Renal Flashcards
Kidney sense hypoxia
Interstitial cells in peritubal caps secrete epo which stim rbc form in bone marrow, get increase o2 capacity
-epo sup inc harmonic kidney disease
Calcidiol to calcitriol
Proximal convoluted tubule via 1 a hydroxylase
Prostagladin
From paracrine cells, vasodilator afferent arterioles and increase filtration of blood
Renal protective
NSAIDs
Block prostaglandins get constriction afferent arterioles and decrease and gfr in low blood flow get renal failure
Dopamine
Proximal convoluted tube
Promotes natriuretic
Dilated arterioles
Increases glomerular filtration
At high doses vasoconstriction
Coma, malaise nausea and stupendous state seizures
Low sodium
Bradycardia, decreased DTN, hypotension with cardiac arrest, hypocalcemia
Increase mg
Arrhythmias, muscle weakness, widened qrs, peaked t waves
Potassium high
Twitching, tetany, seizures, prolonged qt
Low calcium
Bone low, osteomalacia, rickets
Low phosphate
Too much phosphate
Hypocalcemia, kidney stones
Flattened u wave t wave, arrhythmias, muscle cramps, weak
Low k
Kidney stones, abdominal pain, increased urinary frequency, anxiety, altered mental status
Elevated calcium
Elevated calcium
Stones, bones, groans, thrones, psychiatric overtones
Tetany, torsades, hypokalemia, hypocalcemia
Magnesium low
Uti presentation
Suprapubic pain
Dysuria
Increased urgency
Who gets uti
Women, diabetes, indwelling catheter, intercoarse
What causes uti
E. coli, klebsiella, proteus mirabilis-ammonia scent
-staph saphorphiticus
UA UTI
Nitrites-gram negative orgamins
Leukocytes
WBC UA but grow nothin in culture
Won’t grow gonorrhea of chlamydia so keep going
Coca Cola urine, subepithelial humps, positice anti dnase b , high streptolysin O titer
Post streptococcal glomerulonephritis
Streptolysin o titer
Group a strep-strep throat or impetigo
May occur after URI, purpura butt and leg, Berger disease igA
Iga nephropathy-henosch purpura
Defect in type IV collagen, cataracts, hematuria, high frequency hearing loss
Alport
Granulomas in nasal passage, pulmonary infiltrates, hematureia, positive cANCA
Granulomatous with polyangitis
Wagner lung and kidney
Involves nasal passages, associated with asthma, positive pANCA, peripheral eosinophilia
Eosinophilic granulomatosis with polyangitis
Microscopic hematuria, pulmonary infiltrates, type II hypersensitivity, anti GBM antibodies
Good pasture
Acute intestinal nephritis
Acute inflammation of interstitial of the kidneys
Leads to edema of the kidneys, damaged tubules, and azotemia
Urinalysis shows increased WBC no nitrates
Urine smear-eosinophils
What cause acute interstitial nephritis
Diuretics, penicillin, PPI, sulfa, rifampin, NSAIDS
P
Pee(diuretics Pain fre (nsaids) Penicillins and cePhalosporins PPI Rifampin
How
Enter basement membrane act as hapten to stimulate immune response
Acute intestinal nephritis presentation
Asymptomatic, fever, rash, costovertebral tenderness, hematuria
Key is UA
Sulfonamide lop diuretics
Furosemide, bumetanide, torsemide
MOA sulfonamide loop diuretics
Inhibit NaK CL
Ruin hypertonicity of medulla, make urine dilute, stimulate prostagladin E(dilate afferent)
Increase urine output
Who give
Cirrhosis, HF, nephrotic syndrome, pulmonary edema, hypercalcemia
Risk loop
Ototoxicity, hypokalemia, hypomagnesia, dehydration, metabolic alkalosis, nephritis, gout, allergy
OH DANG
Ethacrynic acid
Inhibit Na K Cl in TAL
No sulfa
Ototoxicity
Loop earrings hurt your ears
Ok
Thiazides
Hydrochlorothiazide,
Chlorthalidone
Metolazone
MOA thiazides
Salt not reabsorbed follows
Decrease calcium excretion
Use thiazides for HTN
Idiopathic hypercalciuria
Nephrogenic DI
AE thiazide
Hypokalemia metabolic alkalosis, hyponatremia, sulfa
Hyperglycemia, lipidemia, uric Emma, calcemia
