Renal/Pulmo Flashcards
1
Q
What produces the erythropoeitin?
A
Jg cells
2
Q
What enzyme present in the kidney converts vitamin D to its active form?
A
1 alpha hydroxylase
3
Q
What is the active form of vitamin d?
A
1 25 dihydroxycholecalciferol
4
Q
Normal protein content of urine
A
0
5
Q
Normal glucose content of urine
A
0
6
Q
Usual daily urine output?
A
700-1400mL
7
Q
RBC diameter
A
7.5 micrometer
8
Q
Bladder muscle responsible for urination?
A
Detrusor muscle
9
Q
How does the aphrodisiac canthardin works?
A
Irritate urinary bladder muscle fibers
10
Q
Countercurrent multiploer
A
Loop of henle
11
Q
Countercurrent exchanger?
A
Vasa recta
12
Q
Substance secreted in response to bp changes by the JG cells of the afferent arteriole
A
Renin
13
Q
Specific action of ADH in the kidneys
A
Insertion of aquaporin or water channels on the distal tubules
14
Q
Clearance of _____ is used to estimate renal blood flow and renal plasma flow?
A
PAH paraaminohippuric acid
15
Q
Clearance of _______ is used to estimate GFR
A
Inulin
16
Q
Renal threshold for glucose?
A
180mg/dL
17
Q
Hormone that counteracts the effect of aldosterone and ADH?
A
ANP
18
Q
First urge to void
A
150 mL
19
Q
Marked sense of fullness
A
400 mL
20
Q
Weight of kidneys?
A
150 g
21
Q
Where is erythropoeitin produced?
A
Peritubular capillaries of the kidneys (vasa recta)
22
Q
Inspiratory muscles
A
Diaphragm external intercostals
Scm, anterior serratus, scalenes
23
Q
Expiratory muscles
A
Internal intercostals
Abdominal recti
24
Q
Vertebral fracture that will impair breathing
A
C2
25
Normal pleural pressure at the beginning of inspiration
-5 cmH2O
26
Posterior diaphragmatic hernia
Bockdalek hernia
27
Embryologic defect of diaphragmatic hernia or embryologic origin pf diaphragm
Pleuroperitoneal membrane
28
Anterior diaphragmatic hernia
Morgagni
29
Muscles of expiration
Internal intercostals
| Abdominal recti
30
Measure of lung distensibility
Compliance
31
Measure of the lungs resistane to deformation
Elastance
32
Collapsing pressure is directly proportional to surface tension and inversely to the alveolar radius
Law of laplace
33
Main component of surfactant
Dipalmitoylphosphatidylcholine or dipalmitoyl lecithin
34
Increased or decreased compliance and elastance in obstructive lung diseases?
Increased compliance
| Decreased elastance
35
At what week do we expect mature lungs in a newborn via their surfactant?
34 weeks
36
Asbestosis a restrictive lung disease is assoc with what cancer?
Mesothelioma
37
What resistance must the work of breathing overcome to inspire air?
Compliance resistance
38
Airway resistance is directly proportional to viscosity, airway and length and inversely proportional to the fourth power of the radius of the airway
Poiseuille's equation
39
Volume of tidal vol
500mL
40
Inspiratory reserve volume? ____ml
3000mL
41
Expiratory reserve volume ____mL
1100mL
42
Reserve volume
1100mL
43
Tv + irv+ erv =
Vital capacity
44
Tv + irv +erv +rv
Total lung capacity
45
Formula for alveolar ventilation?
RR x ( tV-physio dead space)
46
Minute ventilation formula
RR x TV
47
V/q of whole lung at rest
0.8
48
Volume of conducting airways not involved in gas exchange
150 mL
| Anatomic dead spacew
49
ERV+ RV =?
Functional residual capacity
50
TV + IRV
Inspiratory capacity
51
Most common cause of v/q mismatch
Hypoxemia
52
Innervation of diaphragm
Phrenic nerve (C3,C4,C5)
53
V/q at lung base
0.6 ( overpefused)
54
V/Q at lung apices
3.3
55
Central control of basic rhythm of respiration
Dorsal Respiratory Group
56
Central control for forced expiratory muscles
Ventral Respiratory Group
57
Location of drg and vrg?
Medulla
58
Inhibits inspiration thereby increasing RR (Central control, fine tune)
pneumotaxic center
59
Increases duration of inspiration thereby decreasing RR (Central control, fine tune)
Apneustic center
60
Most important stimulation for breathing
Hypoxia
61
Reflex of the lung in response to stretch or airway distention
Herring Breur reflex ( inhibits inspiration)
62
Source of venous emboli
Deep leg vein
63
Where does pulmonary embolism occur most often?
Lower lung lobes
64
Most common preventable cause of death among hospitalized patients?
Pulmonary embolism
65
Embolism that occludes the main pulmonary artery impact across the bifurcation
Saddle embolis
66
Embolus that passes through a defect to gain access to systemic circulation
Paradoxical embolus
67
Most common history in Pulmonary embolism
Unexplained breathlessness
68
Most common symptom in pulmo embolism
Dyspnea
69
Most common sign of pulmo embolism
Tachypnea
70
Most common ecg abnormality in pulmo embolism
```
T wave inversion in V1-V4 (CDB and journals)
Sinus tachycardia ( usmle)
```
71
Specific ECG finding in pulmo embolism? 20% of patients
S1Q3T3 sign
| S wave in lead I, q wave in lead III, inverted T wave in lead III
72
Principal imaging test for diagnosis of PE?
CT scan with IV contrast
73
Westermarks sign
Focal oligemia
74
Hamptoms hump
Peripheral wedge shaped density above the diaphragm
75
Palla's sign
Enlarged descending right pulmonary artery
76
Best known indirect sign of PE in exhocardiography?
McConnell's sign ( hypokinesis of RV free wall with normal motion of RV apex)
77
Weight of thyroid
25-30 g
78
Weight of prostate
20g
79
Weight of heart
300-350g (males)
| 250-300 g (females)
80
Weight of liver
1400-1600 grams
81
Weight of pancreas
85-90 grams
82
Azotemia + constellation of clinical signs and symptoms ( robbins 8th ed p. 907)
Uremia
83
Components of Juxtaglomerular apparatus
Macula densa
JG cells
Mesangial cells or lacis cells or Goormaghtigh cells
84
Function of lacis cells
Unclear hahahaha
Tubuloglomerular feedback mechanism
Transmission f signals
85
pH of blood
7.4
86
Normal gfr
125 mL/min
87
Normal renal blood flow
1100 mL
88
Mg/dL of glucose that all transporters are saturated?
350 mg/dL
89
Histology: onion skinning and fibrinoid necrosis of arterioles
Malignant nephroscelrosis
90
Essential components of the nephron
Renal corpuscle (bowman's capsule, glomerulus)
Renal tubules (prox convoluted tubule, loop of henle, distal convoluted tubule, collecting tubule)
91
Disease with normal sized kidneys but with CKD (6)
```
TB
Diabetic nephropathy
Lupus Nephritis
Amyloidosis
Sarcoidosis
HIV
```
92
What is the drug used to treat post-op urinary bladder atony?
Bethanechol
93
Histology: wire loops
Lupus Nephritis
94
Most common cause of primary glomerulonephritis worldwide
IgA Nephropathy
95
Most abundant excreted protein in urine
Tamm Horsfall protein
96
Histology: lumps, bumps, humps
Antigen-antibody complexes at the epitheli cell surface of glomerulus
Post streptococcal GN
97
Histological finding in RPGN
Crescent formation (prolif of parietal cell, WBCs, and fibrin deposits in bowman's space)
98
Massive proteinuria in Nephrotic syndrome
>3.5 gm/day
99
Pathognomonic finding Minimal Change Disease
Podocyte effacement
100
Associated conditions/causes in Focal Segmental Glomerulosclerosis
HIV
| heroin
101
Hallmark histologic finding in FSGS
Epithelial damage
102
Histology: 'tram track' and 'double contour'
Membranoproliferative GN
103
Histologic findings in membranous GN
Spikes or domes (subepithelial deposits)
104
Most common renal Ca in children
Wilm's tumor
105
Drug that causes acute hypersensitivity nephritis/ tubulointerstitial nephritis
Methicillin
106
Most common vasculitis in children
Henoch Schonlein Purpura
107
ACE Inhibitors, when given to pregnant pxs would cause?
Renal agenesis
108
Congenital renal diseases (4)
Renal agenesis
Horseshoe kidney
Hypoplasia
Ectopic kidney
109
Poststreptococcal GN appears 1-4 weeks after a ______ infection
Group A beta hemolytic strep
110
Extrarenal manifestation of adult polycystic kidney disease
Liver cysts
111
Drug that would cause hemorrhagic cystitis
Cyclophosphamide
112
Avascular portion of the kidney
Renal medulla
113
Location of donor kidney
Iliac fossa
114
Disease: elevated BP, abdominal bruit on ausculation
Renal artery stenosis
115
Regulation of urine concentration
Medullary countercurrent system
| ADH
116
Normal value of GFR for both kidneys
125 ml/min
117
Combined renal blood flow through both kidneys in an average adult
1100 ml/min
