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Flashcards in Renal Deck (53)
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1
Q

kidney embryo - 3 phases and final fate

A

pronephros - degenerates
mesonephros - interim kidney in 1st TM > male genital system
metanephros - permanent, becomes kidneys

2
Q

Potter’s syndrome - causes and effects

A

caused by ARPKD, post urethral valve, bilat renal agenesis
results in oligohydramnios > compression of fetus > limb deformities, facial deformity, pulmonary hypoplasia (can cause death)

3
Q

horseshoe kidney assoc w/

A

Turner syndrome

4
Q

relationship of ureters to uterine artery / ductus deferens

A

“water under the bridge” - ureters go under both structures

5
Q

what makes the charge barrier in the glomerular filtration barrier?

A

heparan sulfate in the BM

6
Q

clearance formula

A

C = U*V/P

7
Q

normal filtration fraction

A

20%

8
Q

at what glucose level does glucosuria begin, and at what level do the transporters reach there maximum?

A

160 mg/dl it begins, at 350 mg/dl its at Tm

9
Q

Hartnup’s disease

A
def of neutral AA transporter
results in pellagra
10
Q

3 stimuli for renin release

A
dec BP (JG cells)
dec Na delivery (macula densa cells)
inc sympathetic tone (beta 1 receptors)
11
Q

what cells secrete renin

A

juxtaglomerular cells

12
Q

6 things that shift K out of cells / cause hyperkalemia

A
digitalis
hyperosmolarity
insulin def
lysis of cells
acidosis
beta adrenergic antagonist
13
Q

U waves on ECG

A

hypoK

14
Q

peaked T waves on ECG

A

hyperK

15
Q

Henderson Hasselbach Eqn

A

pH = 6.1 + log (bicarb/(0.03PCO2))

16
Q

Winter’s formula

A

predicts resp compensation for primary metab acid/base disturbance
PCO2 = 1.5bicarb + 8 +/- 2

17
Q

type 1 RTA

A

distal - defect in CD’s excretion of H. assoc w/ hypoK and inc risk of Ca kidney stones and bone resorption

18
Q

type 2 RTA

A

proximal - defect in PCT bicarb reabs. assoc w/ hypoK and inc risk for hypophosphatemic rickets. does not respond to tx w/ bicarb

19
Q

type 4 RTA

A

hypoaldosteronism / reduced response to aldosterone. causes hyperK > impairs ammoniagenesis in PCT > acidosis

20
Q

granular muddy brown casts in urine

A

ATN

21
Q

fatty casts “ oval fat bodies” in urine

A

nephrotic syndrome

22
Q

2 MCC nephrotic synd in adults

A

1 - focal segmental glomerulosclerosis

2 - membranous nephropathy

23
Q

causes of focal segmental glomerulosclerosis

A

HIV, heroin, obesity, interferon, CKD due to congenital absence or surgical removal

24
Q

EM kidney biopsy - “spike and dome” w/ subepithelial deposits

A

membranous nephropathy

25
Q

causes of membranous nephropathy

A

idiopathic, drugs, infxns, SLE, solid tumors

26
Q

MCC nephrotic synd in kids

A

minimal change dz

27
Q

membranoproliferative glomerulonephritis is assoc w/

A

HBV, HCV

28
Q

“tram track” appearance

A

membranoproliferative glomerulonephritis

29
Q

Kimmelstiel Wilson lesions

A

diabetic glomerulonephropathy

30
Q

“lumpy bumpy” glomeruli

A

acute post strep glomerulonephritis

31
Q

conditions that can cause crescentic glomerulonephritis

A

Goodpasture’s
Wegener’s (granulomatosis w/ polyangiitis)
microscopic polyangiitis

32
Q

MCC death in SLE

A

diffuse proliferative glomerulonephritis

33
Q

“wire looping” of capillaries in glomeruli

A

diffuse proliferative glomerulonephritis

34
Q

Berger’s dz (IgA nephropathy) - related to what condition, what appearance on LM

A

Henoch-Schonlein purpura

mesangial proliferation

35
Q

high pH vs low pH calcium kidney stones

A

high pH > Ca phos

low pH > Ca oxalate

36
Q

hexagonal crystals (kidney stone type)

A

cystine stone

37
Q

clear cell RCC originates from what cell

A

proximal tubule cell

38
Q

genetic cause of RCC

A

gene deletion on chromosome 3 (can be sporadic or part of von Hippel Lindau)

39
Q

paraneoplastic synd assoc w/ RCC

A

ectopic EPO, ACTH, PTHrp

40
Q

Wilm’s tumor assoc w/ (2 things)

A
Beckwith-Wiedemann synd
WAGR complex (Wilm's, Aniridia, Genitourinary malformation, mental Retardation)
41
Q

MC tumor of urinary tract system

A

transitional cell CA (urothelial tumor)

42
Q

diffuse cortical necrosis - causes

A

vasospasm and DIC - occurs after obstetric catastrophes and septic shock

43
Q

MCC intrinsic renal failure

A

ATN

44
Q

phases of ATN

A

inciting event
maintenance phase - oliguric for 1-3 wks, risk of hyperK
recovery phase - polyuric, BUN and Cr fall, risk of hypoK

45
Q

renal papillary necrosis is assoc w/

A

DM
acute pyelonephritis
chronic phenacetin use
sickle cell anemia and trait

46
Q

dec BUN/Cr ratio

A

intrinsic renal failure

47
Q

renal osteodystrophy

A

failure of vit D hydroxylation > hypoCa and hyperPhos > 2ndary hyperPTH > subperiosteal thinning of bones

48
Q

assoc conditions w/ ADPKD

A

berry aneurysms, mitral valve prolapse, benign hepatic cysts

49
Q

effect of loop diuretics and thiazides on Ca

A

loops inc Ca excretion

thiazides dec Ca excretion

50
Q

tox of furosemide

A
OH DANG
ototox
hypoK
dehydration
allergy (sulfa)
nephritis (interstitial)
gout
51
Q

non-sulfa drug version of furosemide

A

ethacrynic acid

52
Q

tox of thiazides

A

hypokalemic metab alkalosis
hyponatremia
sulfa allergy

hyperGLUC (glycemia, lipidemia, uricemia, calcemia)

53
Q

ACEi tox

A
CATCHH
cough
angioedema
teratogen (renal abnlties)
Cr increase (dec GFR)
hyperK
hypoTN