Renal Flashcards
Proximal tubule..
Main site for reabsorbtion
Aldosterone acts on..
Na channel in DCT to reabsorb water and sodium (secrete k and H)
Renal angiomyolipomas in what syndrome
TS
Peritonitis organisms in dialysis
SA 20% CONS 40% strep 20% pseudomonas 5%
Fanconi syndrome renal problem location
Proximal tubule dysfunction (RTA2), not reabsorbing all the good stuff so lose sodiuma nd don’t grow well and have tubular dysfunction so drink and wee lots
Causes: cystinosis and Lowes syndrome
In phaeo with HTN don’t use..
Bets blocker but use a blocker (phentolamine IV or oral phenoxybenzamine)
Persistently low C3 in…
Membranoprolif
RPGN presentation
Nephrotic or nephritic
Crescents on biopsy
Tx steroid
Presents with family history and haematuria
Alports genetic test and biopsy result?
Hereditary nephritis mainly XL (dominant)
Mutation in COL4 gene encoding type IV collagen which affects BM
Macroscopic haematuria
Biopsy variable thickness and splitting of BM - basket weave appearance
SNHL ears
Eyes cataracts, anterior lenticonus, macular abnormalities
ESRD 50% by 25
IgA nephropathy
Mostly boys Recurrent (at time of infection) Macroscopic haematuria Most are ok by 10% to EsRf Biopsy IgA deposits Tx steroids If bad
Three causes of nephrotic syndrome
Minimal change (steroids)
FSGN
Memb snouts nephropathy
Renal stone increased by high ? Diet
Na (decreases calcium absorption)
Present with FTT, recurrent episodes dehydration, hypercalciuria, 20% low serum mg, renal stones
Hypokalaemic metabolic acidosis
Bartter syndrome:
AR dysmorphic
Nephrocalcinosis
Like frusemide abuse
Present with hypokalaemic metabolic alkalosis, some mild growth failure, pr sent later, hypomagnesemia, hypocalciuria
Gitelman syndrome
AR defect na/cl CT
Like thiazide abuse
Prune belly =
Abdo wall defect, undescended testes, UT abnormalities
Granular casts in..
ATN
GFR gold standard
Inulin (gold standard but difficult to measure)
DTPA vs DMSA
Parenchyma defects
DMSA for structure/morphology - scarring, static scan, size and % function
DTPA for transit over time and looks for obstruction and drainage, how whole system is working, dynamic
Haematuria excretion rate increases with
Age and exercise
Proteinuria with fever, exercise, heart failure
Risk of nephritis in ahSP after 2m
2%
6 forms of steroid resistant nephrotic syndrome in childhood
Minimal change Membranoproliferative glomerulosis Membranous nephropathy Secondary (IgA, HSP, Lupus) FSGS Congenital
Syndrome causing childhood HTN
Liddle due to acting like there is high aldosterone (but it’s normal)
Best drug for reduction BP, proteinuria, preservation of renal function
ACEi
MCDK
1/4000, non heritable, unilateral nonfunctional cystic mass
Bilateral fatal often other kidney can make up for it but may have VUR - monitoring important