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Physiology > Renal, USMLE > Flashcards

Renal, USMLE Flashcards

1
Q

Embryologic kidney in week 4 AOG

A

Pronephros

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2
Q

Functions as interim kidney for first trimester

A

Mesonephros

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3
Q

Mesonephros also contributes to which organ system

A

Male genital system

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4
Q

Embryologic kidney which is PERMANENT and first appears at 5th week AOG

A

Metanephros

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5
Q

Derived from the caudal end of the metanephros

A

Ureteric bud

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6
Q

Ureteric bud gives rise to (4)

A

1) Ureters
2) Pelvises
3) Calyces
4) Collecting tubules

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7
Q

Ureteric bud is fully canalized at

A

10th week AOG

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8
Q

Aberrant interaction of ureteric bud with this tissue may result in several congenital malformations of the kidney

A

Metanephric mesenchyme

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9
Q

Portion of the ureter that is the last to canalize and is the most common site of obstruction (hydronephrosis in fetus)

A

Ureteropelvic junction

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10
Q

Syndrome of oligohydramnios > fetal compression > limb and facial deformities + pulmonary hypoplasia

A

Potter’s syndrome

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11
Q

Cause of death in Potter’s syndrome

A

Pulmonary hypoplasia

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12
Q

To which structure is the horeshoe kidney trapped

A

IMA

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13
Q

T/F: Horseshoe kidney is dysfunctional

A

F

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14
Q

Syndrome with which horseshoe kidney is associated

A

Turner syndrome

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15
Q

Condition due to abnormal interaction between ureteric bud and metanephric mesenchyme leading to a nonfunctional kidney

A

Multicystic dysplastic kidney

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16
Q

Most common form of multicystic dysplastic kidney

A

Unilateral (asymptomatic)

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17
Q

Which kidney is taken during living donor transplantation

A

Left

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18
Q

Why is the left kidney preferred in living donor transplantation

A

Longer renal vein

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19
Q

Parietal layer of glomerulus

A

Bowman’s capsule

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20
Q

Visceral layer of glomerulus

A

Podocytes

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21
Q

JG cells are found ___

A

At the wall of afferent arteriole

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22
Q

Macula densa is found

A

At the wall of the DCT

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23
Q

Ureters in relation to the uterine artery and ductus deferens (retroperitoneal)

A

Under

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24
Q

Vessels and ureter at the renal hilum

A

Vein, artery, ureter

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25
The glomerular filtration barrier is composed of
1) Fenestrated capillary endothelium (size barrier) 2) Fused basement membrane with heparan sulfate (negative charge barrier) 3) Epithelial layer consisting of podocyte foot processes
26
Hydrostatic pressure in glomerular capillaries
60 mmHg
27
Effect of afferent arteriole constriction on RPF
Decreases RPF
28
Effect of efferent arteriole constriction on RPF
Decreases RPF
29
Effect of ureteral constriction on GFR
Decrease GFR
30
Transporter at the PCT responsible for complete reabsorption of glucose
Na-glucose cotransport (SGLT-2)
31
Increase vs Decrease: Effect of pregnancy on reabsorption of glucose and aa at the PCT
Decrease
32
Transporter responsible for reabsorption of aa from PCT
Na-dependent transporters
33
Deficiency of neutral amino acid transporter at the PCT
Hartnup's disease
34
AA wasted in Hartnup's disease
Tryptophan
35
Hartnup's disease is associated with this nutrient deficiency state
Pellagra
36
Hormone acting on PCT to increase phosphate excretion by inhibiting Na/phosphate cotransport
PTH
37
Hormone acting on PCT to increase Na, H2O, and HCO3 reabsorption by stimulating Na/H exchanger
ATII
38
Transport mechanism by which water is reabsorbed from the thin descending LOH
Passive diffusion via medullary hypertonicity
39
Transport mechanism by which Mg and Ca are reabsorbed in the thick ascending LOH
Paracellular transport via (+) lumen potential generated by K backleak
40
Means by which PTH increases Calcium reabsorption in the kidneys
Increases activity of Na/Ca exchanger in the early DCT
41
How aldosterone exerts its mineralocorticoid effect on kidneys
Insertion of Na channel in luminal side of principal cell
42
How ADH exerts its effect on kidneys (receptor; action)
Acts at V2 receptor>insertion of aquaporin H2O channels on luminal side of principal cell
43
Effects of ATII
1) Vascular smooth muscle constriction via AT1 receptors 2) Efferent arteriole constriction 3) Increase absorption of Na, HCO3 and water from PCT 4) Production of aldosterone by adrenals 5) Stimulates thirst via hypothalamus
44
Tubuloglomerular feedback fails once SBP falls below
80mmHg
45
Stimulus for release of ANP
Increased atrial pressure
46
Shift K out of cells causing hyperkalemia (6)
DO Insulin LAb 1) Digitalis 2) Hyperosmolarity 3) Insulin deficiency 4) Lysis of cells 5) Acidosis 6) b-adrenergic antagonist
47
How insulin and b-adrenergic agonists cause K shift into cells
Stimulation of Na-K ATPase pump
48
ECG changes in hypokalemia
1) U waves | 2) Flattened T waves
49
Shift K into cells causing hypokalemia (4)
1) Hypoosmolarity 2) Insulin 3) Alkalosis 4) b-adrenergic agonist
50
Hypocalcemia vs hypercalcemia: Tetany
Hypocalcemia
51
Hypocalcemia vs hypercalcemia: Seizures
Hypocalcemia
52
Symptoms of hypercalcemia (4)
1) Stones 2) Bones 3) Groans 4) Psychiatric overtones
53
Hypomagnesemia vs hypermagnesemia: Tetany
Hypomagnesemia
54
Hypomagnesemia vs hypermagnesemia: Decrease DTR
Hypomagnesemia
55
Hypomagnesemia vs hypermagnesemia: Bradycardia
Hypomagnesemia
56
Hypomagnesemia vs hypermagnesemia: Hypotension
Hypomagnesemia
57
Predicted respiratory compensation can be calculated using
Winter's formula
58
Winter's formula
PCO2 = 1.5 (HCO3) + 8 +/-2
59
Normal anion gap
8-12 mEq/L
60
Type 1 vs Type 2 RTA: Distal
Type 1
61
Type 1 vs Type 2 RTA: Defect in COLLECTING TUBULE's ability to EXCRETE H+
Type 1
62
Type 1 vs Type 2 RTA: Defect in PCT's ability to REABSORB HCO3
Type 2
63
Type 1 vs Type 2 RTA: Risk for calcium phosphate formation in kidney
Type 1
64
Type 1 vs Type 2 RTA: Rickets
Type 2
65
Type 1 vs Type 2 RTA: Urine pH >5.5
Type 1
66
Type 1 vs Type 2 RTA: Urine pH less than 5.5
Type 2
67
Pathophy of Type 4 RTA
Lack of collecting tubule response to aldosterone resulting in hyperkalemia
68
Hyperkalemia in Type 4 RTA results in impaired
Ammoniagenesis in PT, decreasing buffering capacity, decreasing urine pH
69
RBC casts are seen in (3)
1) GN 2) Ischemia 3) Malignant HTN
70
WBC casts are seen in
1) Tubulointerstitial inflamm 2) Acute pyelonephritis 3) Transplant rejection
71
Casts seen in ATN
Granular/muddy casts
72
Casts seen in advanced renal disease/chronic renal failure
Waxy casts
73
Glomerular disorders with hypercellular glomeruli
Proliferative
74
Glomerular disorders with thickening of GBM
Membranous
75
Nephritic syndromes (4)
1) APGN 2) RPGN 3) Berger's IgA glomerulonephropathy 4) Alport syndrome
76
Both nephritic and nephrotic (2)
1) Diffuse proliferative GN | 2) MPGN
77
In nephrotic syndrome, risk of infection is increased due to
Loss of Igs in urine
78
Segmental sclerosis and hyalinosis on LM
FSGS
79
Effacement of foot processes similar to MCD on EM
FSGS
80
Normal glomeruli on LM
MCD
81
Type of proteins lost in MCD
Albumin, not globulins
82
Congo red stain shows apple-green birefringence under polarized light
Amyloidosis
83
MPGN type with tram-track appearance
I
84
MPGN type with dense deposits
II
85
Type I MPGN is associated with what infections (2)
1) HBV | 2) HCV
86
Type II MPGN is associated with what factor
C3 nephritic factor
87
Pathophysiology of DM nephropathy
Non-enzymatic glycosylation of GBM increasing permeability and thickening
88
Kimmelsteil-Wilson lesion can be seen on LM as
Eosinophilic nodular glomerulosclerosis
89
Lumpy-bumpy appearance of APGN is seen under
LM
90
Subepithelial humps of APGN is seen under
EM

Physiology (15 decks)

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