Renal

Question 1

Normal GFR

Answer 1

Normal GFR=100 mL/min

Question 2

GFR (calculation)

Answer 2

GFR=UV/P Cx(inulin)=GFR( freely filtered , no reabsortion,no secretion) Cx(PAH)=ERPF(freely filtered and actively secrete, no reabsorb)

Question 3

Filtration fraction(FF)

Answer 3

FF=GFR/RPF Normal FF=20%

Question 4

increase excretion of all aminoacids,glucose,HCO3 and PO4

Answer 4

FANCONI SYNDROME it causes metabolic acidosis(proximal renal tubular acidosis)

Question 5

Hypokalemia Metabolic alkalosis hypercalcemia

Answer 5

BARTTER SYNDROME(AR) affects loop of henle , reabsorptive defect NA/K/CL cotransporter

Question 6

Hypokalemia metabolic alkalosis WITH OUT HYPERCALCEMIA

Answer 6

GITELMAN SYNDROME(AR) reabsorptive defect on NaCl in DCT

Question 7

Hypokalemia metabolik alkalosis hypertention DECRESE ALDOSTERON

Answer 7

LIDDLE SYNDROME (AD) increse reabsortion in distal and collecting tubules(increase activity of epithelial Na channel) Tx:amiloride

Question 8

PCO2=1.5[HCO3]+8-+2

Answer 8

WINTERS FORMULA(predicted respitaroty compensation for a simple metabolic acidosis) if the measured PCO2 differs significantly from the preducted PCO2,then a mixed acid-base disorder is likely present.

Question 9

Ph<7.35

CO2<40

Answer 9

Metabolic acidosis MUDPILES(increase anion gap)

• Methanol (formic acid)
• Uremia
• DKA
• Propylene glycol
• Iron tablets or INH
• Lactic acidosis
• Ethylene glycol(Oxalic acid)
• Salicylates

Question 10

Hexagonal staghorn kidney stone

Answer 10

Cysteinuria (AR)

PTC defect

excretion of COLA

• Cysteine
• Ornithine
• Lysine
• Arginine

Question 11

painless hematuria with PMH of aniline dyes,phenacetin ,smoking and cyclophosphamide

Answer 11

Transitional cell carcinoma

(most common tumor of urinary tract system)

Question 12

chronic irritation of urinary bladder

schistomsoma hematobium

painless hematuria

Answer 12

squamos cell cacinoma of the bladder

Question 13

sterile pyuria with negative urione culture

Answer 13

URETHRITIS

• Neisseria gonorrhoeae
• Chlamydia trachomatis

Question 14

kidney thyroidization

kidney scarring

Answer 14

chronic pyelonephritis

Question 15

oliguria increase azoemia with tubullar cells that slough into tubular lumen(proximal tubule and thick ascending limb)

Answer 15

ACUTE TUBULAR NECROSIS

(muddy bron cast)

Question 16

loop diuretic of choise in sulfa allergic patint

Answer 16

Ethacynic acid

Question 17

contraindicated diuritcis in gout

Answer 17

Loop diuretics

• bumetanide
• furosemide
• torsemide
• ethacrynic acid

Question 18

blocks na channels in the CCT

Answer 18

triamterene and amiloride

Question 19

diuritic causing methabolic ACIDOSIS

Answer 19

carbonic anhydrase inhibitors

K sparing

Question 20

dirutic causes metabolic alkalosis

Answer 20

loop diruetics and thiazides

• increase HCO3 absortion
• increa Na/H exchange
• k loos lead to k exiting all cells, in exchange for H entering cells.

Question 21

JG cells(in the afferent arteriole) ande the macula densa in the DCT

Answer 21

JG aparatus

Question 22

only duuretic that specifically limit calcium loss??

Answer 22

thiazides

Question 23

Amphetamine overdose treatment

Answer 23

Nh3Cl(amonium cloride)acidify the urine and increase renal clearance of the weak base(amphetamine)

Question 24

metabolic disturbance cause by diarrhea

Answer 24

metabolik acidosis with normal anion gap(colon secretes a lot of HCO3)

if you lose HCO3 the Cl will elevevate , thus no change in anion gap.

Question 25

MESANGIAL IgA depositon

Answer 25

berguer disease

Question 26

only radiolucent kidnet stone

Answer 26

uric acid(increse turn over)

• leukemia
• myeloproliferative disorders
• psoriasis

Question 27

Px fever,rash,loss of the urine concentration ability(low specific gravity of urine)

Answer 27

ACUTE INTESTITIAL NEPHRITIS (EOSINOPHILS)

• B-lactams
• sulfonamides
• quinolones
• rifampin
• anticonvulsant
• streptococcus
• staphylococcus
• legionella
• EBV
• CMV
• HIV

Question 28

Ca reabsortion in the kidney

Answer 28

PCT:reabsorption is coupled to sodium

DCT:controlled by PTH

thick ascendin limb:dependent on the function of the Na,K,Cl contransporter.

Question 29

subepithelial immune complex deposition” lumpy bumpy”

Answer 29

Acute poststreptococal glomerulonephritis.