Renal and Anemia Test memorization Flashcards
Estimate GFR using the Cockroft-Gault formula. (give the formula).
What if it’s a woman?
GFR = (140-age) x weight (kg) / 72 x serum [Cr]
Multiply by 0.85 if female
Define AKI (3).
W/in 48 hrs: ↑ in serum creatinine of > 0.3mg/dL OR Percentage ↑ in serum creatinine of 50% OR Oliguria of < 0.5mL/kg/hr for > 6 hours
How many months must GFR decline for (at least) for it to be considered CKD?
3 months
What are the 3 hematuria imposters?
Free Hemoglobin
Myoglobin
Menstrual contamination
3 characteristics of nephritic syndrome?
Acute onset:
- hematuria with dysmorphic cells and RBCs/casts in the urine,
- some degree of oliguria and azotemia and
- hypertension.
What is proteinuria defined as, in terms of loss (mg/day) of protein?
What is “massive proteinuria” defined as?
> 30 mg/day
> 3.5g/day
What is considered hypoalbuminemia? (< ___ g/dL)
< 3 g/dL
What is the characteristic clinical syndrome a/w diabetic nephropathy?
- proteinuria,
- progressive decline in GFR
- hypertension
Why do a kidney bx in SLE?
- to determine the severity of kidney involvement
- to determine potential for reversibility of lesions
- to determine treatment options
What 3 drugs can cause acute drug-induced interstitial nephritis?
- PCN derivatives
- Diuretics
- NSAIDs
(also PPIs, rifampin)
What specific kidney pathology can NSAIDs cause?
Acute hypersensitivity interstitial nephritis
Clinical: *nephrotic syndrome + *renal failure
What does each of these become?
Pronephros
Mesonephros
Metanephros
- Pronephros is redimentary, doesn’t fcn
- Mesonephros fcns a short time
- So mesonephros forms ureter (ureteric bud) and part of kidney that connects to it
Ureteric bud derivatives: become renal pelvis, major calyx, minor calyx - Metanephros forms kidney
Mesenchymal derivatives: become collecting duct system
Metanephric blastema: nephrons
Genes a/w childhood polycystic kidney disease?
Adult?
Child (AR): PKHD1 gene, 6p, fibrocystin
Adult (AD):
- APKD1 – polycystin 1, cell-cell, cell-matrix interaction (85%, earlier onset of renal failure, more severe)
- APKD2 – polycystin 2, regulation of intercellular Ca2+ levels (later onset of renal failure)
What two clinical findings is APKD a/w?
Mitral prolapse, berry aneurysms
Genes a/w angiomyolipoma?
Tuberous Sclerosis:
TSC1 - Hamartin 9q34
TSC2 - Tuberin 16p13
Gene mutated in RCC?
What ts factor then accumulates? Leading to what cellular effect?
VHL gene (tumor suppressor gene, nlly ubiquitinates HIF)
- Loss of VHL gene results in accumulation of the ts factor HIF-1α, facilitating adaptation to tissue hypoxia
- Origin from proximal tubular epithelium
(VHL = von Hippel Lindau, also a syndrome; earlier onset vs RCC, a/w CNS hemangioblastoma)
What drug is a risk factor for urothelial carcinoma?
Analgesics (smoking also big risk factor, I believe.
Strong association w/hematuria, esp. gross
What genes are a/w Wilm’s tumor?
WT1, WT2
WAGR: WT1 deletion, DDS: WT1 mutation, BWS: WT2 gene cluster mutation
RPF = \_\_\_\_\_\_\_\_\_\_\_ clearance RBF = \_\_\_\_\_\_\_\_\_\_\_ (equation)
PAH
= RPF/(1-Hct)
Filtration fraction (FF) = _____/_____
GFR/RPF
“The typical _________ decline in GFR will be evident when GFR is plotted vs. time” in CKD.
How would Cr change in chronic?
Acute?
linear
- Exponential increase
- Linear increase
What is the fractional excretion formula.
Fractional excretion = Amount excreted / Amount filtered
FENa = (UNa/PNa) / (UCr/PCr)
How is FeNa+ affected by changes in GFR?
Assuming no change in dietary sodium intake, the FENa will double for every halving of GFR.
Casts seen in prerenal AKI?
hyaline