Retake Flashcards
Angiotensin II directly increases water reabsorption in which tubule?
the proximal tubule
Aldosterone directly increases water reabsorption in which tubule?
the distal tubule
Aldosterone is produced by which organ?
the adrenal cortex
Aldosterone acts to increase the expression and activity of which transporters?
ENaCs and Na/K-ATPases
What kind of transporter is the Na/H transporter?
an antiport
Bicarb reabsorption from the tubular lumen requires what transporter activity?
Na/H antiport to supply protons for carbonic anhydrase
Ca-ATPases are located on which surface of tubular epithelial cells?
the basolateral
Which tubular epithelial cells are primarily responsible for regulating pH?
intercalated cells in the distal and collecting tubules
Describe proton and bicarb movement across the tubular epithelim in a state of acidosis.
- protons derived from CO2 by intracellular carbonic anhydrase are pumped into the tubular lumen by H-ATPases and H/K-ATPases
- the bicarb produced by carbonic anhydrase is reabsorbed through the Cl/3HCO3- antiport
Describe proton and bicarb movement across the tubular epithelium in a state of alkalosis.
- carbonic anhydrase splits CO2 in intercalated cells
- protons are reabsorbed by H-ATPases and H/K-ATPases on the basolateral surface
- bicarb is excreted via Cl/3HCO2- antiports no the apical surface
What three compounds are used to buffer urine?
bicarb, ammonia, and phosphate
Give the equation for the UAG. What is considered normal?
Na + K - Cl with a negative value being normal
What is furosemide?
a loop diurective that blocks NKCC transporters
What are thiazides?
Na/Cl transport inhibitors that function in the distal tubule
Thiazides are best used for what clinical purposes?
long-term use of a diurectic given their limited SEs
What is spironolactone?
a K-sparing diuretic that acts on aldosterone and Na/K-ATPases in the collecting tubule
What is acetazolamide?
a carbonic anhydrase inhibitor
Where does acetazolamide fucntion?
the proximal tubule
Acetazolamide blocks reabsorption of what molecule?
bicarbonate
What is mannitol?
an osmotic diuretic
In which clinical scenario would you use mannitol?
the acute treatment of severe edema
Clearance of a substance that is subject to reabsorption ___ as the concentration of that substance increases?
clearance increases
Give the equation for estimating tubular reabsorption.
GFR x P - U x V
Give the equation for estimating tubular secretion.
U x V - GFR x P
How do we estimate renal plasma flow?
using the clearance of PAH
How do we estimate renal blood flow?
RPF/1-hematocrit
Which renal neoplasia is often exacerbated by pregnancy?
angiomyolipomas
What is the primary risk factor for RCC?
smoking
Stallate scars are a feature of which renal neoplasia?
oncocytomas
Oncocytomas arise from which renal structure?
collecting duct
Clear cell RCCs are derived from which renal structure?
proximal tubules
A cancer of the renal pelvis is like a ____
urothelial carcinoma
What are the components of nephrotic syndrome?
- proteinuria
- hypoalbuminemia
- edema
- hyperlipidemia
What are the components of nephritis?
- hematuria
- proteinuria
- hypertension
- urine sediment
Hypocomplementemia and history of recent infection are characteristic of which glomerular disorder?
PIGN
Subepithelial humps are a histological features of what glomerular disorder?
PIGN
What is the histopathology of primary IgAN?
mesangial expansion and cellular proliferation
What is the main cause of secondary IgAN?
cirrhosis and liver disease
Which glomerular disorder is morphologically indistinguishable from IgAN?
Henoch-Schonlein purpura
How do we differentiate IgAN from Henoch-Schonlein purpura?
Henoch-schonlein purpura is accompanied by systemic vasculitis and skin pain
Which nephritis-causing disorder shows linear IgG in the GBM?
goodpasture syndrome
Describe the histopathologic featuers of diabetic nephropathy.
- GBM thickening
- diffuse mesangial expansion
- KW nodules
Congo red staining will show what sort of glomerular disorder?
amyloidosis
Minimal change disease primarily affects which age group?
children
Damage to foot processes is a characteristic of what glomerular disease?
minimal change disease and FSGN
Minimal change disease is responsive to what treatment?
steroids
How can we differentitate minimal change disease from FSGN?
FSGN does not respond to steroids while minimal change disease does, additionally, sclerosis is not a feature of minimal change disease
What is collapsing glomerulopathy?
a subtype of FSGS related to HIV, drug use, and itiopathic causes
What is the characteristic histopathologic feature of membranous glomerulopathy?
diffuse global thickening of teh GBM
Membranoproliferative glomerulonephritis is caused by what?
abnormal complement activation
HCV and HBV are causes of what secondary nephritis?
membranoproliferative glomerulonephritis
The pineal gland secretes ____.
melatonin
C cells are part of which endocrine gland?
the thyroid
Three layers of the adrenal cortex
glomerulosa, fasciculata, reticularis
Where are chromaffin cells located?
the adrenal medulla
Which neoplasia is related to heightened epinephrine release?
pheochromocytoma
Elevated PTHrp is indicative of what cause of hypercalcemia?
a malignancy
A ___ carcinoma is indistinguishable from an adenoma until it metastasizes.
pituitary
Rathke’s pouch remnants can give rise to what pituitary neoplasia?
craniopharyngioma
What is bromocryptine?
a DA antagonist used to treat acromegaly
What is Addison’s disease?
primary hypoadrenalism
What is CRH?
the hypothalamic mediator that triggers ACTH release
What is congenital adrenal hyperplasia?
a 21-OH deficiency
What is Sheehan’s syndrome?
diminished pituitary functioning due to reduction in perfusion, commonly during and after birth
How does metformin function?
stimulate increased insulin production
Which drugs sensitize the periphery to insulin naturally secreted by the pancreas?
thiazolidinedines
Which diabetic drug is contraindicated for those with renal disease?
metformin
How do sulfonylureas treat diabetes?
by stimulating extra production
Which thyroid cancer is highly associated with MEN1?
medullary carcinoma of thryoid
Which thyroid carcinoma invades the trachea?
anaplastic
Where does leptin come from?
adipocytes
Leptin does what to apetite?
decrease apetite
What is the long-acting form of insulin?
glargine
