Renal Path 1

Question 1

Where is visceral epithelium incorporated into?

Answer 1

Capillary wall-podocytes

Question 2

Where is parietal epithelium?

Answer 2

Lining Bowman’s space

Question 3

What type of collagen monomers form the backbone of the GBM?

Answer 3

Type IV collagen

Question 4

What is the antigenic site in anti-GBM nephritis?

Answer 4

NC1 (nonollagenous domain at carboxyl terminus of collagen helix)

Question 5

What do the podocytes interdigitate with?

Answer 5

Lamina rara externa

Question 6

Name 2 slit diaphragm proteins

Answer 6

Nephrin and podocin

Question 7

What type of cells make scars?

Answer 7

Mesangial cells (of mesenchymal origin)

Question 8

What is the number one cause of acute renal failure?

Answer 8

Renal tubular necrosis (often due to ischemia)

Question 9

What does the macula densa detect?

Answer 9

Cl- delivery

Question 10

Which type of renal disease is typically immune mediated?

Answer 10

Glomerular

Question 11

Which type of renal disease is usually due to toxic/ischemic and inflammatory reactions?

Answer 11

Tubulointerstitial

Question 12

Which type of renal disease is ususally due to some occlusiveness or vasculitis?

Answer 12

Vascular

Question 13

What is azotemia?

Answer 13

increased BUN and creatinine

Question 14

What is uremia?

Answer 14

Azotemia + clinical symptoms (gastroenteritis, anemia, peripheral neuropathy, pruritis, pericarditis etc.)

Question 15

What will you hear in a bread & butter uremic pericarditis?

Answer 15

3 component friction rub

Question 16

What is the GFR less than in chronic renal failure?

Question 17

What are the 4 stages of renal disease?

Answer 17

1. Diminished renal reserve (GFR around 50 % of normal)
2. Renal insufficieicny (GFR 20-50 %, azotemia, anemia, HTN)
3. Renal failure (GFR

Question 18

What is normal creatinine?

Answer 18

0.7 to 1.5 mg/dL

Question 19

What is uremia?

Answer 19

Azotemia + clinical symptoms (gastroenteritis, anemia, peripheral neuropathy, pruritis, pericarditis etc.)

Question 20

What will you hear in a bread & butter uremic pericarditis?

Answer 20

3 component friction rub

Question 21

What is the GFR less than in chronic renal failure?

Question 22

What is the most common acquired cause of a renal tubular defect?

Answer 22

Lead toxicity

Question 23

What is the best overall measure of kidney function?

Answer 23

GFR

Question 24

What is the equation for clearance?

Answer 24

UV/P
U= urine concentration
V=urine flow
P=plasma concentration

Question 25

If you use creatinine to approximate GFR, is it high or low? Why?

Answer 25

High! because some is secreted by proximal tubule

Question 26

At what GFR should you refer to nephrologis?

Question 27

What is BUN?

Answer 27

Major end product of protein nitrogen metabolism

Question 28

What is normal BUN?

Answer 28

10-20 mg/dl

Question 29

What pre-renal things may increase BUN?

Answer 29

High protein diet
GI bleed
hemolysis
catabolism (burns, fever, stress)

Question 30

What things might cause a renal increase in BUN?

Answer 30

glomerular disease, acute tubular necrosis, interstitial disease

Question 31

What post-renal causes could increase BUN?

Answer 31

Urinary tract obstruction

Benign prostatic hypertrophy etc.

Question 32

What is serum creatinine?

Answer 32

waste product formed by the spontaneous dehydration of body creatine

Question 33

What is normal creatinine?

Answer 33

0.7 to 1.5 mg/dL

Question 34

What is the normal BUN: Creatinine ratio?

Answer 34

10-20:1

Question 35

If the FENa is less than 1 %, does that favor pre-renal or renal disease?

Answer 35

pre-renal

Question 36

if FENa is more than 2 %, does that favor pre-renal or renal disease?

Answer 36

Renal disease (ATN)

Question 37

Why does the FeNa go up in ATN?

Answer 37

Because the tubules can’t reabsorb and the urine concentration of Na is high!

Question 38

What are urine protein dipsticks sensitive to?

Answer 38

ONLY ALBUMIN