Flashcards in DIT Renal Deck (45)
What does ureteric bud do?
caudal end of metanephros and makes COLLECTING SYSTEM and induces metanephros to differentiate into renal tubular epithelial structures
If fails, could cause POTTER SEQUENCE
Potter sequence mneonic?
from oligohydramnios so compression of fetus
Twisted face (wrinkles)
Renal failure (in utero)
What syndrome is associated with horseshoe kidney?
3 things that tell that special cell to release renin?
JG release renin when:
Low pressure in afferent arteriole
Low sodium sensed by macula densa and signal is relayed to it
Fluid compartment. How is body weight dispersed for water volume, intracellular and extracellular?
60, 40, 20 rule
60% of weight is water
40% of weight is intracellular
20% is extracellular
Inulin is useful for what?
Freely filtered by glomeruli and not reabsorbed. So the clearance of it is equal to the GFR
UV over P=Cl urine concentration times flow rate divided by plasma concentration
Use inulin if you want it b/c not reabsorbed or secreted and it is freely filtered. (creatinine is more practical but no need to calculate that)
Normal is 100
Renal plasma flow is calculated how?
PAH b/c almost all of the PAH to kidney is pissed out b/c filtered and not reabsorbed. IT IS ALSO secreted so blood to tubules ALSO gets rid of it.
SO RPF= UV/P for PAH
Filtration fraction? NEED TO KNOW
GFR/RPF. Glom filt rate/renal plasma flow
(clearance creatinine/clearance PAH is good estimate)
it is normally 20%
Do #4 on pg 511
What is Hartnup disease?
Deficiency of transporter for neutral AA in PCT of kidney
Can't absorb tryptophan and CANT MAKE NIACIN
3 D's of pellagra
Psammoma bodies are in what?
Flash cards for session 3
Acetazolamide works where? Used for what?
Won't reabsorb it in the kidney so your urine is more basic, which helps to get rid of acidic toxins
ALSO ALTITUDE sickness to adapt for resp alkalosis
It is a sulfa drug (a if PFACTSSS)
What diuretic decreases calcium?
Loops loose calcium. used if hypercalcermia
Side effects of loop diuretics?
Non sulfa loop diuretic?
If you need loop who has a sulfa allergy
NER USE FOR GOUT
HCTZ mechanism? Toxicity?
Inhibits NaCl reabsorption in early distal tubule
hypokalemic metabolic alkalosis, hyponatremia
Potassium sparing diuretics?
Spironolactone, Triamterene, amiloride. and Eplerenone (eplerenone has less androgen affect)
T and A block Na channels in convoluted tubule
Drugs that cause nephrogenic diabetes insipidus? Mechanism?
Lithium blocks aquaporins in kidney that have been inserted into principle cells as does
DEMECLOCYCLINE (which makes sense b/c that is SIADH tx)
other causes: hypercalcemia, and hereditary mutation of ADH receptor
Potassium shift out of cell is caused by?
DO INSULIN LAB
Lysis of cells
Tx for hyperkalemia?
Dextrose and insulin
Beta agonist (albuterol or soemthing)
bicarb to put into alkalosis
Tx for nephrogenic diabetes insipidus? 3 of them
Indomethacin (less prostaglandin, less renal blood flow)
What happens with MPTP exposure?
Dopamine is gone b/c MPTP converted to MPP which destroys substantia nigra
Acid base result in PE?
Resp alkalosis b/c so much breathing to try to get rid of hypoxemia.
What is renal tubular acidosis? What is mnemonic for each kind? pH of urine for each?
Renal tubule problems causing non-anion gap acidosis
Type 1: H excretion problem in alpha intercalated (H is 1 letter) in distal convuluted tubule and so no HCO3 is made and acidosis with HYPOKALEMIA (duh, can't trade H for K). Higher pH and more bone turnover so risk of calcium stones
Type 4: NH4! 4 letters in aldosterone. Aldosterone receptors don't work, so high aldosterone levels (or K+ sparing diuretics). No NH4 mdd in proximal tubules so no buffer and then you get normal urine pH
Type 2 is leftover. Defect in proximal tubule HCO3 reabsorption so excrete more HCO3 and acidosis. alpha intercalated acidify urine so HYPOKALEMIA happens and normal low pH of urine. HYPOPHOSPHATEMIA and can have rickets
Anion gap acidosis?
INH or Iron tabs
Kid with puffy eyes 2 weeks after a skin infection comes in with cocacola urine. What are findings for: (which is the one we HAVE TO KNOW)
LM: enlarged and hyper cellular glomeruli (hypercel menangium, may see neutrophils)
IF: starry sky with lumpy bumpy IgG, IgM and C3 deposition
EM: MUST KNOW sub epithelial immune complex humps (HUMP DAYYYY)
remember epithelium is podocytes
Labs with high antiDNAse B and low complement?
Acute post streptococcal glomerulonephritis