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AUBF LEC > Renal Disease Prt.2 > Flashcards

Renal Disease Prt.2 Flashcards

1
Q

•Each nephron processes ~_____ of filtrate daily with____% reabsorption

A

180L

99%

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2
Q

•Tubular system performs (3)

A

reabsorption, secretion, and concentration

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3
Q

•The____ is the functional unit of the kidney with distinct segments

A

nephron

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4
Q

Key Tubular Segments and Functions

A

Proximal tubule
LOH
Distal tubule
Collecting duct

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5
Q

Proximal Tubule
1. Reabsorbs 65-80% of filtered (3)
2. Handles virtually all (2) reabsorption
3. Reabsorbs 80-90% of (1)

A

sodium, chloride, water

glucose and amino acid

bicarbonate

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6
Q
  1. Establishes concentration gradient
  2. Impermeable to water in ascending limb
A

Loop of Henle

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7
Q

•Fine-tunes electrolyte balance
• Regulated by hormones (PTH, aldosterone)

A

Distal Tubule

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8
Q

• Water reabsorption (ADH-controlled)
• Final acid-base regulation
• Potassium secretion

A

Collecting Duct

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9
Q

Pathophysiological Patterns

•_______: Failure to reabsorb filtered substances
•_______: Failure to secrete substances
•_______: Disrupted water handling

A

Wasting Syndromes

Retention Syndromes

Concentration/Dilution Defects

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10
Q

Clinical Manifestations
• Polyuria/polydipsia
•Electrolyte abnormalities
•Acid-base disturbances
•Growth issues in children
• Nephrolithiasis/nephrocalcinosis

A

Tubular Disorders

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11
Q

Tubular disorders

Diagnostic Approach (4)

A

• Urinalysis (pH, specific gravity, glucose, protein)
•Serum electrolytes and acid-base status
•Specialized functional testing
• Imaging and genetic studies when indicated

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12
Q

Proximal Tubular Disorders (5)

A

Fanconi Syndrome
Renal Glucosuria
Cystinuria
RTA T2
Hartnup Disease

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13
Q

Loop of Henle Disorders (2)

A

Bartter Syndrome
Medullary Sponge Kidney

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14
Q

Distal Tubular Disorders (2)

A

RTA T1
Gitelman Syndrome

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15
Q

Collecting Duct Disorders (2)

A

Nephrogenic DI
RTA T4

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16
Q

Proximal Tubular Disorders

•Pathophysiology: Generalized proximal tubular dysfunction

A

Fanconi Syndrome

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17
Q

Proximal Tubular Disorders

•Clinical Features: Polyuria, polydipsia, dehydration, growth retardation

• Laboratory Findings:
• Glucosuria with normal blood glucose
• Aminoaciduria
• Phosphaturia and hypophosphatemia
• Bicarbonaturia and metabolic acidosis
• Low-molecular-weight proteinuria

A

Fanconi Syndrome

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18
Q

Proximal Tubular Disorders

•Pathophysiology: Isolated defect in glucose reabsorption

A

Renal Glucosuria

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19
Q

Proximal Tubular Disorders

•Clinical Features: Often asymptomatic
• Laboratory Findings:
• Glucosuria with normal blood glucose
•No other tubular abnormalities

A

Renal Glucosuria

20
Q

Proximal Tubular Disorders

•Pathophysiology: Defective transport of dibasic amino acids

A

Cystinuria

21
Q

Proximal Tubular Disorders

•Clinical Features: Recurrent kidney stones

A

Cystinuria

22
Q

Proximal Tubular Disorders

Cystinuria

• Laboratory Findings:
Increased urinary excretion of (4)

•Characteristic____ crystals in urine

•Positive______test

A

cystine, ernithine, lysine, and arginine

hexagonal

cyanide-nitroprusside test

23
Q

Proximal Tubular Disorders

•Pathophysiology: Defective bicarbonate reabsorption

A

Renal Tubular Acidosis Type 2 (Proximal RTA)

24
Q

Proximal Tubular Disorders

•Clinical Features: Growth failure, rickets, osteomalacia

• Laboratory Findings:
•Hyperchloremic metabolic acidosis
• Urine pH < 5.5 during acidosis
•Bicarbonaturia
• Hypokalemia

A

Renal Tubular Acidosis Type 2 (Proximal RTA)

25
Q

Proximal Tubular Disorders

•Pathophysiology: Defective neutral amino acid transport

A

Hartnup Disease

26
Q

Proximal Tubular Disorders

•Clinical Features: Pellagra-like rash, cerebellar ataxia

• Laboratory Findings:
• Increased urinary excretion of neutral amino acids
•Normal serum amino acid levels

A

Hartnup Disease

27
Q

Hartnup Disease

•Clinical Features:

A

Pellagra-like rash
cerebellar ataxia

28
Q

RTA T2

•Clinical Features:

A

Growth failure, rickets, osteomalacia

29
Q

Cystinuria

•Clinical Features:

A

Recurrent kidney stones

30
Q

Fanconi syndrome

•Clinical Features:

A

Polyuria, polydipsia, dehydration, growth retardation

31
Q

Loop of Henle Disorders

• Pathophysiology: Defect in sodium-potassium-chloride cotransporter

A

Bartter Syndrome

32
Q

Loop of Henle Disorders

•Clinical Features: Growth retardation, muscle weakness, polyuria

• Laboratory Findings:
• Hypokalemic metabolic alkalosis
•Hypochloremia
•Normal blood pressure
•Elevated renin and aldosterone
• Hypercalciuria

A

Bartter Syndrome

33
Q

Loop of Henle Disorders

• Pathophysiology: Cystic dilation of collecting ducts in renal pyramids

A

Medullary Sponge Kidney

34
Q

Loop of Henle Disorders

•Clinical Features: Nephrolithiasis, hematuria, UTIs

• Laboratory Findings:
•Nephrocalcinosis
• Hypercalciuria
•Microscopic hematuria
•Sterile pyuria

A

Medullary Sponge Kidney

35
Q

Bartter syndrome

•Clinical Features:

A

Growth retardation, muscle weakness, polyuria

36
Q

Medullary sponge kidney

•Clinical Features:

A

Nephrolithiasis, hematuria, UTIs

37
Q

Distal Tubular Disorders

•Clinical Features: Growth failure, rickets, nephrocalcinosis

• Laboratory Findings:
•Hyperchloremic metabolic acidosis
• Urine pH > 5.5 despite acidosis
•Hypercalciuria
•Hypokalemia
•Nephrocalcinosis

A

Renal Tubular Acidosis Type 1 (Distal RTA)

38
Q

Distal Tubular Disorders

•Pathophysiology: Inability to secrete hydrogen ions

A

Renal Tubular Acidosis Type 1 (Distal RTA)

39
Q

Distal Tubular Disorders

•Clinical Features: Muscle weakness, fatigue, tetany

• Laboratory Findings:
• Hypokalemic metabolic alkalosis
•Hypomagnesemia
•Hypocalciuria
•Normal blood pressure

A

Gitelman Syndrome

40
Q

Distal Tubular Disorders

•Pathophysiology: Defect in thiazide-sensitive sodium-chloride cotransporter

A

Gitelman Syndrome

41
Q

Collecting Duct Disorders

•Clinical Features: Polyuria, polydipsia, dehydration

• Laboratory Findings:
•Dilute urine (specific gravity < 1.005)
• Hypernatremia
•No response to desmopressin
•Normal or elevated ADH levels

A

Nephrogenic Diabetes Insipidus

42
Q

Collecting Duct Disorders

•Pathophysiology: Resistance to antidiuretic hormone (ADH)

A

Nephrogenic Diabetes Insipidus

43
Q

Collecting Duct Disorders

•Clinical Features: Muscle weakness, cardiac arrhythmias

• Laboratory Findings:
•Hyperkalemia
•Mild hyperchloremic metabolic acidosis
•Urine pH < 5.5
•Low or normal aldosterone levels
•Associated with diabetic nephropathy or interstitial nephritis

A

Renal Tubular Acidosis Type 4 (Hyperkalemic RTA)

44
Q

Collecting Duct Disorders

• Pathophysiology: Aldosterone deficiency or resistance

A

Renal Tubular Acidosis Type 4 (Hyperkalemic RTA)

AUBF LEC (20 decks)

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