O157:H7

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52
Q

PT early

A

Na co-transport for glucose, AA, P, or lactate

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53
Q

PT late

A

NaCl pulled in

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54
Q

organic cations and anions

A

in PT

organic cations to urine via H-exchanger

organic anions to urine via BL a-KG exchange, then single transport out

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55
Q

Ca and Mg in kidney

A

pulled in at ThAL

H2O cannot come

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56
Q

Early DT

A

Na-Cl co-transporter

Ca in channel

57
Q

CD cell types

A

principle cells - save H2O/Na, lose K (ADH/aldo)

intercalated cells - save K, lose H/bicarb

  • lose H = A cell
  • lose bicarb = B cell
58
Q

K sparing diuretics

A

affect principle cells
spironolactone/eplerenone - Aldo antagonists
triamterene/amiloride - block Na channel

“taKe a SEAT”

59
Q

loop diuretic that is not a sulfa

A

ethacrynic acid

60
Q

thiazides

A

block DT Na-Cl:
chlorthalidone
metolazone**

61
Q

bumetanide

A

loop

62
Q

diuretics that increase pH

A

loops and thiazides

CAI and K-sparings lower pH

63
Q

causes of DI

causes of SIADH

A

lithium, hyperCa, demeclocycline, ADH-R mutation

cyclophosphamide

64
Q

high Mg

A

hyporeflexia

65
Q

cause hyperkalemia

A 
acidosis**
digoxin**
B-blockers
low insulin
ACE-I
66
Q

normal bicarb

A

22-28

67
Q

RTA

A

I - low K, urine pH >5.5, a-intercalated cell H fail

II - low K, low P, pH

68
Q

MUDPILES

A 
methanol
uremia
DKA
propylene glycol
Iron, isoniazid
lactic acid
ethylene glycol
salicylates
69
Q

splitting BM

A

Alport

70
Q

diffuse proliferative glomerulonephritis

A

lupus

71
Q

subepithelial

A

spike-dome of membranous nephropathy

72
Q

subendothelial

A

humps of membranoproliferative tram-track

73
Q

cause membranoproliferative glomerulonephritis

A

Hep B/C
lupus
subacute endocarditis

74
Q

complex renal cysts

A

lead to RCC

75
Q

WAGR

A

Wilms
aniridia
GU malformation
retardation

chr 11

76
Q

struvite stones

A

Proteus
Klebsiella
Staph
Pseudomonas

77
Q

Ca stones

A

ethylene glycol

vitamin C

78
Q

AIN

A

eosinophilia, azotemia
fever, rash

causes ARF

79
Q

AIN caused by

A

PPI, indinavir, ciprofloxacin, allopurinol, cimetidine, mesalamine, sulfonamides, cefs, penicillins, NSAID

80
Q

ATN caused by

A 
aminoglycosides
cephalosporins
polymyxins
contrast dye (bicarb prevents)
rhabdomyolysis
myoglobinuria
81
Q

renal papillary necrosis causes

A 
sickle cell
acetominophen
NSAIDS
diabetes
pyelonephritis
82
Q

labs in renal failure

A 
low Ca
low pH
high K
high uric acid
high BUN
high Cr
83
Q

pronephros

A

week 4, degenerates

84
Q

retrognathia

A

Potter sequence

85
Q

ARPKD causes

A

Potter sequence

86
Q

Horseshoe kidney associated with

A

stones

aneuploidy

87
Q

Y shaped bifid ureter

A

= duplex collecting system

get reflux, UTI, obstruction

88
Q

longer renal vein on

A

left kidney - take in transplant

89
Q

total body water/mass

A

42 L = 42 kg

90
Q

HCT

A

3 * Hb in g/dL

91
Q

normal osmolarity

A

285-295 mOsm/kg

92
Q

fused with glomerular BM

A

heparan sulfate

93
Q

V in equation

A

urine flow rate mL/min

94
Q

normal GFR

A

100 mL/min

95
Q

Creatinine and GFR

A

overestimate since secreted slightly

96
Q

GFR

A

Kf * [(P-P) - (n-n)]

97
Q

RBF

A

RPF / 1-Hct

98
Q

PAH and RPF

A

underestimate by 10%

99
Q

NSAIDS

ACE-I

A

constrict afferent arteriole

dilate efferent arteriole

100
Q

Glucose renal clearance

A

threshold for glycosuria = 200 mg/dL
saturation = 375

glucosuria and AAuria in normal pregnancy

101
Q

treatment Hartnup disease

A

nicotinic acid

high protein

102
Q

defect Hartnup disease

A

proximal tubule neutral AA transporter

enterocyte neutral AA transporter

103
Q

resorbs bicarb and secretes NH3

A

early PCT

104
Q

ATII causes

A

Na in/H out at apical early PCT

saves Na, water, and bicarb

contraction alkalosis

105
Q

bicarb transport

A

exchange with Cl

out of cell

BL a-intercalated cell
apical B-intercalated cell

106
Q

Fanconi syndrome

A

PCT general defect

lose AA, glucose, bicarb, P
renal tubular acidosis possible

107
Q

Fanconi syndrome causes

A 
Wilson
tyrosinemia
glycogen storage disease
ischemia
multiple myeloma
expired tetracycline
tenofovir
lead poisoning
108
Q

Gitelman syndrome

A

distal CT Na-Cl

low magnesium

109
Q

Liddle syndrome

A

collecting tubule GOF in Na resorption

treat with amiloride

110
Q

Bartter syndrome

A

thick AL

low blood K
hpercalcuria

111
Q

glycyrrhetic acid

A

in licorice

causes syndrome of apparent mineralicoticoid excess by blocking 11-B-hydroxysteroid dehydrogenase

112
Q

Syndrome of apparent mineralicorticoid excess

A

CT excess cortisol (no 11-B-hydroxysteroid DH to convert to cortisone) activated mineralicorticoid R like aldosterone

113
Q

low serum aldosterone

A

Liddle syndrome

syndrome of apparent MC excess

114
Q

PCT chart

A

urea up
P down

Cl under urea
bicarb under P

115
Q

ATII actions

A

increase ADH

stimulate thirst via hypothalmus

116
Q

ANP/BNP actions

A

increase GFR

decrease renin

117
Q

JGA

A

low NaCl in DCT?
release adenosine to vasoconstrict

B1 receptors/low BP release renin

118
Q

Ca reabsorption

A

DCT via PTH

119
Q

hyperkalemia from…

A

B blocker
low insulin
renal failure

120
Q

low Mg causes

A

hypokalemia, torsades

121
Q

metabolic acidosis

A

diarrhea
Addison
acetazolamide, spironolactone

122
Q

metabolic acidosis

A

vomiting
loop/thiazides
hyperaldosteronism

123
Q

type 4 RTA has…

A

hyperkalemia

124
Q

granular cast

A

ATN

125
Q

PSGN hypersensitivity type

A

type III HS reaction

126
Q

increased anti-DNase B

A

PSGN

127
Q

type 1 MPGN

A

tram track
after hep B/C
subendothelial

128
Q

type II MPGN

A

low C3
intramembranous
dense deposits

129
Q

lymphoma can cause

A

minimal change disease

130
Q

SLE can cause

A

membranous nephropathy

DPGN - death - wire looping

131
Q

calcium oxalate precipitates at

A

low pH

132
Q

abdominal mass with painless hematuria

A

renal oncocytoma

133
Q

Beckwith-Wiederman

A

Wilms
macroglossia
organomegaly
hemihypertrophy

134
Q

urine with ammonia scent

A

Proteus mirabilis UTI

135
Q

thyroidization of kidney

A

chronic pyelonephritis

136
Q

diffuse cortical necrosis

A

infarcts in both kidneys from abrupt placentae, septic shock etc

137
Q

maintanance phase of ATN

A

oliguric

risk of hyperkalemia

138
Q

urine osmolality >500

A

prerenal - but low FeNa

139
Q

HT in ADPKD

A

from high renin

Pathology (8 decks)

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