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Renal Flashcards

(60 cards)

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1
Q

Minimal Change Disease

A

Primary Glomerular Disease, selective albumin loss (loss of anions of BM), Only visible on EM - foot process effacement.

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2
Q

EM spike and dome appearance with subepithelial deposites.

A

membranous nephropathy

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3
Q

second most common cause of primary nephrotic syndrome in adults

A

membranous nephropathy

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4
Q

nephrotic syndrome causes

A

focal segmental glomerulosclerosis, membranous nephropathy, minimal change disease (Lipoid nephrosis), amyloidosis, MPGN - membranoproliferative glomerulonephritis, diabetic glomerulonephropathy.

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5
Q

frothy urine with greater than 3.5 g/day protein. hyperlipidemia, fatty casts, and edema.

A

nephrotic syndrome

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6
Q

LM - diffuse capillary and GBM thickening

A

membranous nephropathy - drugs, infections, SLE and solid tumors

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7
Q

focal vs diffuse glomerular problems

A

> or < 50% of glomeruli involved

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8
Q

nephritic syndromes

A

acute post-strep glomerulonephritis, rapidly progresive glomerulonephritis, Berger’s, Alport

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9
Q

both nephritic and nephrotic

A

diffuse proliferative glomerulonephritis, Membranoproliferative glomerulonephritis.

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10
Q

most common congenital renal anomaly.

A

horseshoe kidney - turner syndrome

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11
Q

Potters sequence

A

flat face, low ears, limb abnormalities

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12
Q

causes of Potters

A

Oligohydramnios - bilateral renal agenesis, autosomal recessive PKD

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13
Q

cysts in kidney, unilateral, surrounded by abnormal tissue (cartilage), non-inherited

A

dysplastic kidney - malformation of renal parenchyma

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14
Q

cysts in the kidneys, bilateral, cortical and medullary, infants, hepatic fibrosis (portal hypertension), hepatic cysts

A

autosomal recessive PKD

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15
Q

cysts in the kidneys, bilateral, cortical and medullary, young adults, berry aneurysms, hepatic cysts and mitral prolapse

A

autosomal dominant PKD

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16
Q

shrunken cystic kidneys, medullary collecting ducts, parenchymal fibrosis - worsening renal failure

A

medullary cystic kidney disease

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17
Q

Azotemia

A

urea, creatinine, and other nitrogen rich compounds in the blood.

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18
Q

most common ARF

A

acute tubular necrosis - intrarenal azotemia

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19
Q

Prerenal azotemia

A

bun/cr >15, FENa <1, normal urine concentration

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20
Q

early postrenal azotemia

A

increased BUN/Cr, normal FENa and urine osmolarity

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21
Q

late postrenal azotemia

A

decreased BUN/Cr, FENa >2, decreased urine osmolality <500

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22
Q

brown granular casts are seen in urine

A

Acute tubular necrosis, intrarenal

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23
Q

intrarenal azotemia

A

decreased BUN/Cr, FENa >2, decreased urine osmolality <500

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24
Q

etiology of acute tubular necrosis

A

eschemic (proximal tubule, medullary TAL), nephrotoxic

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25
nephrotoxic
aminoglycosides, heavy metals, myoglobin, ethylene glycol, radiocontrast dye, urate
26
aminoglycosides
-mycins, gram (-) aerobes
27
decrease rate of chemo urate induced ATN
hydration and allopurinol
28
oliguria, rash, fever days to weeks after starting NSAIDs, Penicillin, or diuretics. eosinophils in urine
acute interstitial nephritis - may progress to renal papillary necrosis
29
gross hematuria and flank pain - result of ; chronic phenacetin or aspirin, DM, Sickle Cell, or severe acute pyelonephritis.
renal papillary necrosis
30
oxalate crystals in urine
ethylene glycol - nephrotoxic acute tubular necrosis
31
Tumor lysis syndrome
initiating Chemo causes excessive waste in nitrogen products (urate) - nephrotoxic ATN
32
avoid tumor lysis syndrome
hydration and allopurinol
33
causes of acute interstitial nephritis
NSAIDs, penicillin, diuretics
34
nephrotic syndrome in hispanic, african american, HIV, heroin, and sickle cell
focal segmental glomerulosclerosis - FSGS
35
nephrotic syndrome in caucasian adults
membranous nephropathy
36
glomerular subepithelial deposits
membranous nephropathy
37
causes of subepithelial deposits
Hep B and C, solid tumors, SLE, drugs (NSAIDs, penicillamine)
38
tram track appearance
type I membranoproliferative glomerulonephritis
39
subendothelial deposits associated with HBV and HCV
type I membranoproliferative glomerulonephritis
40
intramembranous deposits associated with C3 nephritic factor (autoantibody stabilizes C3 convertase)
type II membranoproliferative glomerulonephritis
41
all glucose and amino acid resorption occurs in
PCT - as well as 65% of all other ions
42
drives reabsorption in the PCT
Na/K pump
43
AA and glucose pct resorption is coupled to
Na
44
Type I vs II DM
lack of insulin or decreased sensitivity.
45
post pituitary hormones
ADH/vasopressin and oxytocin
46
descending loop of henle
20% reabsorption of filtered water
47
paracellular absorption of Mg and Ca
ascending loop
48
loop diuretics
furosemide, ethacrynic acid, bumetinide
49
side effects of hyponatremia, hypokalemia, metabolic alkalosis
loop diuretics
50
treat HTN and CHF. blocks NaCl symporter
hydrochlorothiazide
51
blocks aldosterone receptors - blockade of Na/K and H/K exchange pumps
spironolactone
52
side effects of spironolactone
hyperkalemic metabolic acidosis
53
water absorption in cortical collecting ducts
vassopressin
54
renal mass in 3 yo
Wilms tumor - nephroblastoma
55
deletion in chromosome 11, histo collection of cells resembling primitive glomeruli.
wilms tumor - nonpainful, bilateral, good prognosis
56
organomegaly, macroglossia, and neonatal hypoglycemia with wilms tumor
beckwith-weidemann syndrome
57
abdominal mass in 2-4yo elevated catecholamines
neuroblastoma - neural crest cell derivative
58
wilms benign or malignant
malignant
59
child abdominal mass is most likely... mesodermal in origin
wilms tumor
60
bence jones proteinuria
associated with multiple myeloma - of marrow

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