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STEP 1 > renal > Flashcards

renal Flashcards

1
Q

pronephros degenerate when

A

week 4

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2
Q

mesonephros contribute to

A

male genital system

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3
Q

when do mesonephros function

A

function as kidney for 1st trimester

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4
Q

when do metanephros appear

A

5th week

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5
Q

where is the ureteric bud derived from

A

caudal end of mesonephric duct

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6
Q

by what week is the ureteric bud / collecting system fully canalized?

A

10th week

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7
Q

what does the ureteric bud give rise to

A

ureters
pelvis
calyces
collecting ducts

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8
Q

interaction between mesonephros (ureteric bud) and metanephric mesenchyme leads to formation of what

A

glomerulus through DCT

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9
Q

what is last to be recanalized

A

ureteropelvic junction

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10
Q

what is the most common site of obstruction + hydronephros in fetus

A

ureteropelvic junction because it is the last to recanalize

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11
Q

most common cause of death in fetus with potter sequence

A

respiratory failure due to pulmonary hypoplasia

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12
Q

multicystic dysplastic kidney occurs because of what

A

abnormal interaction between urereteric bud and metanephric mesenchyme

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13
Q

what causes potter sequence

A

oligohydramnios due to failure of ureteric buds to develop

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14
Q

what rib injury could damage kidney

A

11 or 12

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15
Q

what kidney is taken during donor transplant and why

A

left because it has a longer renal vein

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16
Q

macula densa cells live inside what part of kidney

A

DCT

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17
Q

what cells secrete renin

A

juxtaglomerular cells

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18
Q

what charge do glomerular basement membranes have and why

A

negative to prevent proteins from escaping

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19
Q

what do the ureters pass under in females

A

uterine artery

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20
Q

what do the ureters pass under in males

A

vas deferens

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21
Q

where do JG cells live

A

in the afferent arteriole

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22
Q

what spinal level are the kidneys at

A

T12 through L3

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23
Q

what kidney is larger

A

left

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24
Q

where is the location of the kidneys in relation to one another

A

right kidney is lower and `more lateral than the left due to the liver

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25
Q

what molecule can approximate plasma volume

A

albumin

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26
Q

what molecule can approximate extracellular volume

A

inulin

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27
Q

how much of body weight is fluid

A

60%

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28
Q

how much of body fluid is ECF

A

20%

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29
Q

how much of body fluid is ICF

A

40%

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30
Q

How much of ECF is plasma volume

A

25%

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31
Q

how much ECF is interstitial fluid

A

75%

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32
Q

what makes basement membrane negatively charged

A

heparan sulfate

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33
Q

what is the size barrier in glomerulus

A

fenestrated capillary endothelium

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34
Q

renel clearance equation

A

C=UV/P

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35
Q

what substances predict GFR

A

inulin and creatinine

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36
Q

normal GFR

A

100 mL/min

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37
Q

if creatinine is used to estimate GFR, is it accurate?

A

slightly overestimates GFR

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38
Q

relationship between GFR and creatinine

A

every time GFR is cut in half, creatinine doubles

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39
Q

RPF is estimated by

A

PAH

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40
Q

eRPF underestimates RPF by how much

A

10%

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41
Q

RBF equation in terms of hematocrit

A

RPF/1-Hct

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42
Q

FF equation

A

GFR/RPF

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43
Q

normal FF

A

20%

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44
Q

filtered load equation

A

GFR x plasma concentration

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45
Q

excretion rate equation

A

E=UV

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46
Q

reabsorption equation

A

R= filtered - excreted

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47
Q

secretion equation

A

S= excreted- filtered

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48
Q

at what glucose level does glucosuria start

A

200 mg/dL

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49
Q

at what glucose level are all the glucose transporters saturated

A

375 mg/dL

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50
Q

hartnup inheritance

A

autosomal recessive

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51
Q

hartnup etiology

A

deficiency of neutral amino acid transporters in the PCT and on enterocytes = lose tryptophan –> niacin deficiency –> pellagra

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52
Q

rx. hartnup

A

high protein diet and nicotinic acid

53
Q

3 Ds of pellagra

A

diarrhea
dementia
dermatitis

54
Q

how is glucose reabsorbed and where

A

in the PCT via Na glucose cotransporter

55
Q

how does osmolarity of filtered fluid change in PCT

A

no change - isotonic reabsorption

56
Q

thin descending loop of henle reabsorbs what

A

water only - concentrating segment

57
Q

how does the thin descending loop reabsorb water

A

passively due to medullary hypertonicity

58
Q

ADH works on what cell type

A

principal cells

59
Q

expired tetracyclines can cause what

A

fanconi syndrome

60
Q

tenofovir can cause

A

fanconi syndrome

61
Q

where is defect in fanconi

A

PCT

62
Q

inheritance of bartter syndrome

A

autosomal recessive

63
Q

inheritance of gitelman syndrome

A

autosomal recessive

64
Q

inheritance of liddle syndrome

A

autosomal dominant

65
Q

metabolic symptoms in fanconi

A

metabolic acidosis (losing bicarb)

66
Q

metabolic symptoms in bartter

A

hypokalemia (losing K) and hypercalciuria (losing Ca)

metabolic alkalosis

67
Q

bartter affects what channels

A

Na-K-Cl transporter in the thick ascending loop

68
Q

Gitelman is a defect in what part of the nephron

A

DCT (Na Cl reabsorption)

69
Q

liddle syndrome is associated with what type of mutation

A

gain of function (increased Na+ reabsorption via ENaCs in the collecting tubule)

70
Q

Rx liddle syndrome

A

Amiloride

71
Q

only renal tubular defect to cause hypercalciuria

A

bartter

72
Q

only renal tubular defect to cause acidosis

A

fanconi

73
Q

syndrome of apparent mineralocorticoid excess is actually an excess of _____, why?

A

cortisol - because deficiency of 11-beta hydroxysteroid dehydrogenase that normally converts cortisol –> cortisone

74
Q

syndrome of apparent mineralocorticoid excess can be acquired from what food

A

licorice (glycyrrhetic acid)

75
Q

what makes ACE

A

endothelial cells of pulmonary vasculature

76
Q

what cells sense decreased bp

A

juxtaglomerular

77
Q

what cells sense decreased Na

A

macula densa

78
Q

JG cells are what type of cells

A

modified smooth muscle cells

79
Q

where is EPO released from

A

interstitial cells in peritubular capillary bed

80
Q

what part of nephron converts vit d to active form

A

PCT

81
Q

how do prostaglandins affect the nephron

A

vasodilate the afferent arteriole

82
Q

where does PTH affect nephron

A

DCT (increased Ca reabsorption) and less PO4 reabsorption (PCT)

83
Q

ANP net effect in nephron

A

Na+ loss and volume loss

84
Q

wide QRS, peaked T waves

A

hyperkalemia

85
Q

tetany

A

hypocalcemia

86
Q

QT prolongation

A

hypocalcemia

87
Q

torsades de pointes

A

hypomagnesemia

88
Q

stones bones groans overtones

A

hypercalcemia

89
Q

u waves on ecg

A

hypokalemia

90
Q

flattened T waves

A

hypokalemia

91
Q

decreased DTR

A

hypermagnesemia

92
Q

muscle weakness

A

hyperkalemia

93
Q

how does pH relate to hco3- and pco2

A

pH is proportional to HCO3/pCO2

94
Q

how to calculate anion gap

A

anion gap = Na-Cl - HCO3

95
Q

dysplastic kidney inheritance

A

not inherited

96
Q

AR PKD presents when

A

presents in infants

97
Q

AD PKD presents when

A

presents in young adults

98
Q

dysplastic kidney vs. PKD

A

dysplastic kidney usually has abnormal tissue in the parenchyma (like cartilage)

99
Q

ARPKD presentation

A

kid with portal hypertension (due to hepatic cysts)

100
Q

ADPKD presentation

A

hypertension (too much renin), hematuria, renal failure, associated with berry aneurysms and hepatic cysts and MVP

101
Q

main cause of death in ADPKD

A

berry aneurysm

102
Q

mutations that lead to ADPKD

A

APKD1 and APKD2

103
Q

PKD presents with what kind of kidneys

A

enlarged

104
Q

medullary cystic kidney disease presentation

A

shrunken kidneys with parenchymal fibrosis

105
Q

medullary cystic kidney disease inheritance

A

autosomal dominant

106
Q

most common renal congenital anomaly

A

horseshoe kidney

107
Q

unilateral renal agenesis causes what in the other kidney

A

hypertrophy of other kidney + renal failure later in life

108
Q

most common ADPKD mutation

A

PKD1, chr. 16

109
Q

less common ADPKD mutation

A

PKD2, chr 4

110
Q

shrunken kidneys on ultrasound

A

medullary cystic kidney disease

111
Q

majority of all renal masses are what

A

simple cysts (filled with ultrafiltrate)

112
Q

2 areas of nephron susceptible to ischemia

A

PCT and medullary Thick ascending limb

113
Q

most common cause of acute tubular necrosis

A

aminoglycosides

114
Q

how to prevent acute tubular necrosis

A

hydration and allopurinol

115
Q

eosinophils in urine

A

acute interstitial nephritis

116
Q

4 things that can lead to renal papillary necrosis

A

1) sickle cell
2) severe pyelonephritis
3) diabetes
4) long term analgesic use (phenacetin, aspirin)

117
Q

most common cause of nephrotic syndrome in caucasian adult

A

membranous nephyropathy

118
Q

nephrotic syndrome associated with hodgkins

A

minimal change disease

119
Q

spike and dome appearance

A

membranous nephropathy

120
Q

tram track appearance

A

membranoproliferative glomerulonephritis

121
Q

nephrotic presentation of SLE

A

membranous nephropathy

122
Q

kimmelsteil wilson lesion

A

DM

123
Q

first sign of DM

A

microalbuminuria

124
Q

acute post streptococcal glomerulonephritis is what kind of HS

A

3

125
Q

subepithelial immune complex hump

A

PSGN

126
Q

crescent moon shaped LM and IF

A

RPGN

127
Q

crescents in RPGN are made from

A

fibrin and macrophages

128
Q

most common cause of death in lupus patients

A

DPGN

129
Q

wire looping of capillaries

A

DPGN

STEP 1 (26 decks)

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