Uworld - Renal VII Flashcards by Matt Stanton

muddy brown casts

acute tubular necrosis

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clear cell

renal cell carcinoma

MC kidney tumor

risk fx - smoking and obesity

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origin of renal cell carcinoma

epithelial cells of prox renal tubules

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MC nephrotic in adults

membranous glomerulopathy
-thick glomerular BM - spike and dome appearance

granular deposits IgG and C3

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net filtration pressure

(Pc - Pi) - (Oc - Oi)

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diabetic nephropathy

MC cause of nodular glomerulosclerosis

kimmelstein wilson nodules - PAS positive

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uric acid crystals

with gouty arthritis

negative birefringement

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hep C

with MPGN

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HIV and drug users

focal segmental glomerulosclerosis

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solid tumors

membranous glomerulonephritis

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MC kidney stone

calcium oxalate and P

50% idiopathic hypercalciuria - with normocalcemia

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prader willi/angelman genetics

genomic imprinting

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trinucleotide repeat diseases

fragile X
huntington disease
myotonic dystrophy

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X-linked recessive

ducennes

hemophilia A

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establish corticomedullary concentration gradient

reabsorption in thick portion ascending loop - Na/K/2Cl

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overactive bladder tx

antimuscarinic - M3 receptors

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M3 receptors

bladder detrusor muscle - stimulation urine release

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M1 receptors

brain

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M2 receptors

heart

decreased HR and atrial contraction

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M3 receptors

lung, bladder, eye, GI, skin

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M3 receptors in eyes

miosis and accomodation

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lead intoxication

tubulointerstitial nephritis - renal failure

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multiple myeloma

easy fatigue - anemia
constipation - hyperCa
bone pain
renal failure

myeloma kidney - cast nephropathy -bence jones proteins

precipitate with tam horsfall proteins - eosinophilic casts

amphotericin B

most toxic antifungal
causes hypoK and hypoMg
-severe hypoK - get T wave flattening, ST depression, and U waves
-premature A and V contractions - Vtach and Vfib

drugs with pulmonary fibrosis

busulfan and bleomycin

drugs with liver necrosis

acetaminophen and halothane

phases of acute tubular necrosis

initiation - original insult maintenance - injury established - GFR low 1-2 weeks recovery - re-epithelialization of tubules - polyuria and normalizing GFR

drug induced interstitial nephritis

fever, rash, oliguria -after take beta-lactam - one cause plasma cells and eosinophilia IgE hypersensitivity

painless hematuria

bladder tumor

renal potassium handling

100% filtered at glomerulus 65% reabsorbed prox tube 25% reabsorbed ascending loop 5-100% secreted collecting duct - regulator - principal cells hypoK - more K reabsorbed alpha intercalated cells hyperK - principal cells secrete K

concentrations with no ADH

most concentrated bottom of loop most dilute - collecting duct

hexagonal crystine crystal stones

cysturia

cyanide-nitroprusside test

test for cysteine in urine

tx of cystinuria

hydration and urinary alkalinization (acetazolamide)

microalbuminuria

cannot be detected on urine dipstick

conns syndrome

primary hyperaldosteronism aldosterone secreting tumor - adenoma tx - aldosterone antagonist - spironolactone HTN, hypoK, metabolic alkalosis, decreased plasma renin activity

tx of conns

spironolactone - aldosterone antagonist

type 1 RPGN

goodpastures

type 2 RPGN

immune complex mediated PSGN, SLE, IgA nephropathy, HSP

type 3 RPGN

pauci-immune - no Ig or complement deposits on BM ANCA - wegeners

carbonic anhydrase

reforms H2CO3 intracellularly

acid buffers

2 in urine -HPO4 and NH3 trap H+ and allow secretion

secondary hyperaldosteronism

increased renin - renin tumor - rare B9 tumor - JG cells

lytes with pheochromocytoma

hypoK - beta2 stimulation

mets of renal cell carcinoma

lungs

polyuria with acute tubular necrosis

during recovery phase can get hypoK

maintenance stage of acute tubular necrosis

can get anion gap metabolic acidosis hyperP volume overload

MC cause pyelonephritis

gram negative rods

nephrotic syndrome and coag

hypercoag state | -loss of anticoag factors - antithrombin III

left side varicocele

left testicular vein to renal vein -right to IVC directly loss of antithrombin III - thrombotic occlusion of renal vein - with nephrotic syndrome

risk with radical hysterectomy surgery

damage ureter can get secondary hydronephrosis if ligate ureter

MC cause hydronephrosis

BPH - flow obstruction

muddy brown casts

acute tubular necrosis MC cause intrinsic renal failure in hosp patients

chronic renal transplant rejection

3 months or more worsening HTN and rising serum Cr obliterative fibrous intimal thickening and mononuclear infiltrate of surrounding tissue

uric acid stones

not seen on Xray need abdominal U/S or CT

struvite stones

Mg ammonia sulfate