Renal UWorld 2 Flashcards
What is renal angiomyolipoma, what is it associated with?
Benign tumor made of blood vessels, smooth muscle, fat. Bilateral associated with tuberous sclerosis
Filtration/absorption/secretion pattern of inulin and mannitol
Freely filtered, neither resorbed nor secreted
Inulin can be used to calculate GFR
IF for postsreptococcal glomerular nephritis
granular deposits of IgM, IgG, C3 in mesangium and basement membranes - “starry sky”
Embryonic kidney development: pronephros, mesonephros, metanephros
Pronephros is a very primative structure arising from cephalic portion of nephrogenic cord, degnerates
Mesonephros forms midportion of nephrogenic cord, functions as kidney for first trimester then becomes Wolffian ducts
Metanephros: true kidney. Formation of ureteric bud from caudal end of mesonephric duct - ureter, pelvises, calyces, collecting ducts (collecting system). Metanephric mesenchyme - interacts with uteric to differentiate and form glomerulus through DCT.
Post strep glomerulonephritis: EM findings
electron dense deposites on epithelial side of basement membrane, composed of immune complexes
Addition of ___ to standard CHF therapy improves morbidity and mortality.
Spironolactone
Selective proteinuria
Albumin loss, but minimal loss of bulkier proteins like IgG and macroglobulin
Acyclovir nephrotoxicity
Excreted in urine. When concentration gets high in collecting duct, it crystallizes and can cause renal tubular damage. Prevented with adequate hydration
Acute post-strep glomerulonephritis - damage is mediated by:
Immune complexes deposited in subepithelial glomerulus (lumpy bumpy)
common side effects of ACE-Is
Cough, hyperkalemia, decreased GFR (increased Cr), angioedema
Constricting ureters ___ GFR and ___ Filtration Fraction
decreases, decreases
Method for diagnosing diabetic nephropathy
Albumin in urine
Visual impairment in HIV patient is most commonly due to:
CMV induced retinitis. Tx is ganciclovir, foscarnet, cidofovir
Foscarnet toxicity
Hypocalcemia (chelates calcium), hypomagnesemia (promotes nephrotoxic renal Mg wasting)
Calculate filtration fraction
FF = GFR/RPF
GFR is clearance of Cr or inulin
RPF is PAH clearance
Calculate clearance of substance
Cl = urine conc x urine flow rate / plasma conc
What part of the nephron is normally impermeable to water
ascending loop of henle
End stage renal disease relation to renal osteodystrophy
Hypocalcemia and secondary hyperparathyroidism
ESRD causes decreased formation of active VD –> decreased intestinal Ca absorption –> low calcium (leads to 2ndary hyperparathyroid)
ESRD causes phosphate retention, high serum phosphate also causes hypocalcemia and leads to secondary hyperparathyroidism
Hysterectomies and pelvic surgeries can harm what/cause what
Harm to ureters leads to hydronephrosis
Hydronephrosis
Distention/dilation of renal pelvis and calyces usually be urinary tract obstruction. Leads to compression atrophy of cortex and medulla
Clearance of digoxin
renal
Angiotensin II preferentially contracts
efferent arterioles
Acute rejection: time, mediators, treatment
within first 6 months
Can be antibody or cell mediated (lymphocytic infiltration)
Treat with anti-CD3 antibodies, which inhibit T-lymphocytes
What is the most important complication during recovery phase of acute tubular necrosis?
Hypokalemia. Also decreased Mg, PO4, and Ca
