Renal Flashcards
What do the pronephros and mesonephros become?
What parts of the kidney are the metanephros? and when does it first appear?
and the ureteric bud?
Duplex collecting mechanism?
Posterior urethral mechanism?
Horseshoe kidney
Unilateral renal agenesis mechanism?
Potter sequence
Multi
Clearance equation?
and if Cx<gfr></gfr>
<p>Cx>GFR?</p>
<p>equal?</p>
</gfr>
1 using inulin and #2 using forces
GFR equations
normal GFR is?
Course of the ureter? arises from? travels under? over the? and under the?
3 places for constriction?
Fluid compartments
Plasma volume can be measured using?
ECF measured using?
normal plasma osmolality?
Normal HCT?
How do we measure RPF?
equation?
Plasma volume?
Filtration fraction equation?
Normal FF?
Filtered load equation?
Prostaglandins do what?
AG2 does what?
Glomerular filtration barrier composed of what 3 things?
Charge barrier b/c all 3 layers contain?
Size barrier b/c?
Formula for Excretion rate?
So reasborption rate?
Formula for FeNa
Early DCT reasorbs? impermeable to? makes urine?
PTH effect?
how much sodium reabsorbed?
Effects on GFR, RPF, FF?
Afferent arteriole constriction?
efferent constriction?
incraesed plasma protein?
decreased plasma protein?
ureter constriction
dehydration
ANP/BNP
Renin
EPO released by what cells in respons to?
Calciferol converted by what cells in kidney?
Prostaglandins secrete how and do what to afferent?
Dopamin secreted by? promotes?
Gittlemans
Barrter?
AT2 limits?
Syndrome of apparent mineralocorticoid excess
In cells containing these receptors, what converts what?
inheritd how?
causes what to potassium? metabolic ______?
Treat with?
loop of henle
Descending?
ascending?
collecting duct?
Liddle
ADH
Aldosterone
PCT
Glucose transport
Fanconi
Relative concentrations
Which ones are secreted more than water?
and less?
JG appartus
Alkalosis causes for resp and metabolic
HardASS
Resp Acidosis causes
Mudpiles stands for?
and Anion gap is?
Symptoms when sodium is low? high?
Potassium low? high? (include ECK findings)
What shifts potassium into the cell?
and out of the cell? DO LABSS
Autosomal dominant polycystic kidney
AG2 effects on kidney?
PTH?
ANP?
Aldosterone?
ADH?
Symptoms when calcium low?high?
magnesium low? high?
Symptoms when phosphate low? high?
Renal tubular acidosis types? which part of kidney affected?
Types of casts
RBC?
WBC?
Fatty?
Granular (muddy brown)?
waxy?
hyaline?
hematuria with no casts?
Minimal change disease
Etiology: most common nephrotic syndrome in children, 15% in adults, idiopathic usually but can be seen in hodgkins and renal cell carcinoma
Labs: serum: low albumin, normal creatinine
Normal BP, Edema
Podocyte injury - effacement -protein goes between slits. No immune deposition. Normal LM, no IF, EM shows above.
Membranous nephropathy
idiopathic or secondary to SLE, HepB, syphilis, malaria, captopril, lithium, mercury, gold, penicillamine (Wilson’s)
Domes and Spikes
Sub-EPIthelial
Focal Segmental
also secondary to HIV, morbid obesity, chronic reflux nephropathy, heroin use, malignancies, congenital renal agenesis, renal ablation nephropathy, glomerulonephritis
Pathogenesis of secondary is due to reduction in renal mass, compensatory hypertrophy and hyperfiltration of remaining glomeruli to maintain GFR, intraglomerular hypertension–injury
IgA nephropathy
Associated with hepatic cirrhosis, gluten enteropathy, HIV infection, minimal change disease, membranous, wegeners, ankylosing spondylitis, small cell cancer
Post-Strep GN
Post Strep -preceded by pharyngitis (7-10 days) or impetigo (3 weeks)
Elevated ASO or anti-DNAase B, LOW CMPLEMENT. Don’t biopsy, do supportive therapy (b/c most likely outcome is resolution)
Complexes start subendo-but are rapidly cleared within a few days-hematuria resolves in this time.
EM: see Humps subepithelial —proteinuria persists for weeks
LM: Global and diffuse hypercellularity
CX: RPGN (Type 2)
Renin, Aldosterone, Ca levels in
Bartter
Gittleman
Liddle, SAME
SIADH
Conn’s
Reninoma
Amyloid deposition in kidney
Diabetic nephropathy
Diffuse cortical necrosis
Membranoproliferative GN
Type 1
Type 2
Type 1: Cryoglobulinemia (Hep C), Hep B, lupus, parasitic infections, endocarditis
(Cryoglobulinemia - IgM made against the virus Hep C precipitating within vessels in extremities.Cx: digital gangrene)
Leads to activation of classical complement pathway- low levels of C1/C4
Deposits are subendothelial made of C1q/C4/IgG
LM: Tram-track- double contour- splitting of basement membrane
Type 2: Idiopathic - worse prognosis- in children -dense deposit disease
Deposits found along basement membrane -made of C3 (very low C3 levels-activation of alternative complement pathway)- also has C3 nephritic factor
Alport
Diffuse proliferative GN
Often due to?
LM shows?
IF type?
Auto recessive polycystic kidney
UTI most common order?
Pyelonephritis
Acute?
Risk factors? tx? Cx?
Chronic? tubules can resemble?
Renal Cell Carcinoma
Tobacco smoking, obesity, HTN, cadmium, long standing dialysis
only 5% inherited -Von-Hippel-Lindau (CH3), autosomal dominant renal cell
Sporadic papillary, - trisomy 7, 17 loss of Y, activated/mutated MET
Hereditary papillary- trisomy 7, mutated/activated MET
Sporadic & hereditary clear cell- deletions on chromosome 3, loss of VHL
Urine osmolality if prerenal, instrinsic and postrenal?
Urine Na?
FeNa?
Serum BUN/Cr?
Causes of each?
Transitional cell carcinoma
Common- p53, rb, p16 genes
Males more than females, smoking (2X), analgesic abuse (phenacetin), cyclophosphamide, naphthylamine, rubber products
Renal Osteodystrophy
See completely throughout the bone (tunneling of bone) - iron and aluminum accumulate in bone to prevent further bone deposition
Also involves decreased BMP7–increased RANKL–FGF-23 (increased phosphate- contributing to secondary hyperparathyroid)
Consequences of renal failure
MAD HUNGER
Wilms tumor
2 tumor suppressor genes short arm chromosome 11 - see triphasic pattern (blastema, stroma, epithelial)
Acute tubular necrosis
most common cause
3 stages?
Can be from? and which impact which part of neprhon?
Acute interstitial nephritis. Often due to?
less commonly due to?
Symptoms? 5 P’s
Renal Oncocytoma
AD Tubulointerstitial kidney disease
Simple vs complex renal cysts
Renal papillary necrosis causes?
presents with?
may be triggered by?
Stress?
Urgency?
Overflow?
Hydronephrosis
Distention of? usualy caused by?
what becomes elevated when?
Sqaumous cell carcinoma caused by?
presnts with?
Rapidly progressive also called?
IF Type 1?
type 2?
type 3?
