Renal tubular disease

Question 1

Renal tubular acidosis (RTA) def

Answer 1

metabolic acidosis caused by impaired acid secretion by kidneys

Question 2

Type 1 RTA

Answer 2

Inability to excrete H ions in the distal tubule

Question 3

Type 2 RTA

Answer 3

Defective HCO3 reabsorption in the proximal tubule

Question 4

Type 3

Answer 4

type 1+2

Question 5

Type 4 RTA

Answer 5

Low renin

Low aldosterone

Question 6

Causes of type 1 RTA

Answer 6

SLE

Sjogrens

Amphotericin (antifungal)

Question 7

Type 1 RTA sx

Answer 7

Rickets/osteomalacia (buffering of H with Ca)

UTIs

Calcium phosphate stones

Question 8

Ix for type RTA

Answer 8

urine pH <5.5 despite metabolic acidosis

Question 9

Rx of type 1 RTA

Answer 9

Calcium bicarb or citrate

Question 10

Dx of type 2 RTA

Answer 10

IV sodium bicarb

high fraction of excreted HCO3 (>15%)

Question 11

Rx of type 2 RTA

Answer 11

high dose bicarb

Question 12

Type 4 RTA causes

Answer 12

Addisons

Diabetic nephropathy

Interstitial nephritis

Question 13

Type 4 RTA rx

Answer 13

Rx cause

Rx hyperkalaemia

Question 14

Fanconi syndrome pathophysiology

Answer 14

proximal tubular defect

Loss of amino acids, glucose, PO4, HCO3 in urine

Question 15

Effect of Fanconi syndrome

Answer 15

dehydration

metabolic acidosis

osteomalacia/rickets

Question 16

Congenital causes of Fanconi

Answer 16

Wilson’s

Tyrosinaemia

Lowe syndrome

Question 17

Acquired causes of fanconi

Answer 17

heavy metal poisoning

gentamaicin

myeloma

amyloid

Sjograns

Question 18

Fanconi rx

Answer 18

replace missing stuff

remove cause

Question 19

Heridetary hypokalaemic tubulopathies

Answer 19

Bartter syndrome

Gitelman syndrome

Question 20

Bartter

Answer 20

low K

metabolic alkalosis

high urine Ca

Inherited version of LOOP DIURETICS effect

Question 21

Gitelman

Answer 21

Low K

Metabolic alkalosis

low urine Ca

Inherited version of THIAZIDEs effect