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Flashcards in DIT Renal Deck (45):
1

What does ureteric bud do?

HIGH YIELD

caudal end of metanephros and makes COLLECTING SYSTEM and induces metanephros to differentiate into renal tubular epithelial structures

If fails, could cause POTTER SEQUENCE

2

Potter sequence mneonic?

from oligohydramnios so compression of fetus

POTTER

Pulm hypoplasia
Oligohydramnios
Twisted face (wrinkles)
Twisted skin
Extremity defects
Renal failure (in utero)

3

What syndrome is associated with horseshoe kidney?

Turner syndrome

4

3 things that tell that special cell to release renin?

JG release renin when:

Beta adrenergic
Low pressure in afferent arteriole
Low sodium sensed by macula densa and signal is relayed to it

5

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

6

Inulin is useful for what?

Freely filtered by glomeruli and not reabsorbed. So the clearance of it is equal to the GFR

7

Clearance equation?

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

8

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

9

Filtration fraction? NEED TO KNOW

GFR/RPF. Glom filt rate/renal plasma flow

(clearance creatinine/clearance PAH is good estimate)

it is normally 20%

10

Do #4 on pg 511

ok

11

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
Dermatitis
Diarrhea
Dementia
Death

12

Psammoma bodies are in what?

PSaMMomA

Papillary adenocarcinoma
Serous cystadenocarcionoma
Meningioma
Mesothelioma

13

Flash cards for session 3

make them

14

Acetazolamide works where? Used for what?

Carbonic anhydrase

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

Psuedotumor cerebri

Chronic glaucoma

It is a sulfa drug (a if PFACTSSS)

15

What diuretic decreases calcium?

Loops loose calcium. used if hypercalcermia

16

Side effects of loop diuretics?

OH DANG

Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis
Gout

17

Non sulfa loop diuretic?

Ethacrynic acid

If you need loop who has a sulfa allergy

NER USE FOR GOUT

18

HCTZ mechanism? Toxicity?

Inhibits NaCl reabsorption in early distal tubule

hypokalemic metabolic alkalosis, hyponatremia

HyperGLUC
Glucose
Lipidemia
Uricemia
Calcemia

SULFA

19

Potassium sparing diuretics?

K+ STAys

Spironolactone, Triamterene, amiloride. and Eplerenone (eplerenone has less androgen affect)

T and A block Na channels in convoluted tubule

20

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

21

Potassium shift out of cell is caused by?

DO INSULIN LAB

Digitalis
hyperOsmolarity
Insulin deficiency
Lysis of cells
Acidosis
Beta Blocker

22

Tx for hyperkalemia?

Dextrose and insulin
Beta agonist (albuterol or soemthing)
bicarb to put into alkalosis

23

Tx for nephrogenic diabetes insipidus? 3 of them

HCTZ
K+ sparing
Indomethacin (less prostaglandin, less renal blood flow)

24

What happens with MPTP exposure?

Dopamine is gone b/c MPTP converted to MPP which destroys substantia nigra

25

Acid base result in PE?

Resp alkalosis b/c so much breathing to try to get rid of hypoxemia.

26

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

27

Anion gap acidosis?

MUDPILES
Methanol
Uremia
DKA
Propylene glycol
INH or Iron tabs
Lactic Acidosis
Ethylene glycol
Salicylates

28

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

IF

EM?

poststreptococacola glomerulonephritis

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

29

Labs with high antiDNAse B and low complement?

Acute post streptococcal glomerulonephritis

30

Kid has URI or gastroenteritis with purpuric nodules on his ass and legs. What findings would you see for:

LM

IF

EM

IgA nephropathy (purpuric nodules are Henoch Schonlein purpura)

LM: mesangial proliferation

IF: IgA deposits in mesangium

EM: mesangial deposits

31

Alport syndrome symptoms? Findings on biopsy of kidney?

Splitting of basement membrane b/c collagen type 4 issue.

Can't see (cataracts), can't pee, can't hear high c

32

What disease can cause rapidly progressive glomerulonephritis?

What do you see on LM?

Crescentic glomeruloneprhtisi:

Goodpasture (Linear on IF)

Granulomatosis with polyangitis (wegeners)

Microscopic polyangitis

Lupus

33

Lupus is associated with what nephritis?

LM?

IF?

Diffuse proliferative glomerulonephritis (diffuse means lots of glomeruli, proliferative b/c cells proliferate)

anti-dsDNA. WIRE LUPUS!

LM: wire loops b/c deposits line basement membrane

IF: granular. Makes sense

34

Kid had recent immunization now has nephrotic syndrome. Risk of hypercoag b/c loss of antithrombin. Anyway, what type of nephrotic syndrome doe he have?

Tx?

Minimal change disease.

EM: effacement of foot processes and albumin leaks out

CORTICOSTEROIDS just give it if they fit the mold and they should respond

35

Black, fat, HIV has what kind of findings on kidney biopsy?

LM

EM?

LM: segmental sclerosis (FSGSclerosis)

EM: effacement of foot process like minimal change disease)

36

Findings with membranous nephropatphy on biopsy?

LM

IF

EM

Most common for white adutls

LM: BM thickening (MEMBRANOUS in the name)

IF: granular for immune complex

EM: spike and dome with sub epithelial humps

37

Patient with hepatitis has nephrotic syndrome. What kind is it? what do you see on:

LM

IF

EM?

Membranoproliferative glomperulonephritis is caused by hepatitis,, lupus and subacute endocarditis.

IF: Tram track from GBM splitting with mesangial growth

EM: tram track again

Think of it as membrane is growing b/c that is is the name and can have nephritis and RBC case b/c name

SUBENDTHELIAL IM deposits

38

Round pink nodule in kidney is what?

Kimmelsteil wilson lesion b/c diabetic glomerulonephropathy with noneznzymatic glhycosylation fucking things up and causing larger membranes

39

Flashcards for post quiz on page 525

do it

40

Renal tumor in kids is associated with what problem genetically?

What is the complex associated with it?

Wilms tumor on chrom 11

WAGR complex

Wilms tumor
Aniridia (NO IRIS)
Genitourinary malformation
Retardation

41

What hormones can be made by RCC?

Well associated with VHL and chrom 3.

Secrete EPO, ACTH, PTHrP and Prolactin

42

What is a risk for RCC and transactional cell carcinoma?

Smoking! (RCC is obesity too. TCC is aniline dies and cyclophosphamide)

43

What is thyroidization of the kidney?

From chronic pyelonephritis with eosinophilic casts resembling thyroid tissue

44

Prerenal azotemia finding caused by what? What is finding?

Poor kidney perfusion so reabsorb urea!!!!

BUN:Creatinine>20

45

Patient has been taking antibiotics for a few weeks and has pyuria and azotemia. What is mechanism?

Other symptoms?

Acute Interstitial nephritis b/c drug acts as haptens in kidney.

Also can have fever, flank pain, hematuria, rash.