Renal Path 1 Flashcards
Where is visceral epithelium incorporated into?
Capillary wall-podocytes
Where is parietal epithelium?
Lining Bowman’s space
What type of collagen monomers form the backbone of the GBM?
Type IV collagen
What is the antigenic site in anti-GBM nephritis?
NC1 (nonollagenous domain at carboxyl terminus of collagen helix)
What do the podocytes interdigitate with?
Lamina rara externa
Name 2 slit diaphragm proteins
Nephrin and podocin
What type of cells make scars?
Mesangial cells (of mesenchymal origin)
What is the number one cause of acute renal failure?
Renal tubular necrosis (often due to ischemia)
What does the macula densa detect?
Cl- delivery
Which type of renal disease is typically immune mediated?
Glomerular
Which type of renal disease is usually due to toxic/ischemic and inflammatory reactions?
Tubulointerstitial
Which type of renal disease is ususally due to some occlusiveness or vasculitis?
Vascular
What is azotemia?
increased BUN and creatinine
What is uremia?
Azotemia + clinical symptoms (gastroenteritis, anemia, peripheral neuropathy, pruritis, pericarditis etc.)
What will you hear in a bread & butter uremic pericarditis?
3 component friction rub
What is the GFR less than in chronic renal failure?
What are the 4 stages of renal disease?
- Diminished renal reserve (GFR around 50 % of normal)
- Renal insufficieicny (GFR 20-50 %, azotemia, anemia, HTN)
- Renal failure (GFR
What is normal creatinine?
0.7 to 1.5 mg/dL
What is uremia?
Azotemia + clinical symptoms (gastroenteritis, anemia, peripheral neuropathy, pruritis, pericarditis etc.)
What will you hear in a bread & butter uremic pericarditis?
3 component friction rub
What is the GFR less than in chronic renal failure?
What is the most common acquired cause of a renal tubular defect?
Lead toxicity
What is the best overall measure of kidney function?
GFR
What is the equation for clearance?
UV/P
U= urine concentration
V=urine flow
P=plasma concentration
If you use creatinine to approximate GFR, is it high or low? Why?
High! because some is secreted by proximal tubule
At what GFR should you refer to nephrologis?
What is BUN?
Major end product of protein nitrogen metabolism
What is normal BUN?
10-20 mg/dl
What pre-renal things may increase BUN?
High protein diet
GI bleed
hemolysis
catabolism (burns, fever, stress)
What things might cause a renal increase in BUN?
glomerular disease, acute tubular necrosis, interstitial disease
What post-renal causes could increase BUN?
Urinary tract obstruction
Benign prostatic hypertrophy etc.
What is serum creatinine?
waste product formed by the spontaneous dehydration of body creatine
What is normal creatinine?
0.7 to 1.5 mg/dL
What is the normal BUN: Creatinine ratio?
10-20:1
If the FENa is less than 1 %, does that favor pre-renal or renal disease?
pre-renal
if FENa is more than 2 %, does that favor pre-renal or renal disease?
Renal disease (ATN)
Why does the FeNa go up in ATN?
Because the tubules can’t reabsorb and the urine concentration of Na is high!
What are urine protein dipsticks sensitive to?
ONLY ALBUMIN
