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Renal Final Details Flashcards

1
Q

The permenent primitive kidney develops from what primitive structure

A

Metanephros–> uteric bud

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2
Q

Which are is the last of the urogenital system to canalize and is therefore the most common location of fetal obstruction

A

uretopelvic junction

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3
Q

horseshoe kidney is associated with what genetic condition?

A

Turner syndrome

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4
Q

abnormal interaction between the ureteric bud and the metanephric mesenchyme can result in what deformity?

A

Multi-cystic dysplastic kidney

(because the metenephric mesenchyme differentiates into the glomerulus)

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5
Q

The glomerulus is located within the ______ and the nephron is located within the _______.

A

Cortex

Medulla

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6
Q

JG cells release what molecule under what stimulation?

A

Renin

Low Na in DCT

Low BP

Increased B-stimulation

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7
Q

What is the 60-40-20 rule

A

Body weight is:

60% TBW

40% of that is ICF and 20% is ECF

Of ECF–> 25% plasma volume

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8
Q

What molecule used to measure GFR? RPF?

A

GFR- inulin

RPF- PAH

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9
Q

RBF=?

A

RPF/(1-HCT)

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10
Q

Filtration Fraction=?

A

GFR/RPF

(fraction of plasma flowing through that gets filtered)

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11
Q

What molecules affect the afferent arteriole? How about the efferent?

A

Aferent arteriole is dilated by prostaglandins (therefore it is constricted by NSAIDS)

Efferent arteriole is constricted by Angiotensin (therefore relaxed by ACEi)

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12
Q

What affect do NSAIDs and ACEi have on the FF?

A

NSAID decrease the RPF and the GRF therefore FF is unchanged

ATII decreases the RPF while increasing the GFR leading to increased FF

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13
Q

Hartnup disease is characterized by what pathology and findings?

A

Decreased transport of tryptophan (neutral)–> results in lack to Tryptophan

Decreased Trp=decreased Niacin production=pallegra

pallegra=diarrhea, dimentia, dermatits, death

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14
Q

PTH acts on this part of the nephron

A

Early DCT–> Na/Ca antiporter on the basolateral side establishes Ca gradient for passive resorbtion of Ca from the tubular lumen

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15
Q

Function of Intercalated cell?

A

Active H+ secretion

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16
Q

ADH acts on ____ reveptors which are coupled to _____.

A

V2 receptors Coupled to Gs

(V1 on cascular endotheium is coupled to Gq)

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17
Q

JG cells are derived from ____ which the macula densa is derived from _____

A

JG cells: modified smooth muscle cells of the afferent arteriole

macula densa: part of the DCT

18
Q

PTH stimulates this enzyme in the proximal tubule cells

A

1alpha-hydroxylase

(Converts 25-OH Vitamin d—–> 1,25-(OH)2-vitamin D)

19
Q

Difference between the net effect of ANP v. ATII

A

ANP–> Increaed GFR with NO compensatory increase in Na resorbtion (Lowers BP through loss of water and Na)

ATII–> Increased GFR with a compensatory incrased in Na resorbtion (matintains renal function while raising BP)

20
Q

Increased anion gap acidosis causes

A

MUDPILES

M: methanol

U: uremia

D: diabetic ketoacidosis

P: propylene glycol

I: iron tablets or INH

L: lactic acidosis

E: ethylene glycol

S: salicylates (aspirin)

21
Q

Type I RTA

A

Think “Primary” or “1 letter”

Primary **Impaired H+ **secretion by intercalated cells

aka distal RTA

Low urine pH

22
Q

Type 2 RTA

A

Think “Secondary”

Proximal tubule loss of bicarb–> Fanconi syndrome (lack of proximal tubular resorbtion of all kinds of junk)

aka proximal RTA

High Urine pH

23
Q

Type 4 RTA

A

4 Letters “ALDO”

Primary hypoaldosteronism–>hyperkalemia

Excess potassium results in decreased aminogenisis and buffering by proximal tubule

Low Urine pH

24
Q

Nephrotic syndrome associated with HIV and heroin abuse

A

focal segmental golmerulonephritis (effacement of foot processes)

25
Q

GBM thinkening with spike and dome appearence

A

membranous nephropathy

asoociated with SLE

26
Q

Kid with massive proteinurea (selectively albumin) and effacement of foot processes

A

Minimal change disease

Looks normal on LM

27
Q

Congo-red stain showing apple green birefringence

A

amyloidosis

28
Q

tram track appearance or mesangium splitting the GBM

A

Membranoproliferative glomerulonephritis

Associated with HBV, HCV, subacute endocarditis, and lupus

29
Q

Large eosinophillic nodules on light microscopy

A

Kimmelsteil-wilson nodule

Diabetic nephropathy

nonenzymatic glycosylation of the GBM

30
Q

Lumpy-bumpy

Name?

What is causing the lumps and bumps

A

Acute poststreptococcal glomerulonephritis

caused by deposition of C3 along the GBM

(decreased serum C3 with elevated ASO-titer)

31
Q

Crescent shapped deposits of C3b

A

RPGN

–>Goodpasture (anti-GBM), Wegner (c-ANCA), Microscopic polyangiitis (p-ANCA)

32
Q

Deposition of IgA in the mesangium

A

Berger nephropathy

Henoch-Scholein purpura

33
Q

Glomerulonephritis, deafness and vision abnormalities

A

Alport syndrome

Defect in type IV collagen

Can’t see, can’t pee, can’t hear high C

34
Q

Pt with staghorn calliculi

Type and cause

A

Amonium magnesium phosphate “Struvite”

Klebiseall and Proteus–> urease +

35
Q

Hexagonal crystals in the urine

A

Cystine

36
Q

Most common renal malignancy in children

A

Wilms Tumor

37
Q

Cause of Wilms tumor

What is WAGR syndrome

A

Deletion of WT1 (tumor suppressor)

WAGR

Wilms tumor

Aniridia

G/U malformations

Retardation

38
Q

Most common tumor of urinary tract

Causes?

A

Transiotional cell carcinoma

Pee SAC

Phenacatin, Smoking, Analine dyes, Cyclophosphamide

39
Q

Interstital nephritis associated with_____

ATN associated with _______

A

Interstital Nephritis: Drugs mostly–> hematuria and pain

ATN–> Ischemia, drugs, crush injuries (myoglobinuria)–> muddly casts

40
Q

Sickel cell or phenacetin use with gross hematuria and proteinuria

A

renal papillary necrosis

41
Q

Other pathologies associated with ADPKD

A

Cystic Kidney

Berry aneurysm

Hepatic cysys

Mitral valve prolapse

“Cysts in kidney, cysts in liver, cysts in heart, cysts in brain”

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