Renal Flashcards
What is the most common cause of gross hematuria in a young person with sickle cell trait?
Papillary Necrosis
What diuretic can be supplemented in osteoporosis?
Hydrochlorothiazide – increases Ca+2 absorption in distal tubule
What drug can be used for increasing renal blood flow at low doses?
Dopamine
Why does a person with chronic renal insufficiency needing dialysis have increased bleeding time?
Urea inhibits platelet aggregation/adhesion
What can cause oligouria, hempytsis, and sinusitis with positive antibodies to lysosomal enzymes of PMN?
Wegener’s Polyangititis
- c-ANCA
- Pulmonary, Upper Resp, RPGN (Crescent)
What is primary polydipsia?
Drinking too much water
What would the dehydration test show if a patient had primary polydipsia?
Progressive increasing OsMolarity of urine, then with ADH administration osmolarity might not increase much due to chronic deficiency of aquaporins from overhydration.
What is most commonly associated with HIV infection and sickle cell and heroin (IV drug abuse)?
Focal Segmental Glomerulosclerosis (Nephrotic Syndrome)
- glomeruli collapsed and sclerotic
- increased matrix production with microcyst formation
How to calculate anion gap and what causes high gap?
Sodium - (Cl + Bicarb) = 10-14 (Normal), if 14+ = High
Causes: DKA, ASA, Lactic Acidosis, Ethylene Glycol, Isoniazid, Uremia, Methanol
What would be responsible for Clear Cell renal Carcinoma?
von Hippel-Lindau Disease
– Loss of VHL – Tumor Suppressor
Triad – Hemangioblastoma, Pheochromocytoma, Clear Cell Carcinoma
What area of the tubule is most affected by hypotension and acute tubular necrosis?
Medulla – loss blood flow, first to become ischemic and more specifically proximal tubule
What syndrome would have hematuria, elevated creatinine, and eosinophilia?
Churg-Strauss Syndrome
– p-ANCA
If a kidney biospy revealed hypercellular glomeruli and “humps” on EM, what might be occuring?
Post-Strep Nephritis
If a patient over produces aldosterone, which might their electrolytes look like?
Low K+
Elevated BP
Low Renin
Elevated pH (HCO3-) [due to loss of H+ in urine]
Low Sodium – due to ANP from Atria due to too much wall tension from plasma volume and causes sodium loss.
What is the best way to treat primary hyperaldosteronemia and what is an adverse side effect?
Spirolactone
Eplerenone
**Gynecomastia
Where is ADH synthesized?
Paraventricular/Supraoptic nuclei of hypothalamus, anterograde transport to posterior pituitary where Neurophysin post-translational processing
Who is most suspectible to oxalate kidney stones?
Crohn’s Disease
– This is because terminal illeum is inflammed and does not absorb as much bile, thus the bile binds to Calcium in GI tract. Then since the Calcium is bound, it cannot bind Oxalate which is absorbed instead – accumulates in kidneys.
A patient develops oligouria and elevated creatinine, who has recently develop sinusitis and asthma, what might be the cause of these symptoms?
Churg-Strauss Syndrome -- vasculitis (+) p-ANCA Eosinophila **Polyneuropathy Sinus Abnormalties
What is Probenecid used for?
Uricosuric Drug – excretes more uric acids from the kidney. Prevents re-absorption
– can increase risk of kidney – urate stones
What is the most common location of renal cell carcinoma?
proximal tubule
- clear cytoplasm
- high lipid content
- polygonal / cuboidal cells – pushes nuclei to the side
What kind of cell type can cause renal pelvis carcinoma?
Transitional Cell carcinoma
Chronic NSAID use can lead to what?
Chronic Interstitial Nephritis
- modest increase in creatinine / polyuria / proteinuria
What drug can be used to prevent gout in patients with renal impairment?
Febuxostat - Xanthine Oxidase Inhibitor
