Renal Physiology Flashcards
1
Q
Origin of nephron
A
Metanephric blastema
2
Q
Origin of collecting duct system
A
Ureteric bud
3
Q
Components of nephron
A
Renal corpuscle (glomerulus+ bowmans capsule) PCT Loop of henle DCT CT
4
Q
Cells that secrete renin
A
JG cells
5
Q
Senses changes in volume and NaCl concentrations
A
Macula densa
6
Q
Components of JG Apparatus
A
JG cells
Macula densa
Mesangial cells
7
Q
Epithelium of PCT
A
Simple cuboidal with microvilli for absorption
8
Q
Epithelium of loop of henle
A
Ascending limb: Simple squamous
Descending limb: simple cuboidal
9
Q
Epithelium of DCT
A
Simple cuboidal
10
Q
How many % of Cardiac output does kidney receive
A
25%
11
Q
Functional unit of kidney
A
Nephron
12
Q
Location of JG apparatus
A
Vascular pole of glomerulus
13
Q
3 basic processes of kidneys
A
Glomerular filtration
Tubular reabsorption
Tubular secretion
14
Q
Cells that secrete EPO
A
Peritubular capillary cells of kidneys- from interstitial fibroblast and tubular epithelial cells
15
Q
Action is insertion of aquaporin channel
A
ADH
16
Q
Hormone that catalyze in conversion to active vit d form
A
1 alpha hydroxylase
17
Q
Enzymes that breakdown bradykinin
A
ACE
Aminopeptidase P
Carboxypeptidase N
18
Q
First step in urine formation
A
Glomerular filtration
19
Q
What are absorbed by passive diffusion
A
Water:99%
Na:99.5% (primary active transport)
Urea:50%
Phenol:0%
20
Q
How is glucose and amino acid reabsorbed
A
Secondary active transport via sodium gradient
All other steps are passive
21
Q
Makes urine dilute or concentrated
A
Medullary countercurrent system- osmotic gradient is controlled by LOH
22
Q
Permeable to water,not to solute
A
Descending limb of LOH
23
Q
Impermeable to water
Permeable to solute
A
Ascending limb
Ayaw sa agua
24
Q
Components of glomerular membrane
A
Fenestrated endothelium of capillary-70nm negatively charged glycoprotein. No protein can pass
Basement membrane
Podocytes
25
Amount of filtrate formed by both kidneys in a unit time
GFR
26
Normal GFR
125ml/min
27
Site of highest renal vascular resistance
Efferent arteriole
28
What contributes to renal vascular resistance
Interlobular a
Afferrent a
Efferent a
29
Susbtance with highest clearance, used in renal blood flow measurement
Paraaminohippuric acid
30
Used to estimate GFR
Inulin- freely filtered but not absorbed nor secreted
31
Renal threshold for glucose
180mg/dl
32
Arterial threshold for glucose
200mg/dl
33
Usual daily UO
720-1440 ml
34
Oliguria
<400
35
Cholinomimetix used in post op urinary retention
Bethanecol
36
DOC for urge incontinence
Oxybutinin-non selective anticholinergic
37
Causes of cloudy urine
Increased ph
| High phosphate
38
Alkaline urine with ammonia smell
Proteus
39
Ketone is seen in
DKA
Starvation
Common in pregnancy
40
Brown muddy cast
Acute tubular necrosis
41
Average renal blood flow
1100 ml/min for both kidneys
42
Major pathway for reabsorption of na,cl, water
PCT
43
Parts impermeable to urea
TAL
DCT
CCD
44
Group of neuron responsible to maintenance of micturition and defecatory continence and muscular contraction during orgasm
Onufs nucleus
45
Congenital anomaly sec to ACE inh use during pregnancy
Renal agenesis
46
MC site of ectopic kidney
Pelvic brim
47
Gene mutation in ADPKD
PKD1 gene on ch 16-encode for polycystin 1--85%
| Pkd2 gene on ch 4
48
Extrarenal manifestations of ADPKD
Berry aneurysm
Hypertension
MVP
Liver,pancreatic cysts
49
Aka potter syndrome
ARPKD
50
Low set ears, parrot beak nose, lung hypoplasia
Potter facie
51
Multiple cystic dilation of collecting duct and medulla
Medullary sponge kidney
52
MC type of renal cyst
Simple cyst
53
Renal cyst with clear fluid and calcium oxate crystals
Dialysis associated cortical/medullary cyst
54
Type of nephropathy in HSP
Ig A nephropathy
55
Volume with first urge to void
150 ml
56
Sense of fullness of bladder
400ml
57
+ islands of undifferentiated mesenchyme
Cystic renal dysplasia
58
MC type of renal cell carcinoma
Clear cell carcinoma
59
Gene mutation in ARPKD
PKHD1 gene encoding for FIBROCYSTIN
60
Bilateral massive enlargement of kidneys with multiple large cysts
ADPKD
61
Enlarged kidneys with smooth ext appearance
Spongelike appearance on cross section
Spokes on a wheel pattern
Liver cysts
ARPKD
62
Hemangioblastoma of cerebellum,brainstem or retina
Cysts of liver,kidney or pancreas
Renal cell cancer
Von hippel lindau
63
Internists tumor
Renal cell cancer
64
Triad of RCC
Hematuria
Flank pain
Abd mass
65
MC manifestation of SLE
Joint pain
66
Hallmark of lupus nephritis
Deposition of IC
67
Morphology of Lupus nephritis
Wire loop with granular deposit in sub endothelial membrane
68
Most common and most severe type of LN
Type 4 diffuse proliferative
69
New type of lupus nephritis
Type 6 advanced sclerosing
70
Tx of lupus nephritis
```
Induction and maintenance phase
Mainstay:
Steroid: methylprednisolone- induction
Prednisone- maintenance
Other:
Immunosuppressive:
Cyclophosphamide
Mycophenolate mofetil
Azathioprine
Calcineurin inhibitor: tacrolimus
```
71
A return to a near normal renal function and proteinuria < 30 mg/dl per day
Remission
72
Sensitive indicator of dm nephropathy
Thickening of GBM
73
Mx finding in DM nephropathy
Kimmelsteil wilson lesion
74
Glomerular nodular sclerosis with BM thickening
Kimmelsteil wilson lesion
75
Causes of ATN
Ischemia
| Direct toxic injury
76
Is atn reversible
Yes
77
Hallmark of acute pyelonephritis
Patchy interstitial suppurativr inflammation -- abscess
78
Hallmark CM of APN
+ KPS
79
Complications of APN
Papillary necrosis
Pyonephrosis
Perinephric abscess
80
Drug assoc with papillary necrosis
Phenacetin
81
Part of kidney affected in papillary necrosis
Distal tips of pyramids
82
Antibiotic that can cause interstitial nephritis
Methicillin
83
Type of nephritis assoc with analgesic nephropathy
Tubulointerstitial nephritis
84
Renal failure Due to aristolochic acid which increase risk of RCC
Chinese herb nephropathy
85
MC bone tumor in adult
Multiple myeloma
86
Mx finding in MM
Bence jones protein combine with tam horsefall protein--- cast
87
MC bone tumor in children
Osteosarcoma
88
Pt with renal failure and bone pain
Renal osteodystrophy
89
Nephrosclerosis assoc with malignant hypertension
Malignant nephrosclerosis
90
Mx of malignant nephrosclerosis
Flea bitten appearance
Onion skinning
Fibrinoid necrosis
91
Causes of renal artery sclerosis
Atheromatous plaque-70%
| Fibromuscular dysplasia
92
Char by small kidneys with diffuse ischemic atrophy
Renal artery stenosis
93
Serotypes of GABHS assoc with psgn
Types 1,4,12
94
Sub epithelial hump/bump electron dense deposits of IC
PSGN
95
Presence of glomerular crescents in LM due to proliferation of parietal epi cells and infiltration of monocytes and macrophages
RPGN
96
Anti GBM antibodies
Type 1
| goodpasteur syndrome
97
IC mediated seen in sle and hps
Type 2 rpgn
98
Anca positive
| Assoc with systemic vasculitis
Type 3
| wegener granulomatosis
99
Focal rupture in GBM seen in EM
RPGN
| R=rupture
100
Nephrotic range
>\= 3.5 g/day
101
Massive proteinuria
Hypoalbuminemia
Gen edema
Hyperlipidemia
Nephrotic syndrome
102
MC diseases causing nephrotic sx
Minimal change
Amyloidosis
Sle
103
MCC of nephrotic syndrome in adults
Membranous GN
104
Spike and dome appearance
Membranous gn
105
Most abundant protein in urine
Tam horsefall protein
106
Gene mutation in FSGN
NPHS1-nephrin
| NPHS2- podocin
107
MCC of NS in children
Minimal change disease
108
Pathogenesis of MCD
Cytokine damage of visceral epithelium
109
LM finding in MCD
Normal
110
EM finding in MCD
Effacement of podocyte
111
GN assoc with HIV and heroin
FSGS
112
Hallmark of FSGS
Epithelial damage prominent in corticomedullary jxn
113
Tram track/double contour glomerular capillary wall due to duplication of GBM
MPGN
114
More common type of primary mpgn
Type 1
115
Also known as dense deposit disease
Type 2 primary mpgn
116
MC type of GN worldwide
IgA nephropathy/berger disease
117
Char by deposits of IgA in mesagium
IgA nephropathy
118
Present as hematuria after a respi infxn
Ig A nephropathy
119
Hereditary form of gn with nerve deafness
Alport syndrome
120
Defect in alport syndrome
Type 4 collagen BM
121
Drugs that cause ischemic nephropathy
Aminoglycoside
Amphotericin B
Contrast dye
122
Hallmark of ESRD
Chronic GN
123
MCC of esrd
Rpgn
| Fsgn
124
CM of CGN
3 mos azotemia
Small kidneys
Anemia
125
Mx of cgn
Thyroidization due to tubular atrophy
| Symmetrical contracted kidney
126
Earliest sign of NS in children
Periorbital edema
127
Earliest sign of NS in adult
Bipedal edema
