Renal Final Details Flashcards
The permenent primitive kidney develops from what primitive structure
Metanephros–> uteric bud
Which are is the last of the urogenital system to canalize and is therefore the most common location of fetal obstruction
uretopelvic junction
horseshoe kidney is associated with what genetic condition?
Turner syndrome
abnormal interaction between the ureteric bud and the metanephric mesenchyme can result in what deformity?
Multi-cystic dysplastic kidney
(because the metenephric mesenchyme differentiates into the glomerulus)
The glomerulus is located within the ______ and the nephron is located within the _______.
Cortex
Medulla
JG cells release what molecule under what stimulation?
Renin
Low Na in DCT
Low BP
Increased B-stimulation
What is the 60-40-20 rule
Body weight is:
60% TBW
40% of that is ICF and 20% is ECF
Of ECF–> 25% plasma volume
What molecule used to measure GFR? RPF?
GFR- inulin
RPF- PAH
RBF=?
RPF/(1-HCT)
Filtration Fraction=?
GFR/RPF
(fraction of plasma flowing through that gets filtered)
What molecules affect the afferent arteriole? How about the efferent?
Aferent arteriole is dilated by prostaglandins (therefore it is constricted by NSAIDS)
Efferent arteriole is constricted by Angiotensin (therefore relaxed by ACEi)
What affect do NSAIDs and ACEi have on the FF?
NSAID decrease the RPF and the GRF therefore FF is unchanged
ATII decreases the RPF while increasing the GFR leading to increased FF
Hartnup disease is characterized by what pathology and findings?
Decreased transport of tryptophan (neutral)–> results in lack to Tryptophan
Decreased Trp=decreased Niacin production=pallegra
pallegra=diarrhea, dimentia, dermatits, death
PTH acts on this part of the nephron
Early DCT–> Na/Ca antiporter on the basolateral side establishes Ca gradient for passive resorbtion of Ca from the tubular lumen
Function of Intercalated cell?
Active H+ secretion
ADH acts on ____ reveptors which are coupled to _____.
V2 receptors Coupled to Gs
(V1 on cascular endotheium is coupled to Gq)
JG cells are derived from ____ which the macula densa is derived from _____
JG cells: modified smooth muscle cells of the afferent arteriole
macula densa: part of the DCT
PTH stimulates this enzyme in the proximal tubule cells
1alpha-hydroxylase
(Converts 25-OH Vitamin d—–> 1,25-(OH)2-vitamin D)
Difference between the net effect of ANP v. ATII
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)
Increased anion gap acidosis causes
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)
Type I RTA
Think “Primary” or “1 letter”
Primary **Impaired H+ **secretion by intercalated cells
aka distal RTA
Low urine pH
Type 2 RTA
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
Type 4 RTA
4 Letters “ALDO”
Primary hypoaldosteronism–>hyperkalemia
Excess potassium results in decreased aminogenisis and buffering by proximal tubule
Low Urine pH
Nephrotic syndrome associated with HIV and heroin abuse
focal segmental golmerulonephritis (effacement of foot processes)
GBM thinkening with spike and dome appearence
membranous nephropathy
asoociated with SLE
Kid with massive proteinurea (selectively albumin) and effacement of foot processes
Minimal change disease
Looks normal on LM
Congo-red stain showing apple green birefringence
amyloidosis
tram track appearance or mesangium splitting the GBM
Membranoproliferative glomerulonephritis
Associated with HBV, HCV, subacute endocarditis, and lupus
Large eosinophillic nodules on light microscopy
Kimmelsteil-wilson nodule
Diabetic nephropathy
nonenzymatic glycosylation of the GBM
Lumpy-bumpy
Name?
What is causing the lumps and bumps
Acute poststreptococcal glomerulonephritis
caused by deposition of C3 along the GBM
(decreased serum C3 with elevated ASO-titer)
Crescent shapped deposits of C3b
RPGN
–>Goodpasture (anti-GBM), Wegner (c-ANCA), Microscopic polyangiitis (p-ANCA)
Deposition of IgA in the mesangium
Berger nephropathy
Henoch-Scholein purpura
Glomerulonephritis, deafness and vision abnormalities
Alport syndrome
Defect in type IV collagen
Can’t see, can’t pee, can’t hear high C
Pt with staghorn calliculi
Type and cause
Amonium magnesium phosphate “Struvite”
Klebiseall and Proteus–> urease +
Hexagonal crystals in the urine
Cystine
Most common renal malignancy in children
Wilms Tumor
Cause of Wilms tumor
What is WAGR syndrome
Deletion of WT1 (tumor suppressor)
WAGR
Wilms tumor
Aniridia
G/U malformations
Retardation
Most common tumor of urinary tract
Causes?
Transiotional cell carcinoma
Pee SAC
Phenacatin, Smoking, Analine dyes, Cyclophosphamide
Interstital nephritis associated with_____
ATN associated with _______
Interstital Nephritis: Drugs mostly–> hematuria and pain
ATN–> Ischemia, drugs, crush injuries (myoglobinuria)–> muddly casts
Sickel cell or phenacetin use with gross hematuria and proteinuria
renal papillary necrosis
Other pathologies associated with ADPKD
Cystic Kidney
Berry aneurysm
Hepatic cysys
Mitral valve prolapse
“Cysts in kidney, cysts in liver, cysts in heart, cysts in brain”
