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Brain Gainz > Renal smart book > Flashcards

Renal smart book Flashcards

1
Q

Where is the lowest osmolarity in the nephron?

A

its the Distal convoluted tubule

ADH works here

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2
Q

What are the stages of Acute Tubular Necrosis? ATN

A

1- ischemia/toxic phase:

2- maintenence:

oliguria, tubular necrosis, denudation of basement membrane,

3: Recovery: re-epithelization of tubules

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3
Q

What are the depositions found along the GBM after post streptococcal glomerulonephritis?

A

IgM, IgG, C3

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4
Q

whats the fuck up of urinary incontinence when you pee when you sneeze or cough or laugh

A

Urethral sphincter dysfunction

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5
Q

where is the majority of water absorbed throughout the nephron?

A

the Proximal Convoluted tubule (60%)

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6
Q

What are the possible side effects caused at each stage of Acute Tubular necrosis

A

1- ishemia/toxic: decrease blood flow

2- maintence: Hyperkalemia, acidosis

3-hypokalemia

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7
Q

what do you give to prevent side effects of Aciclovir

(intersitial nephritis/crystal formation)

A

Shit ton of water

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8
Q

Which nephrotic syndrome do you think of when you see these lesions?

A

Diabetic Glomerulonephropathy

those are Kimmelstiel-wilson lesions

-eosinophil nodular sclerosis

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9
Q

What are the different transplant rejection reactions?

A
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10
Q

for metabolic alkalosis what findings do you use to diagnose the acid base abnormality?

A

urine chloride and serum volume

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11
Q

what two side effects are EPO stimulators assocaited with

A

Thromboembolic events and HTN

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12
Q

how does forscarnet work? what are the side effects?

A

it chelates calcium and promotes Mg wasting

it can lead to hypocalcemia and hypomagnesia

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13
Q

what are the three types of rapidly progressive (crescentic) glomerulonephritis?

A

1- good pastures - Anti GBM: Linear IF filled with igG and c3. type 2 hypersensitivity along with alveolar basement membrane

2- Granulomatosis with polyangiitis (wegeners); c anca / no igG or c3

3- microscopic polyangiitis - p ance

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14
Q

what causes cysteinuria?

what test do you run?

A

Defective amino acid transport in PCT

decreased reabsorption of cystein (and others) from urine COLA

sodium nitroprusside test

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15
Q

what are the ways to increase rate of dialysis removal of a drug OD

A

increase surface area, temp, pore size

decrease membrane thickness

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16
Q

whats the mutation for Renal cell carcinoma? RCC

A

RCC= 3p = VHL

(3 letters)

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17
Q

Chronic renal hypoperfusion will cause hypertrophy and hyperplasia of which cells in the kidney?

A

Juxtaglomerular cells

which are modified smooth muscle cells of the afferent arteriole

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18
Q

Post strep glomerulonephritis is worst for what age group?

A

Adults

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19
Q

what are the best ways to prevent UTIs from catheters?

A

avoiding unnecesary caths, use sterile techniques, and removing it asap

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20
Q

whats the treatment for Diabetic ketoacidosis (DKA)

A

Insulin and saline

increases serum bicarb,

decr glucose (duh), osmolality, and potassium

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21
Q

bence jones highly eosinophilic casts in urine

A

Multiple myeloma

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22
Q

whats the most common site of fetal hydronephrosis due to obstruction?

A

narrowing or kinging at the uteropelvic junction

(where the ureters join the kidney)

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23
Q

what part of the kidney does the uteric bud ultimately give rise to ?

what about the metanephric blastema?

A

the collecting ducts, major/minor calyces, renal pelvis, ureters

__________

glomeruli, bowmans space, PCT, loop, DCT

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24
Q

where does the ureter lie in reference to the gonadal artery and veins, and the internal illiac?

A

water under the bridge, but anterior to the internal illiac

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25
Q

How would Renal cell Carcinoma present?

A

painless hematuria, flank pain, abdominal mass

incr. hematocrit due to release of EPO from the tumor

26
Q

what is PAH a measure of?

A

renal plasma flow RPF

it gets freely filtered and secreted back into the blood

butttt at increased PAH concentrations the tubule’s carrier transport gets saturated so the extraction ratio goes down

27
Q

renal scarring on upper and lower poles, HTN at younger age?

A

Vesicouretal reflux

when the ureters enter the bladder at a perpendicular angle as opposed to oblique.

when the bladder fills it normally closes the flap that the oblique angle creates. but with perpindicular angle there is no flap

can lead to infections

dilated/blunted calyx & cortical scarring

28
Q

How is PAH a measure of Renal Plasma Flow (RPF)

A

PAH enters the nephron primarily through secretion with only a little bit of filtration

so you increase RPF you increase PAH secretion vice versa

29
Q

Kidney transplant that causes problems a week later

A

acute transplant rejection

HOST T cells attack the graft MHC antigens

30
Q

a person gets a kidney stone (calcium oxalate most common) what is his serum and urine calcium levles

A

Serum: Normocalcemia

Pee: Hypercaliuria

the serum gets regulated by vit d and pth and all that shit

31
Q

a guy has been working at a rubber factory for 30 yrs. and he has slowly increasingly red urine. what should you think?

A

Transitional cell carcinoma of the bladder

Factory workers have high occupational hazards for bladder cancer

32
Q

equation for Renal Plasma Flow. when youre only given renal blood flow and hematocrit

A

RPF= RBF x (1-Hct)

33
Q

which substances are found deposited in Rapidly progressive GN

A

Fibrin/macrophages

with goodpastures: igG/C3

with Wegeners or micro polyangiitis: c/p anca

34
Q

what are the clinical presentation of Acute interstitial nephritis

what can cause this?

A

Fever, RASH, hematuria

Eosinophils in urine!!!

P’s: Pee (diuretics), penicilin, pain free (nsaids), PPI, rifamPin

35
Q

why does spironolactone cause anti androgen side effects?

what are the effects?

A

it acts as an androgen receptor antagonist which inhibits testosterone synthesis

gynecomastia, decr. libido, impotence

36
Q

what are the lab findings of HUS

A

thrombocytopenia (decr. platelets)

Microangiopathic hemolytic anemia MAHA (microthrombi in small vessels)

acute kidney injury

37
Q

Renal transplat patient that comes in months-years later. what type of rejection is this?

A

Chronic rejection

due to vascular wall thickening

interstitial fibrosis/ parenychma atrophy

38
Q

which casts are seen in pyleonephritis?

A

White blood cell CASTS

39
Q

how would cells look on biopsy of Renal cell carcinoma?

A

its a clear cell carcinoma

-accumulation of lipids and carbs

40
Q

which diuretics are the best and most potent for rapid relief of HTN

A

Loop diuretics

cmon son

41
Q

what are some factors predisposing to Calcium oxaloate stones?

what are they shapped like?

A

hypercalciuria (high pee calcium)

hyPOcitraturia (low pee Citrate) - acidic Pee

shaped like X-s

42
Q

tell me about HSP

clinical presentation

A

affects younger kids after an upper respiratory infection. the body forms IgA antibodies that get deposited in vessesl causing vasculitis

abominal pain, rash on lower legs and buttocks, joint pain, hematuria

43
Q

porster fractured rib levels

left 9-11

A

1-6: visceral pluera

9-11: spleen

12: Kidney

44
Q

episodic recurrant Hematuria that follows some type of upper respiratory infection

DAYS after

A

IgA nephropathy

Burgers Dz - mesangial proliferation

45
Q

whats antiphospholipid syndrome?

A

you have antiphospholipd antibodies that cause hypercoaguable state as thromboemobli/recurrent pregnancy lost

false positive on VDRL/RPR (syphillis test)

prolonged PTT

associated with Lupus

46
Q

best way to test for early signs of diabetic nephropathy

A

albumin

mesangial expansion

47
Q

phospholipase A receptor antibody that messes with the podocytes. which nephropathy?

A

Membranous nephropathy

Spike/dome

48
Q

what precipitates uric acid in the nephron and which part?

A

low ph (acidic)

in the collecting duct

49
Q

fyi

in metabolic acidosis the nephron compensates by reabsorbing all bicarb (to helpd neutralize) and pee out H+ and NH4 and H2PO2

A
50
Q

what arteries supply the ureter

A

renal artery - proximal ureter

gonadal artery - middle ureter

internal illiac - distal ureter

51
Q

immunosuppresant drugs

A
52
Q

what renal problem can cause a vericocle

A

Renal Vein thrombosis RVT

caused by nephrotic syndrome due to loss of antithrombin 3 ATIII

Hypercoagable state

53
Q

what are the main losses in nephrotic syndrome?

A

Albumin (edema)

immunoglobulin (infection)

ATIII (hypercoag/RVT)

54
Q

what is Renal osteodystrophy? what causes it?

A

Renal osteodystrophy

caused by end stage renal disease

decr in (Vit D hydroxylation) => decr. serum calcium

incr in serum phosphate

55
Q

how do you calculate clearance?

A

Clearnce= (Urine concentration x flow rate) / plasma concentraiont

56
Q

fyi

hypotension leads to decr. RPF which leads to decr. GFR

A
57
Q

what are things associated with renal papillary necrosis

A

Sickle Cell

Pyelnephritis

Analgesics

Diabetes mellitus

SPAD

58
Q

when would ADPKD present?

A

youre totally fine at infancy

cysts start up later in life

59
Q

end stage renal dz what are the calcium/phosphate/pth levels?

A
60
Q

TTP-HUS

A

platelet activation (lack of ADAMST13) in arterioles and capallaries

diffuse microvascular thrombosis

maha w/ shiistocytes

thrombocytopenia

Brain Gainz (30 decks)

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