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USMLE Step 1 > Renal > Flashcards

Renal Flashcards

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USMLE® Step 1 flashcards
1
Q

What is POTTER sequence?

A

Can’t pee in utero- oligohydramnios

  • pulmonary hypoplasia
  • oligohydramnios
  • twisted face
  • twisted skin
  • extremity defects
  • renal failure
  • low set ears and retrognathia, flattened nose
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2
Q

What affects the metanephric mesenchymal differentiation?

A

interaction with the ureteric bud
-if you get this you can get multicystic dysplastic kidney, usually unilateral and nonfunctional, but if bilateral then you get POTTER sequence

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3
Q

what is a duplex collecting system?

A

the ureteric bud bifuricates befor it interacts with the metanephric blastema
-higher risk UTIs and reflux

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4
Q

what does the ureter go over and under anatomically?

A

goes under the gonadal arteriesm over the common iliac artery then under the uterine artery
-gyne procedures can damage the ureter

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5
Q

how do you calculate the clearance of a substance?

A

Cx=UxV/Px, if CxGFR, then net secretion and if they are equal then theres no reabsorption or secretion

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6
Q

what is the normal GFR?

A

100ml/min, can calculate with Uinulin because not absorption or secreted

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7
Q

effective renal plasma flow calculation?

A

is estimated by PAH, because 100% should be excreted

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8
Q

how do you estimate the filtration fraction?

A

GFR/RPF, normal FF 20%

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9
Q

what do prostaglandins and angiotensin 2 due to the afferent and efferent arterioles?

A

prostaglandins dilate afferent arteriole

angiotensin 2 constricts the efferent arteriole

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10
Q

fractional excretion of sodium?

A

UNa x V (flow)/GFR xPNa

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11
Q

What is Fanconi syndrome?

A

PCT reabsorption issue, so excretion HCO3, glucose, PO4, can get osteopenia, metabolic acidosis, hypophosphatemia

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12
Q

What is Bartter syndrome?

A

affects thick ascending loop of henle,- Na/K/2Cl pump- looks like chronic use of loop diuretics so you can get metabolic alkalosis, hyperca, hypoK

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13
Q

Gitelman syndrome?

A

DCT, looks like chronic thiazide diuretic use- get metabolic alkalosis, hypoCa, hypoMg, hypoK

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14
Q

Liddle syndrome?

A

in the collecting duct

  • gain of function mutation
  • only one thats AD
  • you get increased activity of Na channel (more absorption of Na)
  • metabolic alkalosis, hypoK, hypertension, low aldosterone
  • it looks like primary hypoaldosteronism, but the aldosterone is undetectable
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15
Q

Syndrome of apparent mineralocorticoid excess

A

hereditary deficiency in 11B-hydroxysteroid dehydrogenase

  • too much cortisol , increased mineralocorticoid activity
  • metabolic alkalosis, hypoK, hypertension
  • actually have low aldosterone because cortisol is trying to be aldosterone
  • tx with K sparing diuretic and steroids, exogenous steroids will dec endogenous secretion
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16
Q

What are ANP and BNP?

A

ANP-atria
BNP-ventricles
-secreted when high volume, relax vascular smooth muscle so inc GFR and decrease renin, dilate afferent and constrict efferent

17
Q

where is 25OH vit d converted to 1,25 OH vit d?

A

PCT by 1-alpha hydroxylase (PTH increases 1 alpha hydroxylase)

18
Q

What is winters formula?

A

predicted respiratory compensation

PCo2=1.5 (HCO3) + 8 +/-2

19
Q

What are causes of non-anion gap metabolic acidosis?

A

HARDASS-hyperailmentation, addisons disease, renal tubular acidosis, diarrhea, acetozolamide, spironolactone and saline infusion

20
Q

Whats the difference between type 1 and type 4 distal renal tubular acidosis?

A

type 1- alpha intercalated cell dysfunction, pH>5.5, because can’t secrete H, hypokalemia
type 4- hypoaldosteronism-ph urine <5.5 b/c secreting H to compensate, hyperkalemia

21
Q

What is the maltese cross sign?

A

oval fatty casts- nephrotic syndrome

22
Q

what causes nephrotic syndrome?

A
  1. Membranous nephropathy
  2. Minimal change disease
  3. Diabetic nephropathy
  4. Focal segmental glomerulosclerosis
  5. amyloidosis
23
Q

what causes nephritic syndrome?

A
  1. Post strep glomerulonephritis
  2. IgA nephropathy
  3. MPGN
  4. Alports
24
Q

what type of hypersensitivity reaction is post strep glomerulonephritis?

A

type 3

25
Q

what type of hypersensitivity reaction is goodpastures?

A

type 2- plasmapheresis

-get crescentic moon shape on LM-fibrin and plasma proteins

26
Q

What is Beckwith-Wiedemann syndrome associated with?

A

Wilms tumour (nephroblastoma), macroglossia, organomegaly, hemihyperplasia (WT2 mutation-tumour suppressor genes)

USMLE Step 1 (20 decks)

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