Renal

Question 1

Which part of the nephron concentrates urine?

Answer 1

Medulla

Question 2

What is the course of the ureter?

Answer 2

Under the uterine artery and under the deferens.

Question 3

What is the 60/40/20 rule?

Answer 3

60% total body water
40% ICF
20% ECF

Question 4

Goldblatt’e kidney?

Answer 4

Flea-bitten kidney (blown capillaries)

Question 5

Uremia?

Answer 5

Azotemia + symptoms

Question 6

Azotemia?

Answer 6

Inc BUN/Cr

Question 7

Nephritic kidney disease?

Answer 7

Inc size of fenestrations —> vasculitis

Question 8

Nephrotic kidney disease?

Answer 8

Lose of Basement Membrane charge due to deposition of heparin sulfate —> massive proteinuria and lipiduria

Question 9

What is seen in RPGN (Rapidly Progressive Glomerulonephritis)?

Answer 9

Crescents

Question 10

Post-Strep GN?

Answer 10

Subepithelial, IgG/C3/C4 deposition, ASO Ab

Question 11

Interstitial Nephritis?

Answer 11

Urine eosinophils or eosinophilic casts

Question 12

Lupus Nephritis?

Answer 12

Subepithelial

Question 13

MGN (Membranoglomerulonephritis)?

Answer 13

Deposition of “something”

Question 14

MPGN (Membranoproliferative Glomerulonephritis)?

Answer 14

Tram-tracks (Type II has low C3)

Question 15

MCD (Minimal Change Disease)?

Answer 15

Kids, fused foot processes, no renal failure, loss of charge barrier

Question 16

FSGS (Focal Segmental Glomerulosclerosis)?

Answer 16

AA, HIV patients

Question 17

What are the vasculitis with low C3?

Answer 17

PMS in Salt Lake City

Post-Strep GN
MPGN Type II
SBE
Serum sickness
Lupus
Cryoglobulinemia

Question 18

What is the most common cause of kidney stones?

Answer 18

Dehydration

Question 19

What is the most common type of kidney stones?

Answer 19

Calcium phosphate

Question 20

What type of kidney stones have coffin-lid crystals?

Answer 20

Triple phosphate

Question 21

What type of kidney stones have rosette crystals?

Answer 21

Uric acid

Question 22

What type of kidney stones have hexagonal crystals?

Answer 22

Cystine

Question 23

What type of kidney stones have envelope or dumbbell shaped crystals?

Answer 23

Oxalate

Question 24

What disease has Aniridia?

Answer 24

Wilm’s tumor

Question 25

What disease has Iridocyclitis?

Answer 25

Juvenile rheumatoid arthritis

Question 26

Phimosis?

Answer 26

Foreskin scarred at penis head (foreskin stuck smooshed up)

Question 27

Paraphimosis?

Answer 27

Foreskin scarred at penis base (retraction of foreskin —> strangulates penis)

Question 28

Urge Incontinence?

Answer 28

Urgency leads to complete voiding | Detrusor splasticity —> small bladder volume

Question 29

Stress Incontinence?

Answer 29

Weak pelvic floor muscles | Estrogen effect

Question 30

Overflow Incontinence?

Answer 30

Runs down leg but can’t completely empty bladder

Question 31

What structures have one way valves?

Answer 31

Urethra, ejaculatory duct

Question 32

What structures have fake sphincters?

Answer 32

Ureters, LES, ileocecal valve

Question 33

What has WBC casts?

Answer 33

Nephritis

Question 34

What has WBC casts only?

Answer 34

Pyelonephritis (sepsis)

Question 35

What has WBC casts + eosinophils?

Answer 35

Interstitial nephritis (allergies)

Question 36

What has WBC casts + RBC casts?

Answer 36

Glomerulonephritis

Question 37

What has Fat casts?

Answer 37

Nephrotic syndrome

Question 38

What has Waxy casts?

Answer 38

Chronic renal failure

Question 39

What has Tubular casts?

Answer 39

ATN

Question 40

What has Muddy brown casts?

Answer 40

ATN

Question 41

What has Hyaline casts?

Answer 41

Normal sloughing

Question 42

What has Epithelial casts?

Answer 42

Normal sloughing

Question 43

What has Crescents?

Answer 43

RPGN

Question 44

How do you measure Afferent renal function?

Answer 44

Creatinine or inulin

Question 45

How do you measure Efferent renal function?

Answer 45

BUN or PAH

Question 46

What is the Afferent arteriole’s job?

Answer 46

Filter

Question 47

What happens if you constrict the Afferent arteriole?

Answer 47

RPF goes down GFR goes down FF (GFR/RPF) stays the same

Question 48

What is the Efferent arteriole’s job?

Answer 48

Secrete

Question 49

What happens if you constrict the Efferent arteriole?

Answer 49

RPF goes down GFR goes up FF (GFR/RPF) goes up

Question 50

How do you test Afferent arteriole function?

Answer 50

GFR

Question 51

What is normal GFR?

Answer 51

100 mL/min

Question 52

How do you test Efferent arteriole function?

Answer 52

RPF

Question 53

What happens if you increase plasma protein concentration?

Answer 53

RPF stays unchanged GFR goes down FF (GFR/RPF) goes down

Question 54

What happens if you decrease plasma protein concentration?

Answer 54

RPF stays unchanged GFR goes up FF (GFR/RPF) goes up

Question 55

What is pre-renal failure?

Answer 55

Low flow to kidney (BUN:Cr > 20)

Question 56

What is renal failure?

Answer 56

Damage to glomerulus (BUN:Cr < 20)

Question 57

What is post-renal failure?

Answer 57

Obstruction (haven’t peed in last 4 days)

Question 58

What is the job of the proximal tubule?

Answer 58

Reabsorb glucose, amino acids, salt, and bicarb

Question 59

What is the job of the thin ascending limb?

Answer 59

Reabsorb water

Question 60

What is the job of the thick ascending limb?

Answer 60

Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water

Question 61

What is the job of the early distal tubule?

Answer 61

Concentrate urine by reabsorbing NaCl (hypotonic)

Question 62

What is the job of the late distal tubule and collecting duct?

Answer 62

Final concentration of urine by reabsorbing water, excretion of acid

Question 63

What does the macula densa do?

Answer 63

Measures osmolarity

Question 64

What does the JG apparatus do?

Answer 64

Measures volume

Question 65

Fanconi’s Syndrome?

Answer 65

Old tetracycline use —> urine phosphates, glucose, amino acids

Question 66

Bartter’s Syndrome?

Answer 66

Baby with defective triple transporter (low Na, Cl, K with normal BP)

Question 67

Psychogenic Polydipsia?

Answer 67

No concentrating ability —> cerebral edema

Question 68

Hepatorenal Syndrome

Answer 68

High urea from liver —> increased activity of glutaminase —> inc NH4+ —> GABA —> kidney stops working

Question 69

Type I RTA?

Answer 69

Distal renal tubular acidosis H/K in collecting duct is broken —> high urine pH (UTI, stones, Li)

Question 70

Type II RTA?

Answer 70

Proximal RTA: bad CA —> lost all bicarb —> low urine pH | Multiple myeloma

Question 71

Type III RTA?

Answer 71

RTA I + II —> normal urine pH (5-6)

Question 72

Type IV RTA?

Answer 72

Infarct of JG —> no renin —> no aldosterone —> high K | DM, NSAIDs, ACEi, heparin

Question 73

Central Pontine Myelinolysis?

Answer 73

Due to correcting Na faster than 0.5mEq/hr