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Step 1 Review > Renal Embriology/ A&P High Yield > Flashcards

Renal Embriology/ A&P High Yield Flashcards

1
Q

What functions as an interim kidney for the 1st trimester?

A

Mesonephros

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2
Q

When does the metanephros begin to develop?

A

5th week of gestation

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3
Q

What does the ureteric bud give rise to?

A

Ureter, pelvises, calyces, collecting ducts

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4
Q

What results in congenital malformation of the kidney?

A

abberent interaction between the uteric buds and metanephric mesenchyme

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5
Q

What renal condition can cause Pooter sequence/ oligohydramnios?

A

ADPKD, renal agenesis, and obstructive and obstructive uropathy

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6
Q

“inferior poles of both kidneys fuse and get trapped under the IMA”

A

Horeshoe kidney

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7
Q

What chromosomal disorders are horseshoe kidney related to?

A

Edwards
Down
Patau
Turner

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8
Q

“bifurcation of ureteric bud before it enters metanephric blastema that leads to a Y shaped ureter”

A

Duplex collecting system

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9
Q

What congenital renal conditions leads to increased risk of RCC?

A

Renal agenesis

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10
Q

Which kidney is typically taken during a kidney transplant? Why?

A

The Left kidney due to its longer renal vein

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11
Q

Are ureters retro or intraperitoneal?

A

Retro

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12
Q

Does the ureter pass over or under the uterine artery and ductus deferens?

A

under (water under the bridge)

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13
Q

Where in the bladder are ureteral orifices?

A

Near the trigone of the bladder

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14
Q

The uterine vessels are in which ligament?

A

Cardinal ligament

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15
Q

How many liters is total body water (TBW) in a 70L person?

A

42L (60

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16
Q

How many liters in the ECF and ICF?

A

ECF (20%)= 14L

ICF (40%)= 28L

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17
Q

What is the volume of plasma volume?

A

3.5 L (25% of ECF)

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18
Q

What is the volume of interstitial volume?

A

10.5 (75% of ECF)

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19
Q

What 3 factors make up the glomerular filtration barrier?

A

Fenestrated capillary endotheium

Fused basement membrane with heparin sulfate

Epithelial layer consisting of poducyte foot processes

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20
Q

What is the equation for renal clearance?

A

Cx= UxV/ Px

Cx= clearance of X
Ux= urine concentration of x
Px= plasma concentration of x
V= urine flow rate
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21
Q

How is GFR calculated?

A

GFR= clearance of inulin

Cin= UinV/ Pin

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22
Q

What lab value is an approximate measure of GFR?

A

Creatinine clearance

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23
Q

How is renal plasma flow calculated?

A

RPF= UpahV/ Pah

The clearance of PAH!

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24
Q

How is RBF calculated?

A

RBF= RPF/ (1- Hct)

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25
Q

How is PAH used to estimate RPF?

A

Because it is both filtered and secreted in the PCT–> near 100% clearance

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26
Q

How is filtration fraction calculated?

A

FF= GFR/ RPF

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27
Q

What is normal FF?

A

20%

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28
Q

What substance dilates afferent arterioles?

A

Prostaglandins

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29
Q

What preferentially constricts efferent arterioles?

A

Angiotensin II

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30
Q

Does the following increase or decrease GFR, RPF, and FF:

Afferent arteriole constrictoin

A

GFR: decrease

RPF: decrease

FF: –

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31
Q

Does the following increase or decrease GFR, RPF, and FF:

Efferent arteriole constriction

A

GFR: increase

RPF: decrease

FF: Increase

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32
Q

Does the following increase or decrease GFR, RPF, and FF:

Increased plasma protein concentration

A

GFR: decreased

RPF: –

FF: decreased

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33
Q

Does the following increase or decrease GFR, RPF, and FF:

decreased plasma protein concentration

A

GFR: increased

RFP: –

FF: increased

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34
Q

Does the following increase or decrease GFR, RPF, and FF:

Constriction of ureter

A

GFR: decreased

RPF: –

FF: decreased

35
Q

What is the equation for filtered load?

A

Filtered= GFR X Px

36
Q

What is the equation for excretion rate?

A

Excretion rate= V X Ux

37
Q

How and where is glucose reabsorbed?

A

Via Na/ glucose cotransport in the PCT

38
Q

At what glucose concentration are the renal glucose transporters saturated?

A

Approximately 375 mg/dL

39
Q

What is hartnup disease?

A

deficiency of neutral amino acid transporters in the PCT and enterocytes

40
Q

What is the inheritance pattern of Hartnup disease?

A

Autosomal dominant

41
Q

What are the symptoms of Hartnup disease?

A

Pellagra like (because decreased tryptophan conversion to niacin)

42
Q

What transporter does Angiotensin II work on? What results from this interation?

A

Works on Na+/ H+ antiport (H+ enters the urine)

Leads to contraction alkalosis

43
Q

Where is NH3 generated and secreted within the nephron?

A

PCT

44
Q

Which segment of the nephron is impermiable to Na?

A

tDL of henle

45
Q

Is the tubular fluid hypertonic or hypothonic in the tDL?

A

It is Hypertonic because it is impermeable to water yet it allows for H2O reab

46
Q

Which segment of the nephron makes urine less concentrated?

A

TAL

47
Q

Where are Na/K/2Cl transporters found?

A

TAL

48
Q

Where does paracellular Mg and Ca reaborption occur?

A

TAL

49
Q

Where does PTH work in the Nephron?

A

1- inhibits Na/ PO4 cotransport in the PCT

2- increases Ca/ Na exchange in the DT

50
Q

What type of transporter do thiazide diuretics work on?

A

Na/ Cl

51
Q

In the CT, Na is reabsorbed in exchange for…

A

K+ and H+

52
Q

How does aldosterone exert its effects?

A

Induces protein synthesis leading to increased Na/K pump activitry and K+ loss as well as increasing H/ ATPase activity leading to ucreased HCO3/ Cl- activity

53
Q

“increased excretion of nearly all amino acids, glucose, HCO3, and PO4 that can result in metabolic acidosis)

A

Fanconi syndrome (generalized reabsorptive defect in PCT)

54
Q

“defective Na/K/2Cl transporter in the TAL that has AR inheritance”

A

Bartter syndrome

55
Q

What are the electrolye and metabolic changes seen in Bartter syndrome?

A

Hypokalemia, metabolic alkalosis, and hypercalciuria

56
Q

“resorptive defect of NaCl in DCT with AR inheritance”

A

Gitelman syndrome

57
Q

“AD gain of function mutation leading to increased Na reab in the CT”

A

Liddle syndrome

58
Q

What 3 factors can lead to increased renin secretion?

A

Decreased BP (JG cells)

Decreased Na+ delivery (macula densa cells)

Increased sympathetic tone (beta 1 receptors)

59
Q

What is the main function of ADH?

A

regulates osmolarity

60
Q

What is the main function of aldosterone?

A

primarily regulates ECF volume and Na content

61
Q

Through what mechanism does ANP/ BNP work?

A

relaxes vascular smooth muscle via cGMP–> increased GFR–> decreased renin

62
Q

How do beta 1 blocers decrease renin release?

A

Via inhibition of Beta 1 receptors of the JGA cells

63
Q

What cells repease EPO?

A

Peritubular cells

64
Q

Where is 1 alpha hydroxlase found?

A

In PCT cells

65
Q

What cells secrete renin?

A

JG cells

66
Q

What 2 factors promote the secretion of aldosterone?

A

Increased plasma K and decreased blood volume

67
Q

Name 6 factors that lead to Shift of K out of the cell (hyperkalemia)?

A

Digitalis
Hyperosmolarity
Lysis of cells

Acidosis
beta blocker
high blood sugar

68
Q

Name 4 factors that cause the shift of K into the cell (hypokalemia)?

A

Hypoosmolarity
Alkalosis
beta adrenergic agonist
insulin

69
Q

Name the electrolyte abnormality:

U wave

A

HYPOkalemia

70
Q

Name the electrolyte abnormality:

flattened T wave

A

HYPOkalemia

71
Q

Name the electrolyte abnormality:

Wide QRS and peaked T wave

A

HYPERkalemia

72
Q

Name the electrolyte abnormality:

TdP

A

Hypomagnesium

73
Q

Name the electrolyte abnormality:

Bones, groans, psychiatric overtones, stones

A

HYPERcalemia

74
Q

What are the levels of the pH, Pco2 and HCO3 in the folling acid base problem:

Metabolic acidosis

A

pH: decreased

Pco2: decreased

HCO3: decreased

75
Q

What is the compensation for metabolic acidosis?

A

Hyperventilation

76
Q

What are the levels of the pH, Pco2 and HCO3 in the folling acid base problem:

Metabolic alkalosis

A

pH: increased

Pco2: increased

HCO2: increased

77
Q

What is the compensation for metabolic alkalosis?

A

Hypoventilation

78
Q

What are the levels of the pH, Pco2 and HCO3 in the folling acid base problem:

respiratory acidosis

A

pH: decreased

Pco2: increased

HCO3: decreased

79
Q

What is the compensation for respiratory acidosis?

A

increased real HCO3 reabsorption

80
Q

What are the levels of the pH, Pco2 and HCO3 in the folling acid base problem:

respiratory alkalosis

A

pH: increased

Pco2: decreased

HCO3: increased

81
Q

What is the compensation for respiratory alkalosis?

A

decreased renal HCO3 reabsorption

82
Q

What is winter’s formula? What is it used for?

A

Pco2= 1.5 (HCO3) + 8 +/- 2

It is used to see if there is compensation

83
Q

What can cause anion gap metabolic acidosis?

A

MUDPILES:

Methanol
Uremia
Diabetic ketoacidosis
propylene glycol
Iron tables or isoniazid
lactic acudosis
ethylene glycol
salicylates
84
Q

What causes normal non gap metabolic acidosis?

A

HARD-ASS

Hyperalimentation
Addison disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline infusion

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