Renal System Flashcards
MS patients have which type of urinary incontinence? What is the mechanism?
Urge incontinence.
Lesions above the sacral region of the spinal cord results in a loss of higher center control of micturition. Causes detrusor muscle hyperreflexia (“spastic bladder”)
What is Potter Sequence?
P = pulmonary hypoplasia O = oligohydramnios - stimulus T = twisted skin (wrinkled) T = twisted face (Potter facies/flat facies) E = extremities defects (club foot) R = renal agenesis, bilateral
Cause/inciting factor for Potter Sequence?
Renal anomalies -> oligohydramnios -> POTTER
Pipestem fibrosis (periportal fibrosis) + patient swam in a freshwater lake recently =
Hepatic schistosomiasis - S. japonicum, S. mansoni
Blood supply of proximal, middle and distal ureter
Proximal = renal artery Middle = multiple anastamoses Distal = superior vesicle artery
Which type of urinary incontinence is common in type 1 DM patients? What is the mechanism?
Overflow incontinence
Diabetic autonomic neuropathy -> decreased innervation of the detrusor muscle results in impaired contraction
Chronic kidney hypoperfusion results in hyperplasia and hypertrophy of which cells?
Juxtaglomerular cells = modified smooth muscle cells that are part of the afferent arteriole
Non-lactose fermenting cause of UTI?
Pseudomonas aeruginosa
“Lumpy-bumpy” deposits + tea colored urine + periorbital edema =
Post-streptococcal glomerulonephritis
What are the Post-Streptococcal glomerulonephritis deposits made of and where are they located?
IgG, IgM, C3
subepithelial deposits
Kimmelsteil Wilson nodules =
Nephrotic vs Nephritic
Diabetic nephropathy
Nephrotic
What is the first thing you should think of if someone has been taking naproxen for 3+ month daily?
Chronic interstitial necrosis (drug-induced)
Dysuria definition
painful urination
Which structure blocks the ascent of the kidneys in a horseshoe malformation?
Inferior mesenteric artery (L3)
Clearance of which substance is used to calculate RBF and RPF?
PAH
Clearance of which substances is used to calculate GFR?
- inulin
- creatine
Female + glomerulonephritis + photosensitive skin rash+ arthalgias + reproductive age =
Systemic Lupus Erythematosus
Female + arthralgias + african american + prolonged PTT + 2 spontaneous abortions + positive PRP test + negative Treponema pallidum immunoassay =
Antiphospholipid antibody syndrome
2 causes of sterile pyuria =
- acute pyelonephritis - rare
- non-gonococcal urethritis + cystitis - Chlamydia or Ureaplasma
Toddler’s painless GI bleeding =
Meckel’s diverticulum = failure of obliteration of the vitelline/omphalomesenteric duct
Failure of abdominal wall closure, viscera not covered with peritoneum =
Gastroschisis
internal urethral sphincter
- contraction
- relaxation
contraction = sympathetic relaxation = parasympathetic
Thyroidization of the kidney =
chronic pyelonephritis
Crescent shaped proliferation within the glomerulus =
What are they made of?
Rapidly Progressive Glomerulonephritis
Crescents made of fibrin + plasma proteins (C3b)
Wire looping of capillaries =
Diffuse Proliferative Glomerulonephritis
Tramtracks on PAS stain + subendothelial deposits =
Membranoproliferative glomerulonephritis Type 1
Pathology of Membranoproliferative glomerulonephritis Type 2 =
C3 convertase stabilization -> decreased levels of active C3 -> less inflammation
Crescent glomeruli + sinusitis + lung involvement + negative IF stain =
Granulomatosis with polyangitis (Wegner’s) -> Rapidly progressive glomerulonephritis
Negative IF stain + proteinuria = 5 + child =
Minimal Change Disease
Which phase of ATN is this?
oliguric - hyperkalemia, metabolic acidosis, increased ECF volume, hyponatremia, hypocalcemia
Maintenance phase (2nd)
Which phase of ATN is this?
polyuric - hypokalemia
Recovery phase
3rd
How to differentiate between causes of metabolic alkalosis?
- Urine Cl
- Volume status
Obliteration of what neonatal structure leads to the adult medial umbilical ligament?
Umbilical artery
Obliteration of the urachus leads to what adult structure?
Median umbilical ligament
Stones that form in basic urine (high pH)
- Calcium phosphate
- Ammonium magnesium phosphate (struvite)
Stones that form in acidic urine (low pH)
- Calcium oxalate
- Uric acid
- Cystine
IL-2’s anti-tumor effects are due to the action of
IL-2 stimulates T cells and NK cells to mature and proliferate (also stimulates B cells and monocytes)
NK cells and T cells help fight off tumor cells (malignant melanoma and renal cell carcinoma)
proximal tubular cell ballooning + vacuolar degeneration + flattening of tubular epithelial cells + FENa >2% (increased)
Acute Tubular Necrosis
medullary cysts lined with cuboidal or urothelial epithelium + cystic dilation of collecting ducts
Medullary Sponge Kidney
Deficiency of neutral AA transporters in the PCT and enterocytes
Hartnup disease (AR)
Can lead to a niacin deficiency (due to lack of tryptophan absorption) -> Pellagra
Differences in presentation between post-streptococcal GN and Berger disease
Post-streptococcal GN = 2 weeks post-pharyngitis, mostly occurs in children
Berger disease = 5 days post-URI, recurrent
Henoch-Schonlein purpura is what type of hypersensitivity?
Type III - IgA immune complex deposition in small vessels
deaf + hematuria + progressive renal failure + Xlinked Recessive
Alport syndrome = mutation in type IV collagen
Most common cause of nephropathy in HIV+ patients
Focal segmental glomerulosclerosis
-HIV patients have a collapsing variant
Beckwith-Wiedmann Syndrome
- Wilms tumor
- Macroglossia
- Organomegaly
- Hemihypertrophy
mutation in WT2
WAGR complex
- Wilms tumor
- Aniridia
- Genitourinary malformations
- mental Retardation
deletion of WT1
Papillary necrosis causes (4)
- Sickle cell disease or trait
- Acute pyelonephritis
- NSAIDs
- Diabetes mellitus
Cause of stress incontinence
- urethral sphincter dysfunction
- loss of urethral support
