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Flashcards in Renal Deck (189):
1

donor renal A and V anastamosed to

external iliac A and V

2

hartnup disease mech

neutral aminoacidura (also decreased absorption by enterocytes) eg. tryptophan

3

tryptophan gives rise to

nicotinic acid, serotonin, melatonin

4

Fanconi syndrome mech

generalized reabsorptive defect in PCT (involves all AA)

5

Thin descending and thick ascending loop of Henle (water and solutes)

descending permeable to water but not solutes : ascending permeable to solutes but not water

6

In nephon, all glucose and AA absorbed in

PCT

7

In nephon, most dilute urine in

DCT

8

ADH action on nephron and which cell

principal cell, V2 receptor, more aquaporins on the membrane (water hormone)

9

aldosterone on nephron, which cell

Principal cell (Na+ & water reabsorption, K+ secretion)
a-intercalated cell (K+ absorption; H+ secretion)

10

Juxta glomerular cells on

Afferent arteriole (secrete renin)

11

macula densa on

DCT (sense NaCl)

12

trigger for renin secretion

decrease renal arterial pressure and increased renal sympathetic discharge (beta 1)

13

erythropoetin secreted by

interstitial cells in the peritubular capillary bed

14

primary disturbance in metabolic A/A

HCO3

15

Primary disturbance in respiratory A/A is

pCO2

16

All (pCO2, HCO3 and pH) decreased in

metabolic acidosis

17

IF of PSGN two terms

starry sky or lumpy-bumpy

18

what deposits in PSGN

IgG, IgM and C3 (note: type III)

19

crescentic GN

RPGN

20

Goodpasture syndrome leads to what type of GN

RPGN

21

two types of pauci immune RPGN

wegners G and microscopic polyangitis

22

what type of HS in Goodpastures syndrome

type II

23

what type of GN SLE leads to

DPGN (membranous nephropathy is the nephrotic version of SLE)

24

race and nephrotic syndrome

FSG Sclerosis (african american and hispanic)
membranous nephropathy (caucasian)

25

urease + bugs cause what type of stone

AMP, struvite, staghorn (due to alkalinization of urine)

26

clear cell ca originate from

PCT

27

eosinophiluria with rash

drug induced interstitial nephritis

28

acetazolamide MOA

Carbonic anhydrase inhibitor (NaHCO3 diuresis)

29

loop diuretic MOA

inhibit Na+/K+/2Cl- cotransporter of thick ascending LOH

30

what drug inhibits loop diuretics fn

NSAIDS

31

Thiazides MOA

Inhibit NaCl reabsorption

32

Thiazides SE is exploited in

osteoporosis and renal calcium stones

33

aldosterone receptor antagonist in kidney

spironolactone and eplerenone

34

triamterene and amiloride MOA

block Na+ channels

35

aliskiren MOA

direct renin inhibitor, used in hyper tension

36

ACE I and bradykinin

ACE I increases bradykinin (bradykinin is a vasodilator)

37

useless promises, not totally

cadual mesonephric duct= ureteric bud

38

blastema (m mesenchyme)

glomeruli to DCT

39

most common site hydronephrosis

ureteropelvic junction

40

potter sequence cause of death

pulmonary hypoplasia

41

cause of potter sequence

BIL RENAL AGENES

42

foot finding in potter

clubbed foot

43

ACE 1 CI in preg

renala genesis

44

donor kidney art connected to

ext iliac art (on right side)

45

horse shoe kidney which a, risk and syndrome

IMA, turner, risk wilms tumor

46

multicystic dysplastic kidney

no connection between bud and mesemcnyme

47

duplex collecting system risk

reflux, UTI

48

kidney ribs

11, 12

49

during transplantation, lt kidney

goes to rt iliac fossa (longer vein)

50

kidney wedge necrosis

segmental art

51

kidney why emboli

3-5 times more perfused

52

uterine vessels and ureter damage which ligament

cardinal

53

plasma vol is measured by

radiolabelled albumin

54

60% what happens

40% 20%
5% and 15%

55

ECF vol measured by

inulin (also GFR)

56

size barrier

fenestrated capillary endothelium

57

charge barrier

basement memb- heparan sulfate- negative charge barrier

58

C=UV/P, V is

urine flow rate ml/min

59

when creatine level is normal

graph is flat

60

why creatinine clearance overestiamte GFR

moderately excreted

61

RBF

RPF/1-ht

62

FF=

GFR/RPF = 20%

63

filtered load+ excretion rate

GFRXplasma conc (same as UV)

64

why FF increase with angiotensin

efferent constant
GFR increase, RPF dec, FF incre

65

neutral aminoaciduria (tryptophan)

hartnups disease

66

inulinis grouped with

mannitol

67

glucose, Na grouped with

urea

68

PAH grouped with

creatinine

69

PCT_ hormones

PTH_phosphate
angiotensin 11 Na

70

descending loop

permeable to water (not solute)
at end becomes hypertonic

71

ascending loop

Na, K,Cl reabsorbed

72

PCT

na and cl- symporter
PTH-ca
most dilute (hypotonic)

73

Hormones in collecting duct

aldosterone and ADH

74

for AA absorption in PCT, need

Na

75

fanconi syndrome and metabolic defect

generalized defect
renal tubular acidosis
sir general fanconi

76

Bartter syndrome is lik

loop

77

gitelman syndrome is like

thiazide (T.G Ravi)

78

liddle syndrome features

inc na, dec K, metabolic alkalosis and decrease aldosterone

79

liddle syndrome problem

increased na reabsorption

80

SAME defect

11 b HSD def

81

Acquired SAME

licorice (glycyrrhetic acid)

82

things absorbed more quickly than water

glucose, AA, bicarb and Pi

83

JG cells location

afferent

84

macual densa location and sensor

DCT,Nacl

85

Role of b blockers in kidney

block b1 in JGA and decrease renin

86

angiotensionogen from

liver

87

function of angiotension 11 on baroreceptor

limit reflex bradycardia

88

K+ regulation happen at

DCT adn collecting duct (H,K+ ATPase)

89

erythropoetin secreted by

interstitial cells in peritubular capillary bed

90

1 a hydroxylase location

PCT

91

2 metabolic conditions causing hyperkalemia

acidosis hyperosmolarity

92

electrolyte complications after nebulizer use

hypokalemia (note b blockers cause hyerkalemia)

93

hypokalemia ECG

flattened T,U wave

94

hyperkalemia ECG

widened QRS, peak T

95

Mg low and high

torsades de pointes and decreased DTR

96

ECG and low ca

QT prolongation

97

anion gap diarrhea and salin infusion

normal (HARD ASS)

98

winter formula

pco2= 1.5 (Hco3)+8 +/_ 2

99

in metabolic acidosis

all up

100

in compensation

think how to make the opposite

101

high altitude and acid base

resp alkalosis

102

cause of metabolic alkalosis

diuretics
vomiting
antacids
hyperaldosteronism

103

3 types of RTA

1,11 and 1V

104

type 1 RTA

distal, decreased H+ secretion

105

type 11 RTA

proxima, increased bicarbonae secretion

106

type 1V RTA

hypoaldosteronism (hyperkalemia)

107

cause of type 1 RTA

amphotericin B, analgesic nephropathy

108

type !! RTA cause

fanconis synd, acetazolamide

109

RBC casts

g nephritis and malignant HT

110

granular casts (muddy brown)

acute tubular necrosis

111

waxy cast

end stage renal disease

112

GN code

ARDIAM

113

APSGN histology

LM- hypercellular
IF_ starry sky lumpy bumpy
EM- IC humps

114

APSGN deposits

IgG IgM C3

115

lab findings in APSGN

increase antiDNAse B
Increase ASO, decrease C3

116

crescent in RPGN made up of

fibrin, C3b, IgG

117

RPGN types

anti GBM- good pastures
paucimmune- wegener adn microscopic

118

diffusely proliferating wires are seen un

SLE

119

IgA nephropathy (2 names)

buergers disease, HSP

120

IgA nephropathy microscopy

mesangial proliferation and mesangial deposits

121

alport syndrome

can't see, can't pee, cant hear a buzzing bee

122

basket- weave

marfan adn alport EM

123

alport synd mechanism

mutation in type IV colagen X linked

124

MPGN is easy

proliferation inside the GBM
tram track

125

MPGN associated

HBV

126

nephrotic syndrome code

FM MAD

127

NS pneumococcal infection

loosing IgG in urine

128

NS hypercoagulability

loosing antithrombin 111

129

FSGS associated

HIV and african american
conditions

130

selective protenuria

lipod nephrosis (M change D)

131

Antibodies to phospholipase A2

membranous

132

associated with membranous

caucasian, SLE, HBV, solid tumors

133

thrombosis and nephrotic synd

membranous

134

spike adn dome appearance in

methanamine silver
membranous

135

most common cause od nodular glomerlosclerosis

DM

136

dont forget in DM kidney

GBM thickening

137

most commom kidney stone

calcium oxalate

138

chemistry of kidney stone

hypercalciuria, normocalcemia

139

alkaline urine stone

calcium phosphae and AMP
both are phosphate

140

vitamin for calcium oxalate stone

pyridoxine

141

microscopy of calcium stones

calcium- envelope
AMP- coffin lid(death)
uric acid- rhomboid (like pseudo gout)
cystine- hexagonal (sixtine)

142

radioluscent stones

uric acid- cystine

143

sodium cyanide nitroprusside test and renal stone

cystine

144

stone associated wth reflux

AMP

145

RCC origiante from

PCT

146

RCC silent cancer

lung metastasis

147

renal oncocytoma origin

collecting duct

148

2 differentiating feature of renal oncocytoma

central scar and eosinophilic
RCC_ yellow and clear cell

149

embryonic glomerular structure in a tumor

nephroblastoma (wilms tumor)

150

beckwith weiderman synd

beck very muscular
macroglossia, organomegaly, hemihypertrophy

151

wilm tumor association

beckwith weiderman
WAGR

152

diabetes - bladder

overflow incontinence
(detrussor muscle dysfunction and inability to sense bladder)

153

aniline dyes which cancer

transitional CC

154

nitrite test + in urine

E coli

155

sterile pyuria with neg culture

gonococci and chlamydia

156

thyroidization of kidney

c/c pyelonephritis (eosinophilic cast)

157

CT in pyelonephritis

striated parencymal enhancement

158

rash and costvertebral angle tenderness

drug induced interstitial nephritis

159

immunology of drug induced

eosinophils and IgE (takes 2 wks0

160

abruptio placenta and renal complication

diffuse cortical necrosis (vasospasm and DIC related)

161

ATN sites

PCT and thick ascending loop

162

sickle cell disease and kidney

renal papillary necrosis (also NSAIDS)

163

in prerenal azotemia kidney preserve NA and absorb BUN

FENA 20, osm > 500

164

renal azotemai

cant conserve
osm 40, Fena>2%, BUN/cr

165

anemai in CRF

normocytic normochromic
retic cunt normal
platelet, WNC normal

166

ARPKD is associated with

congenital hepatic fibrosis, portal HT

167

ADPKD is associated with

berry aneurysm, hepatic cyst, MVP

168

medullary cystic disease

shrunken kidney (poor prognosis)

169

complex cyst risk

RCC

170

compensation of diuretcis (lop and thiazide)

aldosterone- hypokalemia and alkalosis
ADH_ free water and hyponatermia

171

toxicity of mannitol

pulmonary edema

172

acetazolamide MOA

NaHCo3 losing

173

uses of acetazolamide

metabolic alkalosis, altitude sickness, urianry alkalization

174

SE of acetazolamide

acidosis and sulfa allergy

175

loop diuretics and NSAIDS

loop diuretics cause PGE release (dil of afferent)

176

loop diuretic MOA

na,K,2 cl cotransport

177

ethacrynic acid indications

sulfa allergy, (loop, thiazide, acetazolamide are sulfa drugs)

178

loop diuretic and uric acid

increased, cause gout

179

thiazide is good for people with

osteoporosis and renal stones

180

aldosterone antagonsit

spiranolactone, eplerenone
triamterene and amiloride are Na channel blockers

181

CHF and spiranolactone

decreased ventricualr remodelling and fibrosis

182

gynaecomastia and diuretic

spiranolactone

183

serum Nacl and diuretics

decerase in all except acetazolamide

184

hot summer day id equivalent to

loop diuretics (contraction alkalosis)

185

ACE inhibitor 1st SE

first dose hypotension (severe in RAS, C/c kidney disease and diuretics

186

what happens to GFR In ACEI

eff dil, decrease GFR, increase creatinine

187

aliskiren

direct renin inhibitor for HT

188

micturition reflex

sacral center- bladder contraction
pontine center- co ordinate relaxation of ext urethral sphincter
cerebral corted- inhibit sacral center

189

entire urinary tract from pelvis to urethra covering

transitional cell epithelium