Renal Flashcards
(189 cards)
1
Q
donor renal A and V anastamosed to
A
external iliac A and V
2
Q
hartnup disease mech
A
neutral aminoacidura (also decreased absorption by enterocytes) eg. tryptophan
3
Q
tryptophan gives rise to
A
nicotinic acid, serotonin, melatonin
4
Q
Fanconi syndrome mech
A
generalized reabsorptive defect in PCT (involves all AA)
5
Q
Thin descending and thick ascending loop of Henle (water and solutes)
A
descending permeable to water but not solutes : ascending permeable to solutes but not water
6
Q
In nephon, all glucose and AA absorbed in
A
PCT
7
Q
In nephon, most dilute urine in
A
DCT
8
Q
ADH action on nephron and which cell
A
principal cell, V2 receptor, more aquaporins on the membrane (water hormone)
9
Q
aldosterone on nephron, which cell
A
Principal cell (Na+ & water reabsorption, K+ secretion) a-intercalated cell (K+ absorption; H+ secretion)
10
Q
Juxta glomerular cells on
A
Afferent arteriole (secrete renin)
11
Q
macula densa on
A
DCT (sense NaCl)
12
Q
trigger for renin secretion
A
decrease renal arterial pressure and increased renal sympathetic discharge (beta 1)
13
Q
erythropoetin secreted by
A
interstitial cells in the peritubular capillary bed
14
Q
primary disturbance in metabolic A/A
A
HCO3
15
Q
Primary disturbance in respiratory A/A is
A
pCO2
16
Q
All (pCO2, HCO3 and pH) decreased in
A
metabolic acidosis
17
Q
IF of PSGN two terms
A
starry sky or lumpy-bumpy
18
Q
what deposits in PSGN
A
IgG, IgM and C3 (note: type III)
19
Q
crescentic GN
A
RPGN
20
Q
Goodpasture syndrome leads to what type of GN
A
RPGN
21
Q
two types of pauci immune RPGN
A
wegners G and microscopic polyangitis
22
Q
what type of HS in Goodpastures syndrome
A
type II
23
Q
what type of GN SLE leads to
A
DPGN (membranous nephropathy is the nephrotic version of SLE)
24
Q
race and nephrotic syndrome
A
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
