Tables Flashcards
1
Q
Na transport in the tubules
A
PCT - 60%
LOH - 30%
DCT - 7%
CD - 2-3%
2
Q
Proximal tubule Na transporters
A
A: Cl/IOH, NHE3
B: NaKATPase, KCC3/4
3
Q
LOH Na transporters
A
A: NKCC2, ROMK, Claudin
B: NaKATPase, KCC4, ClC-NKB
4
Q
DCT Na transporters
A
A: NCC, NHE2, ROMK, HCO0/Cl; ENac, ROMK
B: NaKATPase, ClCK-2, Kir, KCC4
5
Q
K transport in tubules
A
DCT 65%
TAL 25%
6
Q
Ca transport in tubules
A
PCT 70%
TAL 20%
DT 8%
7
Q
Ca transport proximal tubule
A
paracellular, TRPV5, V6
8
Q
Ca transport TAL
A
Clauding 16, 19
9
Q
Mg transport tubules
A
PT 20%
TAL 70%
DT 5%
10
Q
Mg transport TAL
A
paracellular 16, 19
11
Q
Mg transport DCT
A
TRPM6/7
12
Q
Phos transport proximal tubule
A
NaPiIIa/IIc
13
Q
Bicab reabsorption tubules
A
PT 80%
TAL 15%
CD 5%
14
Q
Proximal tubule HCO3
A
A: NHE3, AQP1
B: NBce1, NaKATPase
15
Q
DCT Type A intercalated cell Hco3 reabsorption
A
A: HKATPase, HATPase
B: kAE1, KCC4, Clc-2-K-Barttin
16
Q
DCT Type B Intercalated cell Hco3 reabsorption
A
A: Cl/HCO3, NDCBe, HKATPase
B: HATPase, Clc-K2, AE4
17
Q
IgA: predictive of ESKD or 50% decline in GFR
A
Mesangial hypercellularity, tubular atrophy./interstitial fibrosis
18
Q
IgA: not predictive
A
endocapillary hypercellularity
19
Q
IgA: predictive of rate of decline in kidney function
A
segmental sclerosis
20
Q
Chronic lesions in SLE
A
GIFT - Glomerular sclerosis, Interstitial fibrosis, fibrous crescents, tubular atrophy
21
Q
Acute lesions in SLE
A
Fibrinoid necrosis, cellular crescents karyorrhexis, endocapillary hypercellularity, subendothelial deposits, wireloop lesions, rupture of GBM
22
Q
Treatment of SLE Class II
A
proteinuria >3g, steroids + CNI
23
Q
Class 3 SLE Treatment
A
Corticosteroids + cyclophosphamide/MMF
24
Q
Class IV SLE treatment
A
Azathioprine 1.5-2.5 mkd
MMF 1-2 g/day
low dose steroids
or CNI if intolerant to aza and MMF
25
Class V SLE treatment
corticosteroids + cyclophosphamide, CNI, MMF, azathioprine
26
1st line initial therapy in SLE
cyclophosphamide or MMF
27
Maintenance therapy in SLE
AZA or MMF
28
Class 3 or 4 initial therapy options for cyclophosphamide
IV 0.5-1 g/m2 monthly for 6 months, 500 mg q2 weeks for 3 months, 1-1.5 mkd po 2-4 months
29
Cause of hypercalcemia: High PTH, Uca less than 100 mg/24h, FeCa < 0.01
FHH, NSHPT, Lithium
30
Cause of hypercalcemia: High PTH, UCa>200 mg/24h, FeCa> 0.01
primary or tertiary hyperparathyroidism
31
Cause of hyperCa: low PTH, low PTHRP, high 25(OH), high 25 (OH)2
Vitamin D overodse
32
Cause of hyperCa: low PTH, low PTHrP, low 25 (OH), high 25 (OH)2
Granulomatous disorders
33
Cause of hypercCa: low PTH, low PTHrp, low 25 (OH) and 25 (OH)2
LOH, milk alakali syndrome, immobilization, vitamin A, Drugs
34
Cause of hyperca: Low PTH, high PTHrP
HHM
35
Cause of hypoca, High crea
renal failure
36
Cause of hypoca: Normal Crea, Low PTH
hypoparathyroidism, low Mg, genetic
37
Cause of hypoca: Normal Crea, High PTH, Low Vitamin D
Vitamin D deficiency
38
Cause of hypoca: Normal Crea, high PTH, normal vitamin D, Normal 1, 25 (OH)2D
pseudohypoparathyroidism, Vit D dependent rickets
39
Cause of hypoca: Normal Crea, high PTH, normal vitamin D, High 1, 25 (OH)2D
Vit D resistant rickets
40
Cause of hyperK: TTKG>8
advanced kidney failure; dec ECV
41
HyperK: TTKG <5, TTKG <8 after fludrocortisone
drugs
42
HyperK: TTKG <5, TTKG > 8 after fludrocortisone, low aldosterone, low renin
DM, GN, NSaids, b-blockers
43
HyperK: TTKG <5, TTKG > 8 after fludrocortisone, low aldosterone, high renin
AI, ACE, Ketoconazole
44
HypoK: UrineK < 15 mmol/day, 15 mmol/g/Crea, metabolic acidosis
GI K losses
45
HypoK: Urine K < 15 mmol/day, 15 mmol/g/Crea, Normal acid base
profuse sweating
46
HypoK: Urine K < 15 mmol/day, 15 mmol/g/Crea, Metabolic alkalosis
remote diuretic use, vomiting
47
HypoK: Urine K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic acidosis
RTA
48
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl>20, UCa/Crea <0.15
Gitelman
49
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl>20, UCa/Crea > 0.20
Bartter Syndrome
50
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl < 10
extrarenal losses
51
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, Low aldosterone, normal cortisol
Liddle, licorice, AME
52
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, low aldosterone, high cortisol
Cushing syndrome
53
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, High aldosterone, Low Renin
PA, GRA
54
HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, high aldosterone, high renin
RAS, Malignant hypertension
55
Metabolic alkalosis, UCl> 20, UK > 30, HTN, low renin
primary hyperaldosteronism
56
Normal or micronodularity and B masses in Adrenal CT
idiopathic hyperaldosteronim vs GRA
57
Unilateral hypodense nodule > 1 cm in Adrenal CT, > 40 years old, with no lateralization
GRA screening
58
Unilateral hypodense nodule > 1 cm in Adrenal CT, > 40 years old, with lateralization
adrenal adenoma, primary adrenal hyperplasia
59
Unilateral hypodense nodule > 1 cm in Adrenal CT < 40
adrenal adenoma, PAH
60
Hyponat, hypovolemic, UNa < 30
Extrarenal losses
61
HypoNat, Hypovol, UNa > 30
Diuretic, mineralocorticoid deficiency
62
Hyponat, euvol, UNa>30
glucocorticoid deficiency, hypothyroidism, SIADH
63
Hyponat, Hypervol, UNa < 30
Acute renal failure
64
Hyponat, Hypervol, UNa > 30
Nephrotic syndrome, cirrhosis, heart failure
65
Metabolic alkalosis, UCl < 2o
nonrenal
66
Met alk, UCl>20, UK < 30 meq
laxative
67
Met alk, UCl>20, UK > 30 meq, normal BP
Barter, Gitelman, Diuretics
68
Met alk, UCl>20, UK > 30 meq, high BP, high renin, high cortisol
cushing syndrome
69
Met alk, UCl>20, UK > 30 meq, high BP, high renin, normal cortisol, high renin in renal vein
renovascular htn. JGA tumor
70
Met alk, UCl>20, UK > 30 meq, high BP, high renin, normal cortisol, normal renin in renal vein
malignant hypertension
71
Met alk, UCl>20, UK > 30 meq, high BP, low renin
primary aldosteronism, licorice
72
Chains involved in alport syndrome
A3.4.5
73
chains involved in tbmd
a3,4
74
a chains in anti-gbm
a3 chain
75
Tx of MCD
```
corticosteroids (pred 1 mld or 3 mkd for 4-6 weeks)
cycophosphamide 2-2.5 mkd for 8 weeks
cylosporine 3-5 mld
tacrolimus 0.05 - 1 mld for 1-2 years
MMF 500-1000 mg BID 1-2 years
```
76
Tx FSGS
prednisone > 4-16 weeks
CNI 4-6 months
MMF + dexamethasone
77
Tx MN
IV/oral steroids + cyclophosphamimde
| cyclosporine/tacrolimus
78
MPGN Type 1
oral cyclophosphamide/MMF
| low dose alternate day or daily corticosteroids < 6 months
79
Tx IGA nephropathy
RAS blcokers; IV/oral steroids
80
AntiGBM tx
steroids + cyclophosphamide + plasmapharesis
81
Pauci Immune Tx
MPP 7 mkd then pred 1 mkd for 1st month then alternate day 4-5 months; oral pred 2 mkd; cyclophosphamide
rituximab + corticosteroids + plasmapharesis
maintainance: azathioprine 1-2 mkd, MMF 1 g BID, methotrexate 0.3 mk/week
82
Predictors of Likely failure of fluid restriction in Hyponatremia
UOsm > 500, UNa + UK > Serum Na, 24H Urine vol < 1500 ml/day, Inc in serum Na <2 in 24 hours on fluid restriction < 1 L/day
83
Acute rejection Banff
Glomerular inflammation, Interstitial inflammation, Vascular inflammation, Tubulitis
84
Chronic rejection Banff
Interstitial fibrosis, Tubular atrophy, allograft glomerulopathy (GBM duplication), Mesangial matrix increase, Arterial fibrointimal thickening, Arterial hyalinosis, peritubular capillary
85
HSP Class Subtypes
```
Class I: Minimal alteration
Class II: Pure mesangial proliferation
Class IIIa: Focal <50% crescents
Class IIIb: Diffuse < 50% crescents
Class IVa: Focal 50-75% Crescents
Class IVb: Diffuse 50-75% crescents
Class Va: Focal > 75% crescents
Class Vb: Diffuse > 75% crescents
Class VI Membranoproliferative
```
86
RPGN Types
```
Type I: Anti-GBM
Type II: Immune complex
Type III: Pauci-immune
Type IV: Type I + III
Type V: Anca negative, pauci immune renal vasculitis
```
87
DM Classification
```
Class I: GBM thickening
Class II: Mesangial expansion
Class IIa: mild
Class IIb: severe
CLass III: Nodular sclerosis
Class IV: Advanced DM sclerosis
```
88
Factors increasing risk of osmotic demyelination
```
Serum Na < 105
Hypokalemia
Alcoholism
Malnutrition
Advanced Liver Disease
```
89
simple benign cyst
Bosniak Cat I
90
benign with thin septa. fine rim like calcification or uniform high density less than 3 cm
Bosniak Cat II
91
multiple septa
thick area or nodular calcification
high density ctsts > 3 cm
follow up at 6-12 mos
Bosniak Cat IIF
92
thickened irregular walls with enhancement, dense irregular calcficiation
Bosniak Cat III
93
clearly malignant
| nephrectomy <5-6 cm
Bosniak Cat IV
94
absolute contraindications to renal biopsy
```
uncontrolled htn
bleeding diathesus
cystic disease
hydronephrosus
uncooperative patient
```
95
Bartter Syndrome Type 1
NKCC2
96
Bartter Syndrome Type 2
ROMK
97
Bartter Syndrome Type 3
CLC-Kb
98
Bartter Syndrome Type IV
Bartin (B subunit of Clc-Ka and Clc-Kb
99
Bartter Syndrome Type V
Clc-Ka and Clc-Kb
