Renal Flashcards
In males the ureters pass under the ___________, in females the ureters pass under the ___________.
Males: vas deferens
Females: uterine artery
What is the general formula for clearance?
CL = U x V / P
CL = clearance (mL/min) U = urine conc. (eg mg/mL) V = urine flow rate (mL/min) P = plasma conc. (eg mg/mL)
Does Cr over or underestimate GFR?
What does this mean?
Slightly overestimates GFR
- Creatinine is moderately secreted
What does PAH estimate?
How can you get renal blood flow from this?
effective renal plasma flow (100% filtered and secreted)
RBF = RPF / (1 - Hct)
What are some causes of Fanconi syndrome? (reabsorption defect in PCT)
- Hereditary defects: Wilson disease, tyrosinemia, GSD’s, cystinosis
- Ischemia
- Multiple myeloma
- Nephrotoxins/drugs: ifosfamide, cisplatin, tenofovir, expired tetracyclines)
- Lead poisoning
What is the pathology behind Syndrome of Apparent Mineralocorticoid Excess?
- 11beta-HSD2 deficiency, normally inactivates cortisol to cortisone.
Cortisol also partially activates the mineralocorticoid receptors (ang receptors) - Can also acquire the d/o from licorice (glycyrrhetinic acid), which blocks the enzyme
- Sx: HTN, low K+, metabolic alkalosis
Which responds more to osmolarity vs. volume? ADH or ANG II?
ADH
If you see a pt w/hyperkalemia, what should you do?
DO LABS
Digitalis (blocks NKP) hyperOsmloarity Lysis (of cells) Acidosis (H+ in, K+ out of cells) Beta-blocks (less NKP) Sugar (high blood sugar via insulin def.; insulin ^NKP)
Which electrolyte abnormalities can cause Torsades?
Hypocalcemia (QT prolongation)
Hypomagnesemia
What’s the Henderson-Hasselbalch equation?
pH = 6.1 + log [HCO3-] / (0.03 x Pco2)
Review the Winter’s formula?
Explain how is it used.
Pco2 = 1.5 [HCO3-] + 8 +/- 2
If measured Pco2 > predicted Pco2 -> concomitant respiratory acidosis
If measured Pco2 < predicted Pco2 -> concomitant respiratory alkalosis
What are the causes of anion gap (> 12mEq/L) metabolic acidosis?
MUDPILES Methanol (formic acid) Uremia DKA Propylene glycol Iron tablets; INH Lactic acidosis Ethylene glycol (-> -> oxalic acid) Salicylic acid (late) (early: resp alkalosis)
What are the causes of nl anion gap (8 - 12mEq/L) metabolic acidosis?
HARDASS Hyperalimentation (IV nutrients) Addison disease RTA Diarrhea Acetazolamide Spironolactone Saline infusion
What cells produce EPO?
Renal tubular interstitial cells
What are the 4 causes of renal papillary necrosis?
SAAD papa w/papillary necrosis
SCD/trait
Acute pyelonephritis
Analgesic (NSAIDs)
DM
