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STEP 1 > Renal Physio/ Misc > Flashcards

Renal Physio/ Misc Flashcards

1
Q

Normal GFR is ___ ml/min

A

100

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2
Q

Creatinine clearance _____ GFR

A

slightly overestimates

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3
Q

effective Renal Plasma Flow (eRPF) _____ Renal Plasma Flow

A

slightly understimates

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4
Q

If clearance is more than GFR there is ______ of X

A

secretion

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5
Q

If clearance is less than GFR there is ______ of X

A

reabsorption

or not filtered

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6
Q

Clearance of INULIN =

A

GFR

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7
Q

(Urine concentration of z) x (Urine flow rate)
divided by
(Plasma concentration of z)
equals

A

Clearance of z

use for inulin to get GFR

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8
Q

Dilates afferent arteriole

A

Prostaglandins (PDA)

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9
Q

Constricts efferent arteriole

A

Angiotensin II (ACE)

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10
Q

PDA __ GFR

A

↑

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11
Q

Angiotensin II __ GFR

A

↑

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12
Q

(GFR) x (Plasma concentration of z) =

A

Filtration of z

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13
Q

NSAIDS ___ GFR

A

↓

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14
Q

Angiotensin II’s effect on:
RPF
GFR
FF

A

↓ (RPF)
↑ (GFR)
↑ (FF)

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15
Q

Filtration Fraction (FF) is calculated how?

A

GFR/RPF

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16
Q

Afferent constriction effect on:
GFR
RPF
FF

A

↓
↓
no change

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17
Q

Efferent constriction effect on:
GFR
RPF
FF

A

↑ GFR
↓ RPF
↑ FF

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18
Q

Ureter constriction effect on:
GFR
RPF
FF

A

↓ GFR
no change (RPF)
↓ FF

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19
Q

Dehydration’s effect on:
GFR
RPF
FF

A

↓
↓↓
↑

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20
Q

↑ plasma protein concentration effect on:
GFR
RPF
FF

A

↓
no change
↓

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21
Q

Glomerulus has 3 NEGATIVELY charged glycoproteins

Size Barrier prevents >100nm/ blood via ___
Slit Diaphragm prevents > 50nm via ____

A

Fenestrated capillaries

Podocyte foot interposed with GBM

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22
Q

Total body water is __%

A

60%

  • 40% is non water mass (NWM)
  • TBW + NWM= body mass
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23
Q

Of Total body water:
__% is interstitial fluid (ECF)
__% is plasma (ECF)
__% ICF

A

15% (9% of body mass)
5% (3% of body mass)
40% (24% of body mass) of this like 2.5% is RBCs

ECF= 1/3 of TBW
ICF= 2/3 of TBW
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24
Q

Completely reabsorbed in PCT

A

Glucose

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25
Q

Normal pregnancy has __ GFR

A

↑

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26
Q

On a Transport (y-axis) vs Plasma (x-axis) graph

a straight + linear line =

A

Filtered substance

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27
Q

On a Transport (y-axis) vs Plasma (x-axis) graph

a exponentially + growing line =

A

Excreted substance

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28
Q

On a Transport (y-axis) vs Plasma (x-axis) graph

a straight + linear line that tapers to a plateau =

A

Reabsorbed substance

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29
Q

On a Tubular/plasma (y-axis) vs PCT distance (x-axis) graph

The steepest slope =
The middle steepest slope =
The slanted slope that tapers off quickly=
The line that has no slope =

A

PAH- fully filtered and completely secreted

Inulin/Creatinine

Urea

Potassium

*pg 587

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30
Q

What releases ANP? in response to what?

A

Atria

↑ blood volume

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31
Q

What releases BNP? in response to what?

A

Ventricles

↑ blood volume

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32
Q

ANP/BNP ___ the release of Renin

A

↓

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33
Q

ANP/BNP ____ the afferent arteriole

A

Dialate

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34
Q

ANP/BNP ___ the excretion of sodium (Na+)

A

↑

promotes naturesis

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35
Q

ANP/BNP ___ GFR

A

↑

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36
Q

ANP/BNP ___ smooth muscle via ↑cGMP

A

relax (vasodialate arteries)

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37
Q

Primarily regulates ECF volume and Na+ content

A

Aldosterone

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38
Q

Aldosterone acts on alpha intercalated cells to

A

↑ H+ ATPase for H+ excretion

39
Q

Angiotensin II works on ____ receptor on vasculature to promote ____

A 
ANG1 
vasoconstriction (↑BP)
40
Q

Angiotensin II works on the ____ to increase Sodium reabsorption

41
Q

JG cells release Renin in response to ↓ renal perfusion detected by renal baroreceptors in the ___

A

afferent arteriole

42
Q

JG cells release Renin in response to ↑ renal ____ receptor stimulation

A

Beta 1

sympathetic tone

43
Q

JG cells release Renin in response to ↓ NaCl delivery to the _____ cells at the DCT

A

macula densa

44
Q

modified smooth muscle cells of the afferent arteriole

45
Q

JGA maintains GFR via the _____ system

46
Q

Beta blockers __ renin release

47
Q

List 4 Kidney endocrine hormones

A

EPO
Calcitriol (active vit. D) in PCT via 1-alpha-gydroxylase
Prostaglandins (increase RBF)
Dopamine

48
Q

PCT cells release _____ which promotes naturiuresis

49
Q

at ___ doses dopamine ___ afferent/efferent arterioles

A

LOW

Dialates

50
Q

at ___ doses dopamine acts as a _____ of afferent/efferent arterioles

A

High

Vasoconstricts

51
Q

Dopamine’s effect on
RBF
GFR

A

↑ RBF

no appreciable change to GFR

52
Q

Calcidiol is

A

25-OH-D3 (Vitamine D inactive)

53
Q

Calcitriol is

A

1, 25- OH-D3 (Active Vit. D)

*Calciferol is just Vitamin D

54
Q

Stones, Bones, Groans, Thrones, and Psychiatric overtones indicates what?

A

Hypercalcemia

55
Q 
Nephrolithiasis (Renal Calculi)
Bone pain
Abdominal pain
↑ urinary frequency
altered mental status/ anxiety
indicates what?
A

Hypercalcemia

56
Q 
Tetany
Seizures
LOOOOOOONG QT
Twitchin (Chvostek sign)
Spasms (Trousseau sign)
indicates what?
A

Hypocalcemia

Chvostek sign: short contractions (twitching) of the facial muscles elicited by tapping the facial nerve below and in front of the ear

Trousseau sign: ipsilateral carpopedal spasm occurring several minutes after inflation of a blood pressure cuff to pressures above the systolic blood pressure

57
Q 
Arrythmias
Muscle cramps
Spams
weakness
indicates what?
A

Hypokalemia

58
Q

Wide QRS
Arrythmias
weakness
indicates what?

A

Hyperkalemia

59
Q

Gain of function mutation causing

↑ Na+ reabsorption in CT

A

Liddle syndrome

60
Q

↓ Renin
↓ Aldosterone
Hypertensive

A

Liddle syndrome
(due to high Na+ reabsorption+ water in CT)

(possibly SIADH)

61
Q

↑ Renin
↑ Aldosterone
↑ Urine Calcium

A

Bartter syndrome

renin tumor has normal calcium levels in urine

62
Q

↑ Renin
↑ Aldosterone
↓ Urine Calcium

A

Gittleman syndrome

renin tumor has normal calcium levels in urine

63
Q

Reabsorption defect in THICK ascending loop of henle

A

Bartter syndrome

64
Q

Reabsorption defect of NaCl in DCT

A

Gittleman syndrome

↓ Urine Calcium bc too much + ions in tube (Na+) so calcium goes into the cell

65
Q

Reabsorption defect in PCT

wastes glucose, amino acids, bicarb, phosphate, NA+, water etc.

A

Fanconi syndrome

66
Q

Where is the water and sodium most absorbed in the nephron?

67
Q

All the Renal tubular defects
Fanconi’s BaGeLS cause:
metabolic alkalosis/ Hypokalemia
EXCEPT

A

Fanconi syndrome
it causes
metabolic acidosis/hyphosphatemia
(osteopenia)

68
Q

Hereditary deficiency of 11-Beta-HSD

A

Syndrome of apparent Mineralcorticoid excess

SAME

69
Q

Hereditary deficiency of 11-Beta-HSD causes
__ cortisol
__ Aldosterone receptor activity

A

↑
↑

*presents with LOW aldosterone

70
Q

Inability of alpha intercalated cells to secrete H+ causing

metabolic acidosis/ hypokalemia

A

Distal RTA (type 1)

*Fanconi: metabolic acidosis/ hypophosphatemia

71
Q

Defect in PCT Bicarb reabsorption causing

metabolic acidosis/ hypokalemia

A

Proximal RTA (type 2)

72
Q

Hypoaldosteronism or Aldosterone resistance causing hyperkalemia and less ammonium (NH4) excretion

A

Hyperkalemic tubular Acidosis (type4)

73
Q

Person (especially child) with
edema/swelling &/or ascities
with proteinuria
(+/– recent URI) suspicious for

A

Minimal change disease

74
Q

Protrusion of the GBM through the deposits resemble spikes and domes when stained with a silver stain.

A

Membranous glomerular nephropathy

75
Q

NOT RENAL RELATED
Anticardiolipin antibodies are characteristic of ______ syndrome, which typically presents with unprovoked/recurrent arterial and venous thrombosis or recurrent spontaneous abortions.

A

antiphospholipid antibody

76
Q

Antibodies to _____ are typically seen in systemic lupus erythematosus (SLE), particularly in individuals with active lupus NEPHRITIS.

A

double-stranded DNA (dsDNA)

77
Q

Edema + albuminemia especially in young adults or children suggests

A

Minimal change disease

*Clinical features: acute weight gain, diffuse edema, and “frothy urine”

78
Q

often occurs after initiation of new drugs (eg, NSAIDS, diuretics) but causes acute kidney injury with WHITE blood cell CASTS on urinalysis

A

Acute interstitial nephritis

79
Q

Low intravascular oncotic pressure (due to Nephrotic syndrome) stimulates increased _____ production in the liver.

Impaired lipid catabolism due to decreased ____ and abnormal transport of circulating lipid particles also contributes to hyperlipidemia.

A

lipoprotein

lipoprotein lipase

80
Q

PSGN immune complexes are visible on IF as granular deposits of IgG, IgM, and ___ on the GBM and mesangium, producing a “starry sky” appearance.

81
Q

associated with IgG4 antibodies to the phospholipase A2 receptor, a transmembrane protein abundant on podocytes

A

membranous nephropathy

82
Q

This patient has the pentad of fever, neurologic symptoms (progressive lethargy), renal failure, anemia, and thrombocytopenia in the setting of a gastrointestinal illness. She most likely has _____
*Schistocytes, Thrombocytopenia (prolonged BT; normal PT, aPTT), edema, elevated creatinine

A

thrombocytopenic thrombotic purpura-hemolytic uremic syndrome (TTP-HUS)

*one of the thrombotic microangiopathy (TMA) syndromes.

83
Q

EM shows:
irregular, electron-dense immune deposits located on the GBM with moderate effacement of the podocyte foot processes (spikes and domes) consistent with

A

membranous nephropathy (MN)

*if you can’t tell between MCD and MN choose MN for older people and MCD for young adults/kids

84
Q

typically occurs spontaneously (as in this patient) or within 5-7 days of an upper respiratory or pharyngeal infection. Episodic.

A

IgA nephropathy

*kids/ young adults

85
Q

diffuse thickening of glomerular capillary walls on light microscopy is characteristic of

A

membranous glomerulopathy

86
Q

GBM splitting is seen in (2)

A

Membranoproliferative glomerulonephritis (MPGN)– Nephrotic Syndrome

Alport syndrome–
Nephritic syndrome

87
Q

Palpable purpura/petechiae on the lower extremities
Arthritis/arthralgia
Abdominal pain, GI bleeding (bloody diarrhea), intussusception
Renal disease (hematuria ± proteinuria)

A

IgA Vasculitis

Henoch S. Pupura

88
Q

Conjunctival injection is a classic feature of __ infection

A

adenovirus

89
Q

Aphthous ulcers can occur with (2)

A

Crohn disease

SLE

90
Q

can occur after strenuous exercise and results in muscle pain, elevated creatine kinase levels, and myoglobinuria (ie, positive urine dipstick for blood without RBCs on microscopy).

A

Rhabdomyolysis

91
Q

___ secondary to circulating immune complex deposition may complicate Infective Endocarditis and can result in acute renal insufficiency.

A

Diffuse proliferative glomerulonephritis (DPGN)

*IVDU

92
Q

Penicillamine is a copper-chelating agent used as first-line treatment in Wilson disease. Adverse effects include

A

proteinuria due to membranous nephropathy.

93
Q 
ACE-I effects on: 
efferent arteriole
RPF  
GFR
Filtration Fraction
Renin secretion
Breakdown of bradykinin
Vasodilation
A 
Dilates
↑ RPF
↓ GFR
↓  FF
↑ Renin
↓ Breakdown Bradykinin
↑ Vasodilation

STEP 1 (88 decks)

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