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Triad Subjects > Renal Physiology > Flashcards

Renal Physiology Flashcards

1
Q

Origin of nephron

A

Metanephric blastema

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2
Q

Origin of collecting duct system

A

Ureteric bud

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3
Q

Components of nephron

A 
Renal corpuscle (glomerulus+ bowmans capsule)
PCT
Loop of henle
DCT
CT
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4
Q

Cells that secrete renin

A

JG cells

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5
Q

Senses changes in volume and NaCl concentrations

A

Macula densa

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6
Q

Components of JG Apparatus

A

JG cells
Macula densa
Mesangial cells

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7
Q

Epithelium of PCT

A

Simple cuboidal with microvilli for absorption

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8
Q

Epithelium of loop of henle

A

Ascending limb: Simple squamous

Descending limb: simple cuboidal

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9
Q

Epithelium of DCT

A

Simple cuboidal

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10
Q

How many % of Cardiac output does kidney receive

A

25%

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11
Q

Functional unit of kidney

A

Nephron

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12
Q

Location of JG apparatus

A

Vascular pole of glomerulus

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13
Q

3 basic processes of kidneys

A

Glomerular filtration
Tubular reabsorption
Tubular secretion

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14
Q

Cells that secrete EPO

A

Peritubular capillary cells of kidneys- from interstitial fibroblast and tubular epithelial cells

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15
Q

Action is insertion of aquaporin channel

A

ADH

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16
Q

Hormone that catalyze in conversion to active vit d form

A

1 alpha hydroxylase

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17
Q

Enzymes that breakdown bradykinin

A

ACE
Aminopeptidase P
Carboxypeptidase N

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18
Q

First step in urine formation

A

Glomerular filtration

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19
Q

What are absorbed by passive diffusion

A

Water:99%
Na:99.5% (primary active transport)
Urea:50%
Phenol:0%

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20
Q

How is glucose and amino acid reabsorbed

A

Secondary active transport via sodium gradient

All other steps are passive

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21
Q

Makes urine dilute or concentrated

A

Medullary countercurrent system- osmotic gradient is controlled by LOH

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22
Q

Permeable to water,not to solute

A

Descending limb of LOH

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23
Q

Impermeable to water

Permeable to solute

A

Ascending limb

Ayaw sa agua

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24
Q

Components of glomerular membrane

A

Fenestrated endothelium of capillary-70nm negatively charged glycoprotein. No protein can pass
Basement membrane
Podocytes

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25
Q

Amount of filtrate formed by both kidneys in a unit time

A

GFR

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26
Q

Normal GFR

A

125ml/min

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27
Q

Site of highest renal vascular resistance

A

Efferent arteriole

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28
Q

What contributes to renal vascular resistance

A

Interlobular a
Afferrent a
Efferent a

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29
Q

Susbtance with highest clearance, used in renal blood flow measurement

A

Paraaminohippuric acid

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30
Q

Used to estimate GFR

A

Inulin- freely filtered but not absorbed nor secreted

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31
Q

Renal threshold for glucose

A

180mg/dl

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32
Q

Arterial threshold for glucose

A

200mg/dl

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33
Q

Usual daily UO

A

720-1440 ml

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34
Q

Oliguria

A

<400

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35
Q

Cholinomimetix used in post op urinary retention

A

Bethanecol

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36
Q

DOC for urge incontinence

A

Oxybutinin-non selective anticholinergic

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37
Q

Causes of cloudy urine

A

Increased ph

High phosphate

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38
Q

Alkaline urine with ammonia smell

A

Proteus

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39
Q

Ketone is seen in

A

DKA
Starvation
Common in pregnancy

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40
Q

Brown muddy cast

A

Acute tubular necrosis

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41
Q

Average renal blood flow

A

1100 ml/min for both kidneys

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42
Q

Major pathway for reabsorption of na,cl, water

A

PCT

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43
Q

Parts impermeable to urea

A

TAL
DCT
CCD

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44
Q

Group of neuron responsible to maintenance of micturition and defecatory continence and muscular contraction during orgasm

A

Onufs nucleus

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45
Q

Congenital anomaly sec to ACE inh use during pregnancy

A

Renal agenesis

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46
Q

MC site of ectopic kidney

A

Pelvic brim

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47
Q

Gene mutation in ADPKD

A

PKD1 gene on ch 16-encode for polycystin 1–85%

Pkd2 gene on ch 4

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48
Q

Extrarenal manifestations of ADPKD

A

Berry aneurysm
Hypertension
MVP
Liver,pancreatic cysts

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49
Q

Aka potter syndrome

A

ARPKD

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50
Q

Low set ears, parrot beak nose, lung hypoplasia

A

Potter facie

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51
Q

Multiple cystic dilation of collecting duct and medulla

A

Medullary sponge kidney

52
Q

MC type of renal cyst

A

Simple cyst

53
Q

Renal cyst with clear fluid and calcium oxate crystals

A

Dialysis associated cortical/medullary cyst

54
Q

Type of nephropathy in HSP

A

Ig A nephropathy

55
Q

Volume with first urge to void

A

150 ml

56
Q

Sense of fullness of bladder

A

400ml

57
Q

+ islands of undifferentiated mesenchyme

A

Cystic renal dysplasia

58
Q

MC type of renal cell carcinoma

A

Clear cell carcinoma

59
Q

Gene mutation in ARPKD

A

PKHD1 gene encoding for FIBROCYSTIN

60
Q

Bilateral massive enlargement of kidneys with multiple large cysts

A

ADPKD

61
Q

Enlarged kidneys with smooth ext appearance
Spongelike appearance on cross section
Spokes on a wheel pattern
Liver cysts

A

ARPKD

62
Q

Hemangioblastoma of cerebellum,brainstem or retina
Cysts of liver,kidney or pancreas
Renal cell cancer

A

Von hippel lindau

63
Q

Internists tumor

A

Renal cell cancer

64
Q

Triad of RCC

A

Hematuria
Flank pain
Abd mass

65
Q

MC manifestation of SLE

A

Joint pain

66
Q

Hallmark of lupus nephritis

A

Deposition of IC

67
Q

Morphology of Lupus nephritis

A

Wire loop with granular deposit in sub endothelial membrane

68
Q

Most common and most severe type of LN

A

Type 4 diffuse proliferative

69
Q

New type of lupus nephritis

A

Type 6 advanced sclerosing

70
Q

Tx of lupus nephritis

A 
Induction and maintenance phase
Mainstay:
Steroid: methylprednisolone- induction
Prednisone- maintenance
Other:
Immunosuppressive:
Cyclophosphamide 
Mycophenolate mofetil
Azathioprine
Calcineurin inhibitor: tacrolimus
71
Q

A return to a near normal renal function and proteinuria < 30 mg/dl per day

A

Remission

72
Q

Sensitive indicator of dm nephropathy

A

Thickening of GBM

73
Q

Mx finding in DM nephropathy

A

Kimmelsteil wilson lesion

74
Q

Glomerular nodular sclerosis with BM thickening

A

Kimmelsteil wilson lesion

75
Q

Causes of ATN

A

Ischemia

Direct toxic injury

76
Q

Is atn reversible

A

Yes

77
Q

Hallmark of acute pyelonephritis

A

Patchy interstitial suppurativr inflammation – abscess

78
Q

Hallmark CM of APN

A

+ KPS

79
Q

Complications of APN

A

Papillary necrosis
Pyonephrosis
Perinephric abscess

80
Q

Drug assoc with papillary necrosis

A

Phenacetin

81
Q

Part of kidney affected in papillary necrosis

A

Distal tips of pyramids

82
Q

Antibiotic that can cause interstitial nephritis

A

Methicillin

83
Q

Type of nephritis assoc with analgesic nephropathy

A

Tubulointerstitial nephritis

84
Q

Renal failure Due to aristolochic acid which increase risk of RCC

A

Chinese herb nephropathy

85
Q

MC bone tumor in adult

A

Multiple myeloma

86
Q

Mx finding in MM

A

Bence jones protein combine with tam horsefall protein— cast

87
Q

MC bone tumor in children

A

Osteosarcoma

88
Q

Pt with renal failure and bone pain

A

Renal osteodystrophy

89
Q

Nephrosclerosis assoc with malignant hypertension

A

Malignant nephrosclerosis

90
Q

Mx of malignant nephrosclerosis

A

Flea bitten appearance
Onion skinning
Fibrinoid necrosis

91
Q

Causes of renal artery sclerosis

A

Atheromatous plaque-70%

Fibromuscular dysplasia

92
Q

Char by small kidneys with diffuse ischemic atrophy

A

Renal artery stenosis

93
Q

Serotypes of GABHS assoc with psgn

A

Types 1,4,12

94
Q

Sub epithelial hump/bump electron dense deposits of IC

A

PSGN

95
Q

Presence of glomerular crescents in LM due to proliferation of parietal epi cells and infiltration of monocytes and macrophages

A

RPGN

96
Q

Anti GBM antibodies

A

Type 1

goodpasteur syndrome

97
Q

IC mediated seen in sle and hps

A

Type 2 rpgn

98
Q

Anca positive

Assoc with systemic vasculitis

A

Type 3

wegener granulomatosis

99
Q

Focal rupture in GBM seen in EM

A

RPGN

R=rupture

100
Q

Nephrotic range

A

> = 3.5 g/day

101
Q

Massive proteinuria
Hypoalbuminemia
Gen edema
Hyperlipidemia

A

Nephrotic syndrome

102
Q

MC diseases causing nephrotic sx

A

Minimal change
Amyloidosis
Sle

103
Q

MCC of nephrotic syndrome in adults

A

Membranous GN

104
Q

Spike and dome appearance

A

Membranous gn

105
Q

Most abundant protein in urine

A

Tam horsefall protein

106
Q

Gene mutation in FSGN

A

NPHS1-nephrin

NPHS2- podocin

107
Q

MCC of NS in children

A

Minimal change disease

108
Q

Pathogenesis of MCD

A

Cytokine damage of visceral epithelium

109
Q

LM finding in MCD

A

Normal

110
Q

EM finding in MCD

A

Effacement of podocyte

111
Q

GN assoc with HIV and heroin

A

FSGS

112
Q

Hallmark of FSGS

A

Epithelial damage prominent in corticomedullary jxn

113
Q

Tram track/double contour glomerular capillary wall due to duplication of GBM

A

MPGN

114
Q

More common type of primary mpgn

A

Type 1

115
Q

Also known as dense deposit disease

A

Type 2 primary mpgn

116
Q

MC type of GN worldwide

A

IgA nephropathy/berger disease

117
Q

Char by deposits of IgA in mesagium

A

IgA nephropathy

118
Q

Present as hematuria after a respi infxn

A

Ig A nephropathy

119
Q

Hereditary form of gn with nerve deafness

A

Alport syndrome

120
Q

Defect in alport syndrome

A

Type 4 collagen BM

121
Q

Drugs that cause ischemic nephropathy

A

Aminoglycoside
Amphotericin B
Contrast dye

122
Q

Hallmark of ESRD

A

Chronic GN

123
Q

MCC of esrd

A

Rpgn

Fsgn

124
Q

CM of CGN

A

3 mos azotemia
Small kidneys
Anemia

125
Q

Mx of cgn

A

Thyroidization due to tubular atrophy

Symmetrical contracted kidney

126
Q

Earliest sign of NS in children

A

Periorbital edema

127
Q

Earliest sign of NS in adult

A

Bipedal edema

Triad Subjects (8 decks)

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