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Step One > Renal Random > Flashcards

Renal Random Flashcards

1
Q

pronephros

A

degenerates

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2
Q

mesonephros

A

interim kidney in first trimester

contributes to male genital system

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3
Q

ureteric bud

A

ureter pelvises, calyces, collecting ducts

canalized by 10th week

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4
Q

metanephric mesenchyme (blastema)

A

glomerulus through DCT

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5
Q

last to canalize

A

ureteropelvic junction

most common site of obstruction-hydronephrosis

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6
Q

causes Potter sequence

A

ARPKD, obstructive uropathy, bilateral renal agenesis, chronic placental insufficiency

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7
Q

associations horseshoe kidney

A

chromosomal aneuploidy

Turner, trisomy 13, 18, 21

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8
Q

unilateral renal agenesis

A

ureteric bud fails to develop, fails to induce diff of metanephric
leads to complete absence of kidney and ureter

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9
Q

multicystic dysplastic kidney

A

ureteric bud fails to induce diff
cysts and connective tissue in kidney
nonhereditary and unilateral

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10
Q

posterior urethral valves

A

remnant of posterior urethra in males leading to obstruction

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11
Q

kidney in transplant

A

left due to longer renal vein

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12
Q

renal blood flow

A 
seg
interlobar
arcuate
interlobular
afferent arteriole
glomerulus
efferent
vasa recta
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13
Q

damage to ureter

A

gynecologic procedures

ureters pass under uterine artery or vas

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14
Q

measure plasma volume

A

albumin

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15
Q

measure ECF

A

inulin or mannitol

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16
Q

composition glomerular filtration barrier

A

fenestrated capillary endothelium
basement membrane
epithelial layer

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17
Q

basement membrane composition

A

heparan sulfate and type IV collagen

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18
Q

clearance and GFR

A

lower-reabsorption

higher-secretion

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19
Q

measurement RPF

A

PAH

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20
Q

RBF

A

RPF/1-hematocrit

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21
Q

location prostaglandins

A

dilate arteriole

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22
Q

increase FF

A

efferent arteriole constriction (increase GFR, decrease RPF)
decrease plasma concentration (increase GFR)
dehydration

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23
Q

pregnancy and glucose clearance

A

decrease PCT ability to reabsorb glucose and AA

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24
Q

splay

A

between threshold and Tm

due to heterogeneity of nephrons

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25
Q

isotonic absorption

A

PCT

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26
Q

makes hypotonic (dilute) urine

A

Early DCT

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27
Q

concentrating segment

A

thin descending loop of henle

makes urine hypertonic

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28
Q

defect in PCT

A

Fanconi syndrome
increased excretion of AA, glucose, HCO3, PO4
results in metabolic acidosis

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29
Q

causes Fanconi syndrome

A

Wilson disease, tyrosinemia, glycogen storage diseases, cystinosis, ischemia, multiple myeloma, toxins, lead poisoning

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30
Q

defect in thick ascending loop of Henle

A

Bartter
hypokalemia and metabolic alkalosis with hypercalciuria
AR

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31
Q

defect in NaCl in DCT

A

Gitelman
hypokalmeia, hypomagnesemia, metabolic hypocalciuria
AR

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32
Q

gain of function in Na channel

A

Liddle syndrome

hypertension, hypokalmeia, alkalosis, decrease aldo

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33
Q

syndrome of apparent mineraldocorticoid excess

A 
def in 11b hydroxysteroid 
increase mineralocorticoid receptor activity leading to hypertension, hypokalemia, metabolic alkalosis
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34
Q

treatment syndrome of apparent mineralocorticoid excess

A

corticosteroids

cortisol tries to do same as aldo

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35
Q

Cl relative to Na

A

slower than Na in PCT

matches Na more distally

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36
Q

affects baroreceptor function

A

AT II
helps maintain blood volume and blood pressure
limits bradycardia

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37
Q

renin secretion

A

decrease arterial pressure, increase sympathetic discharge, decrease Na delivery to macula densa

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38
Q

modified smooth muscle of afferent arteriole

A

JG cells

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39
Q

release of EPO

A

interstitial cells in peritubular capillary

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40
Q

dopamine in the kidney

A

secreted by PCT to promote natriuresis
low-dilation
high-vasoconstriction

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41
Q

shifts K out of cell

A 
digitalis
hyperosmolarity
lysis-crush injury
acidosis
beta blocker
high blood sugar
succinylcholine
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42
Q

RTA 1

A

alkaline urine
defect in alpha intercalated (distal)
hypokalemia, risk of CaPO4 stones

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43
Q

causes RTA1

A

ampho B, analgesic nephropathy, congenital anomalies

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44
Q

RTA 2

A

acidic urine, defect in HCO3 reabsorption
metabolic acidosis and hypokalemia
risk of hypophosphatemia rickets

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45
Q

causes RTA 2

A

Fanconi and CA inhibitors

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46
Q

RTA 4

A

urine acidic, hyperkalmeia

hypoaldo

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47
Q

causes RTA 4

A 
diabetic hyporeninism, ACEi, ARB, NSAID, heparin, cyclosporine, adrenal insufficiency
aldo resistance (K sparing diuretics, obstruction, TMP/SMX)
48
Q

causes WBC casts

A

tubulointerstitial inflammation, acute pyelonephritis, transplant rejection

49
Q

causes RBC casts

A

glomerulonephritis, malignant HTN

50
Q

fatty casts

A

nephrotic syndrome

Maltese cross sign

51
Q

waxy casts

A

end stage renal disease/chronic renal failure

52
Q

hyaline casts

A

concentrated urine samples

53
Q

subepithelial immune complexes nephritic

A

PSGN

54
Q

depositions along GBM and mesangium in PSGN

A

IgM, IgG, C3

55
Q

components crescent in RPGN

A

fibrin and plasma proteins with glomerular parietal cells, monocytes, macrophages

56
Q

treatment Goodpasture

A

emergent plasmapheresis

57
Q

pauci immune RPGN

A

Wegener, microscopic polyangiitis

58
Q

wire looping of capillaries

A

diffuse proliferative glomerulonephritis

SLE or membranoproliferative as cause

59
Q

Alport EM

A

basket weave appearance

60
Q

type I membranoproliferative

A

hep B/C

tram tracking

61
Q

type II membranoproliferative

A

C3 nephritic factor (IgG Ab that stabilizes C3 convetase leading to decreased C3)

62
Q

cause of hypercoag in nephrotic

A

loss of anti-thrombin III

63
Q

cause of infection risk in nephrotic

A

loss of immunoglobulins

64
Q

causes of secondary minimal change disease

A

lymphoma (cytokine-damage)

65
Q

secondary FSGN

A

HIV, sickle, heroin, obesity, IFN, CKD

66
Q

spike and dome EM

A

membranous glomerulonephritis

67
Q

causes membranous glomerulonephritis

A

Ab to phospholipase A2 receptor, drugs, HBV, HCV, syphilis, SLE, tumors

68
Q

steps in diabetic glomerulonephropathy

A

nonenzymatic glycosylation of GBM leading to increase GFR and mesangial expansion

69
Q

envelope shaped stone causes

A

ethylene glycol, vitamin C abuse, hypocitraturia (Crohn)

calcium oxalate stone

70
Q

wedge shaped stone

A

calcium posphate

71
Q

coffin lid shaped stone

A

ammonium magneisum phospahte

72
Q

radiolucent stone

A

uric acid

73
Q

cause cystine stone

A

hexagonal stone

defective COLA transport

74
Q

test for cystine-reabsorbind defect

A

sodium cyanide nitroprusside test +

75
Q

treatment cystine stones

A

low sodium diet, alkalinization

chelating agent

76
Q

labs hydronephrosis

A

increase serum creatinine if bilateral

77
Q

origin renal cell carcinoma

A

PCT cells

78
Q

histology RCC

A

polygonal cells with lipids and carbohydrates

79
Q

mets RCC

A

lung and bone

80
Q

treatment RCC

A

surgery
aldesleukin
resistant to chemo and radiation

81
Q

association RCC

A

VHL

82
Q

paraneoplastic syndromes RCC

A

EPO, ACTH, PTHrP, renin

83
Q

origin renal oncocytoma

A

from collecting ducts

84
Q

histology renal oncocytoma

A

eosinophilic cells with abundant mitochondria without perinuclear clearing

85
Q

genetics Wilms tumor

A

loss of tumor suppressor WT1/2 on ch 11

86
Q

Beckwith-Wiedemann

A

Wilms, macroglossia, organomegaly, hemihyperplasia

WT2

87
Q

Denys-Drash

A

Wilms, early nephrotic syndrome, male pseudohermaphroditism

88
Q

location transition

A

calyces, pelvis, ureters, bladder

89
Q

associations transitional cell carcinoma

A

phenacetin, smoking, aniline dyes, cyclophosphamide

90
Q

risk factor squamous carcinoma of bladder

A

S haematobium, chronic cystitis, smoking, chronic nephrolithiasis

91
Q

stress incontinence

A

urethral hypermobility or intrinsic sphincter deficiency

leak with increase intra-abdominal pressure

92
Q

causes stress incontinence

A

obestiy, vaginal delivery, prostate surgery

93
Q

urgency incontinence

A

overactive due to detrusor instability

leak with urge to void immediately

94
Q

treatment urgency incontinence

A

oxybutynin

95
Q

overflow incontinence

A

incomplete emptying due to detrusor underactivity or outlet obstruction
leak with overfilling

96
Q

lab findings UTI

A

+ leukocyte esterase
+ nitrites-indicates gram negative
sterile cultures-indicates gonorrhea or chlamydia

97
Q

CT acute pyelonephritis

A

striated parenchymal enhancement

98
Q

xanthogranulomatous pyelonephritis

A

grossly orange nodules that can mimic tumor nodules

granulomatous tissue containing foamy macrophages

99
Q

thyroidization of kidney

A

chronic pyelonephritis

100
Q

cause of diffuse cortical necrosis

A

infarct of both kidneys
due to vasospasm or DIC
associated with obstetric catastrophes (placental abruption, septic shock)

101
Q

renal osteodystrophy

A

hypocalcemia, hyperphosphatemia, failure of vitamin D hydroxylation leading to secondary hyperparathyroidism
causes subperiosteal thinning of bones

102
Q

consequences of renal failure

A 
metabolic aidosis
dyslipidemia (increase TG)
hyperkalemia
uremia
Na retention
growth retardation
EPO failure
renal osteodystrophy
103
Q

systemic causes of acute interstitial nephritis

A

mycoplasma, Sjogren, SLE, sarcoidosis

104
Q

drugs interstitial nephritis

A 
diuretics
NSAID
penicillins and cephalosporins
PPO
rifampin
105
Q

maintenace phase

A

hyperkalemia, metabolic acidosis, uremia

1-3 weeks

106
Q

recovery phase

A

BUN and creatinine fall

risk of hypokalemia

107
Q

associations renal papillary necrosis

A

sickle cell disease, acute pyelonephritis, NSAIDs, diabetes

108
Q

PKD1

A

ch 16

109
Q

PKD2

A

ch 4

110
Q

assocations ADPCKD

A

berry aneurysms, mitral valve prolapse, benign hepatic cysts, diverticulosis

111
Q

cystic dilation of collecting ducts

A

ARPCKD

112
Q

associations AR

A

congential hepatic fibrosis

113
Q

inheritied disease causing tubulointerstitial fibrosis

A

medulalry cystic disease

shrunken kidneys on ultrasound

114
Q

complex cysts

A

septated, enhanced, have solid components

removal due to risk of RCC

115
Q

contraindications mannitol

A

anuria, HF

116
Q

more ototoxic loop

A

ethacrynic acid

117
Q

endocrine effects

A

spironolactone-gynecomastia, anti-androgen

Step One (19 decks)

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