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Flashcards in 14. Renal Deck (80):
1

What artery prevents a horseshoe kidney from ascending in the abdomen?

IMA

2

What fundamental problem creates Potter sequence?

oligohydramnios

3

What cell type releases renin?

juxtaglomerular cells

4

What are the 3 stimuli that induce renin release?

- beta-adrenergic stimulation
- low renal arterial BP (sensed by JG cells)
- decreased Na+ in distal convoluted tubule (sensed by macula densa)

5

What effect will a renal stone that obstructs the ureter have on GFR and FF?

- decreased GFR
- no change in RPF
- thus, decreased FF

6

What is the maximal serum glucose concentration at which glucose can be absorbed in the tubules?

350 mg/dL

7

What vitamin deficiency results from Hartnup disease?

niacin (B3) --> pellagra

note: Hartnup disease is when there is deficiency of neutral amino acid transporters in proximal renal tubular cells (ex. tryptophan)
- thus, decreased tryptophan for conversion to niacin

8

What is the equation for the renal clearance of any substance?

Renal clearance = UV/P
- U = urine concentration of particular substrate (mg/mL)
- V = urine flow rate (mL/min)
- P = plasma concentration of substrate (mg/dL)

9

What segment of the renal tubule matches each of the following statements?
- reabsorbs 67% of the fluid and electrolytes filtered by the glomerulus

prox tubule

10

What segment of the renal tubule matches each of the following statements?
- site of secretion of organic anions and cations

prox tubule

11

What segment of the renal tubule matches each of the following statements?
- always impermeable to water

thick ascending limb

12

What segment of the renal tubule matches each of the following statements?
- permeable to water only in the presence of ADH

late distal tubule, collecting duct

13

What segment of the renal tubule matches each of the following statements?
- site of Na/2Cl/K co-transporter

thick ascending limb

14

What segment of the renal tubule matches each of the following statements?
- site of isotonic fluid reabsorption

prox tubule

15

What segment of the renal tubule matches each of the following statements?
- site responsible for diluting urine

thick ascending limb

16

What segment of the renal tubule matches each of the following statements?
- only site where glucose and amino acids are reabsorbed

prox tubule

17

What segment of the renal tubule matches each of the following statements?
- water reabsorption in the loop of Henle

thin descending limb

18

What are the 2 main cell types of the collecting duct?

- principal cell
- intercalated cell

19

What type of diuretic is each of the following drugs?
- triamterene

K+ sparing

20

What type of diuretic is each of the following drugs?
- acetazolamide

carbonic anhydrase inhibitor

21

What type of diuretic is each of the following drugs?
- hydrochlorothiazide

thiazide

22

What type of diuretic is each of the following drugs?
- bumetanide

loop

23

What type of diuretic is each of the following drugs?
- spironolactone

K+ sparing (aldo-antagonist)

24

What type of diuretic is each of the following drugs?
- ethacrynic acid

loop (non-sulfa)

25

What type of diuretic is each of the following drugs?
- mannitol

osmotic diuretic

26

What type of diuretic is each of the following drugs?
- metolazone

thiazide

27

What type of diuretic is each of the following drugs?
- chlorthalidone

thiazide

28

What type of diuretic is each of the following drugs?
- furosemide

loop

29

What type of diuretic is each of the following drugs?
- amiloride

K+ sparing

30

What type of diuretic is each of the following drugs?
- torsemide

loop

31

What diuretic or class of diuretic would be most useful in each of the following situations?
- acute pulmonary edema

loop

32

What diuretic or class of diuretic would be most useful in each of the following situations?
- idiopathic hypercalciuria (--> calcium stones)

thiazide

33

What diuretic or class of diuretic would be most useful in each of the following situations?
- glaucoma (2)

acetazolamide, mannitol

34

What diuretic or class of diuretic would be most useful in each of the following situations?
- mild to moderate CHF with expanded ECV

loop

35

What diuretic or class of diuretic would be most useful in each of the following situations?
- in conjunction with loop or thiazide diuretics to retain K+

K+ sparing

36

What diuretic or class of diuretic would be most useful in each of the following situations?
- edema associated with nephrotic syndrome

loop

37

What diuretic or class of diuretic would be most useful in each of the following situations?
- increased intracranial pressure

mannitol

38

What diuretic or class of diuretic would be most useful in each of the following situations?
- mild to moderate hypertension

thiazide

39

What diuretic or class of diuretic would be most useful in each of the following situations?
- hypercalcemia

loop

40

What diuretic or class of diuretic would be most useful in each of the following situations?
- altitude sickness

acetazolamide

41

What diuretic or class of diuretic would be most useful in each of the following situations?
- hyperaldosteronism

spironolactone, eplerenone

42

What is the site of action of the thiazides?

distal convoluted tubule

43

A patient with heart failure exacerbation needs medical diuresis but has a sulfa allergy. What diuretic can be used?

Ethacrynic acid (loop)

44

Which electrolyte disturbance fits each of the following presentations?
- correcting too rapidly may result in central pontine myelinolysis

hypo Na+

45

Which electrolyte disturbance fits each of the following presentations?
- peaked T waves

hyper K+

46

Which electrolyte disturbance fits each of the following presentations?
- tetany

hypo Ca2+, hypoMg2+

47

Which electrolyte disturbance fits each of the following presentations?
- arrhythmias

hyper K+, hypo K+, hypo Mg2+

48

Which electrolyte disturbance fits each of the following presentations?
- decreased deep tendon reflexes

hyper Mg2+

49

Which electrolyte disturbance fits each of the following presentations?
- flattened T waves, U waves on EKG

hypo K+

50

What factors/substances cause hyperkalemia? (8)

- acidosis
- low insulin
- beta-blocker
- digitalis
- cell lysis (rhabdo, crush injury)
- hyperosmolarity
- K+ sparing diuretics
- ACE inhibitors (b/c of decrease in aldosterone)

51

What factors/substances cause hypokalemia? (5)

- insulin
- beta agonist
- alkalosis
- loops
- thiazides

52

What are the causes of acidosis with elevated anion gap?

MUD PILES
- methanol
- uremia
- diabetic ketoacidosis
- propylene glycol
- iron tablets/isoniazid
- lactic acidosis
- ethylene glycol
- salicylates (late)

53

A patient is found to have both glomerulonephritis and pulmonary vasculitis. What two diagnoses should be considered?

- Goodpasture
- GPA (Wegener)

54

An 8 yo girl presents with abdominal pain, hip and knee pain, and purpura on the backs of the arms and legs. U/A shows microscopic hematuria and mild proteinuria. What is the most likely diagnosis?

IgA nephropathy (HSP)

55

Which glomerular disease would you suspect most in a patient with the following findings?
- linear pattern of IgG deposition on IF

Goodpasture

56

Which glomerular disease would you suspect most in a patient with the following findings?
- lumpy-bumpy deposits of IgG, IgM, and C3 in the mesangium

PSGN

57

Which glomerular disease would you suspect most in a patient with the following findings?
- Deposits of IgA in the mesangium

IgA nephropathy

58

Which glomerular disease would you suspect most in a patient with the following findings?
- anti-GBM antibodies, hematuria, hemoptysis

Goodpasture

59

Which glomerular disease would you suspect most in a patient with the following findings?
- crescent formation in the glomeruli

RPGN (crescentic)

60

Which glomerular disease would you suspect most in a patient with the following findings?
- wire-looping appearance on LM

lupus-nephritis

61

What are the defining features of nephrotic syndrome? (3)

- proteinuria > 3.5 g/day
- hypoalbuminemia
- peripheral edema

62

Glomerular histology reveals multiple mesangial nodules. This lesion is indicative of what disease?

Diabetic glomerulonephropathy
- Kimmelstiel-Wilson lesions

63

Which glomerular disease would you suspect most?
- most common nephrotic syndrome in adults

FSGS

64

Which glomerular disease would you suspect most?
- EM: effacement of epithelial foot processes

minimal change

65

Which glomerular disease would you suspect most?
- nephrotic syndrome associated with hep B

membranoproliferative glomerulonephritis (MPGN)

66

Which glomerular disease would you suspect most?
- nephrotic syndrome associated with HIV

FSGS

67

Which glomerular disease would you suspect most?
- EM: subendothelial humps and tram-track appearance

MPGN

68

Which glomerular disease would you suspect most?
- LM: segmental sclerosis and hyalinosis

FSGS

69

Which glomerular disease would you suspect most?
- purpura on back of arms and legs, abdominal pain, IgA nephropathy

Henoch-Schonlein purpura (HSP)

70

Which glomerular disease would you suspect most?
- EM: spiking of the GBM due to electron-dense subepithelial deposits

membranous nephropathy

71

What is the WAGR complex?

Wilm's tumor
Aniridia
GU malformation
Retardation (mental)

72

What are the risk factors for transitional cell carcinoma? (3)

- smoking
- aniline dyes
- cyclophosphamide

73

What GU pathology fits each of the following descriptions?
- most common tumor of the urinary tract

TCC

74

What GU pathology fits each of the following descriptions?
- most common renal malignancy of early childhood (age 2-4)

Wilm's

75

What GU pathology fits each of the following descriptions?
- most common type of renal stone

calcium

76

What GU pathology fits each of the following descriptions?
- type of renal stone associated with Proteus vulgaris

struvite stones

77

What GU pathology fits each of the following descriptions?
- red cell casts

acute glomerulonephritis

78

What GU pathology fits each of the following descriptions?
- waxy casts

chronic renal failure (long standing kidney disease)

79

What are the classic features of drug-induced acute interstitial nephritis? (4)

fever, rash, eosinophilia, azotemia

80

What changes will be seen in a BMP in a pt with renal failure? (3)

- high K+
- low Ca2+
- high BUN and Cr