Renal Flashcards
mesonephros becomes
male genital system
paramesonephros becomes
female genital system
metanephros becomes
glomerulus through DCT
ureteric bud becomes
collecting ducts to ureter
MC location for fetal hydronephrosis
ureteropelvic junction
trace path of renal artery
RA > segmental > interlobar > arcuate > interlobular > afferent > glomerulus > efferent > vasa recta/peritubular capillaries > venous outflow
effective renal plasma flow is measured by clearance of
PAH (para-aminohippuric acid)
renal blood flow =
RPF/(1-Hct)
note: plasma fraction by volume = 1-hct
estimated Renal Plasma Flow (over/under) estimates true RPF
underestimates slightly
filtration fraction (FF) =
GFR/RPF
dehydration effects on GFR, RPF, and FF
GFR and RPF go down, but FF goes up
FENA =
Na excreted / Na filtered
= (Una * V) / (GFR * Pna)
= (Pcr * Una) / (Ucr * Pna)
PTH inhibits phosphate reabsorption in this part of kidney
proximal tubule
AT II has this tubular effect
increases water, Na and bicarb reabsorption in proximal tubule (responsible contraction alkalosis)
paracellular transport of Mg2+ and Ca2+ into the blood occurs where
thick ascending loop
PTH increases Ca absorption in this part of the kidney
early distal tubule. does so by increasing Ca/Na exchange at basement membrane of cell
this drug blocks mineralocorticoid receptor but doesn’t block androgen receptor
eplerenone
these drugs block ENaC
amiloride and triamterine
this syndrome syndrome has effects of chronic loop diuretic use
Bartter sydnrome. AR. Causes hypokalemia and metabolic alkalosis with increases urine calcium
this syndrome has the effects of chronic thiazide use
Gitelman syndrome. AR, less severe than Bartter. Hypokalemia, hypomagnesemia, metabolic alkalosis, decreases urine calcium
this syndrome has the effects of hyperaldosteronism
Liddle syndrome. AD (ENaC gain of function)
syndrome of apparent mineralocorticoid excess etiology
deficiency in 11-beta-hydroxysteroid dehydrogenase
JG cells sense
BP. Note: these are modified smooth muscle cells of afferent arterioles
macula densa senses
NaCl. note this is part of DCT
effects of dopamine released by PCT
natriuresis. at low doses, dilates to increase RBF (without changing GFR). At high doses, vasoconstricts
where does conversion of 25OH D to 1,25 OH D take place?
proximal tubule
insulin effects on potassium
shifts into cells
digoxin effect on potassium
causes hyperkalemia
beta agonist effect on potassium
shifts into cells
ECG signs of hypokalemia
U waves and flattened T waves
ECG signs of hyperkalemia
wide QRS and peaked T waves
low Mg can cause hypo___
hypokalemia
high Mg can cause hypo___
hypocalcemia
what does MUDPILES stand for
methanol, uremia, DKA, propylene glycol, iron/INH, ethylene glycol, salicylates
Diuretics that can cause normal anion gap acidosis
acetazolamide and spironolactone
renal tubular acidosis with increased urine pH
Distal RTA (type 1) due to impaired H+ secretion
RTA with hyperkalemia
Hyperkalemic RTA (type 4) due to hypoaldosteronism
potassium blood levels in proximal RTA (type 2)
hypokalemic
deposits in PSGN
subepithelial
specific dz assoc with RPGN
goodpasture, wegener, microscopic polyangiitis
EM finding Alport syndrome
basket-weave
deposits Berger disease
IgA in mesangium
deposits in type I MPGN
subendothelial
deposits in type II MPGN
intramembranous
note: also called dense deposit disease
association with type I MPGN
HBV/HCV
association with type II MPGN
c3 nephritic factor
tram-track is associated with which syndrome
type I MPGN
deposit membranous nephropathy
subepithelial spike and dome
associations with membranous nephropathy
primary is antibodies to phospholipase A2 receptor. can also be drug induced, SLE, or HBV/HCV
calcium oxalate precipitates with
hypocitraturia
calcium oxalate crystal shape
envelope or dumbbell
calcium phosphate precipitates with
basic pH
calcium phosphate crystal shape
wedge-shaped prism
treatment calcium stones
thiazides
ammonium magnesium phosphate stones precipitate with
basic pH (urease)
ammonium magnesium phosphate crystal shape
coffin lid
uric acid stones precipitate with
acidic pH
uric acid crystal shape
rhomboid or rosettes
cystine stones precipitate with
acidic pH
cystine crystal shape
hexagonal
renal tumor from collecting ducts
oncocytoma - eosinohphilic cells with abundant mitochondria
renal tumor from PCT
RCC
denys-drash syndrome
WT1. wilms tumor, early-onset nephrotic syndrome, male pseudohermaphroditism
Beckwith-Wiedemann syndrome
WT1. wilms tumor, macroglossia, organomegaly, hemihypertrophy
WAGR complex
WT1. wilms tumor, aniridia, GU malformations, retardation
diuretic use for those with sulfa allergies
ethacrynic acid (loop target)
diuretics that are bad for gout
thiazide and loop
calcium excretion in loops is (increased/decreased)
increased. can cause hypocalcemia
calcium excretion in thiazides is (increased/decreased)
decreased. good for calcium stones