Renal and Resp Flashcards
what is the enzyme that converts 25-OH vit D to 1,25 OH Vit D?
1 alpha hydroxylase
What causes a normal anion gap metabolic acidosis?
HARD ASS Hyperalimentation Addisonsdisease Renal tubular acidosis Diarrhea Acetazolamid Spironolactin/Saline infusion
RTA type 1
defect in collecting tubules ability to excrete H, pH >5.5, failure of H secretion by the alpha intercalated cells
- increase in urine pH increases the risk for CaPO4 kidney stones
RTA tpe 2
defect in proximal tubule’s ability to reabsorb HCO3, urine pH <5.5
- increased risk for hypophosphatemic rickets
spike and dope ammearance with supepithelial deposits
EM
what does the LM show in minimal change disease?
normal LM
em = foot process efacement
what is type 1 MPGN assoc w?
HBV HCV and SBE SLE
how do you distinguish between IgA nephropathy (Bergers) and PSGN?
IgA = days after infection PSGN = weeks after infection, have a decrease in C3
glomerulonephritis, deafness, eye problems
Alport syndrome
cant see, cant pee cant hear
spit basement membrane
how does GBM lose its polyanions in Minimal change disease?
due to a decrase in sialic acids
how do you prevent kidney stone formation?
- HIgh urine citrate concentration (binds to free Ca)
2. Fluids!
what are the urease positive bugs that can cause kidney stones?
- Proteus
- Klebsiella
- Staph
where does renal cell carcinoma originate from?
proximal tubule cells
how does RCC spread?
it invades renal vein then ICV and spreads hematogenously
genetics of WILMs tumor??
WT1 tumor suppressor gene
- contains embryonic glomerular structures
WAGR complex
wilms tumor
aniridia
genitourinary malformation
retardatoin: mentor and motor
thyroidization of kidney
seen in chronic pyelonephritis, tubules contain eosinophilic casts
what drugs are assoc with AIN?
-diuretics
- penicillin derivatives
- sulfonamides
- rifampin
- NSAIDs
usually 1-2 weeks after beginning drugs
What is ARPKD assoc with?
congenital hepatic fibrosis
in what pt population should you avoid loops?
gout!
what patient population should you avoid with ACE inhibitors?
Bilateral renal artery stenosis
tissue type of type I and II pneumocytes?
type I; squamous
type II: cuboidal
whats CCSP?
clara cell secretory protein: inhibits neutrophil recruitment and activation
calculation for physiologic dead space
Vd = Vt (PaCO2 - PeCO2)/PaCO2
BMPR2 gene
mutation behind primary pulmonary hypertension
- normally functions to inhibit vascular smooth mm proliferation
what is the activating mutation in adenocarcinoma of the lung?
k-ras
what lung cancer is assoc with hypertrophic osteoarhtropathy?
Adenocarcinoma- clubbin
what is a chylothorax?
lymphatic pleural effusion
- due to thoracic duct injury from trauma malignancy
- milky appearing and increased TGs
What is tryptase?
an enzyme released by mast cell degranulation and is specific to mast cells
What do cystic fibrosis patients usually die from?
pneumonia
prolonged sleep apnea can cause what?
pulmonary hypertension and right heart failure- due to hypoxemia induced pulmonary vasoconstriction
what is responsible for the green color of pus?
neutrophil myeloperxidase: heme based pigmented molecule contained within the azurophilic granules of neutrophils
- catalyzes the production of H2O2
how does m tb cause caseous necrosis?
due to a T lymphocyte mediated delayed type hypersensitivity reaction
