Renal Flashcards
(139 cards)
1
Q
PLA2R antibodies
A
membranous nephropathy, usually IgG4
2
Q
Renal angiomyolipoma
A
BL in tuberous sclerosis
AD disease, get brain hamartomas, seizures, retardation, cardiac rhabdomyoma, skin angiofibroma, ash leaf spots with no pigment
3
Q
VHL syndrome
A
BL renal cell carcinoma
cerebellar hemangioblastomas
retinal hemangiomas
liver cysts
4
Q
descending loop
ascending loop
A
water permeable
water impermeable –> dilute DCT
5
Q
death in Potter sequence
A
lung immaturity - pulmonary hypoplasia
6
Q
hemophilia C
A
factor 11 deficiency
7
Q
spike and dome
A
membranous nephropathy
8
Q
Berger disease
A
after URI
IgA nephropathy
Henoch-Schonlein has…
GI pain, migratory arthralgias
9
Q
ATII site of action
A
efferent arteriole
10
Q
tumor lysis syndrome
A
uric acid precipitates in CD from low pH
11
Q
non lactose fermenting gram negative rod
A
Pseudomonas
12
Q
lactose fermenting gram negative rod
A
E coli
Enterobacter cloacae (Abx resistance)
Klebsiella
13
Q
Gram positive coccus
A
Enterococcus faecalis
14
Q
struvite
A
magnesium aluminum phosphate
“coffin lids” pH > 7
15
Q
uric acid stone
A
rhombus
16
Q
primary aldosteronism
A
low renin, high aldosterone
17
Q
V2 receptor
A
water and urea (medullary CD) permeability
18
Q
mesonephros
metanephros
A
male Wolffian ducts, female Gartner ducts
true kidney
ureteric bud - CD forward
metanephric blastema/mesoderm - rest
19
Q
loop diuretics also…
A
cause renal PG release
20
Q
Fabry disease
A
alpha galactosidase deficiency
ceramide trihexoside accumulation
hypohidrosis, acroparesthesia, angiokeratomas on abdomen, progressive renal insufficiency!
21
Q
Diabetic autonomic neuropathy
A
Type 1 DM, overflow incontinance, incomplete emptying
22
Q
nephrotic syndrome
A
activates RAAS
23
Q
FF
A
GFR/RPF
=20%
24
Q
c-ANCA
A
Wegeners
type 3 pauci-immune RPGN
cough, dyspnea, hemoptysis, epistaxis, chronic sinusitis, mucosal ulceration
25
acute hemorrhagic cystitis
adenovirus in children
26
ethylene glycol ingestion
calcium oxalate crystals
| anion gap metabolic acidosis
27
linear IgG and C3 deposits
Goodpastures
28
Lactate dehydrogenase
Pyruvate to lactate
29
Prevent Ca stones
give citrate
restrict protein and Na
don't restrict Ca
acid -- calcium oxalate
basic -- calcium phosphate
30
metabolic alkalosis
loss of H or Cl
| vomiting, diuretics, Conn, Cushing
31
K regulation
a-intercalated save
| principal cells secrete
32
ATN
lose K, Ca, P, Mg in recovery phase
33
ESRD
osteodystrophy
34
Selective proteinuria
albumin mostly
| in minimal change disease
35
easy fatiguability
constipation
bone pain
renal failure
multiple myeloma
see eosinophilic casts of light chain
36
outer medulla
PCT and Thick AL
37
Clearance
UV/P
38
PSGN
60% full recovery in adults
39
cystenuria
sodium-cyanide nitroprusside test
turns red purple
treat with acetazolamide
40
NSAID use
chronic interstitial nephritis
41
Fanconi syndrome
aminoaciduria
glycosuria
low phosphate
hypouricemia
42
treat nephrogenic diabetes insipidus
HCTZ
amiloride (if lithium induced?)
indomethacin to increase blood flow
43
relationship to ureters
vas deferens and uterine artery run above
44
plasma volume
1/4 of 1/3
45
renal clearance
CL = UV/P
46
renal plasma flow
U(PAH) * V
-----------------
P(PAH)
47
estimate GFR
inulin or Cr clearance
48
excretion rate
UV
49
filtered load
GFR*P
50
FF
GFR/RPF
| ~20%
51
HUS
thrombocytopenia
renal failure
and hemolytic anemia
from E coli O157:H7
52
PT early
Na co-transport for glucose, AA, P, or lactate
53
PT late
NaCl pulled in
54
organic cations and anions
in PT
organic cations to urine via H-exchanger
organic anions to urine via BL a-KG exchange, then single transport out
55
Ca and Mg in kidney
pulled in at ThAL
| H2O cannot come
56
Early DT
Na-Cl co-transporter
| Ca in channel
57
CD cell types
principle cells - save H2O/Na, lose K (ADH/aldo)
intercalated cells - save K, lose H/bicarb
- lose H = A cell
- lose bicarb = B cell
58
K sparing diuretics
affect principle cells
spironolactone/eplerenone - Aldo antagonists
triamterene/amiloride - block Na channel
"taKe a SEAT"
59
loop diuretic that is not a sulfa
ethacrynic acid
60
thiazides
block DT Na-Cl:
chlorthalidone
metolazone**
61
bumetanide
loop
62
diuretics that increase pH
loops and thiazides
CAI and K-sparings lower pH
63
causes of DI
causes of SIADH
lithium, hyperCa, demeclocycline, ADH-R mutation
cyclophosphamide
64
high Mg
hyporeflexia
65
cause hyperkalemia
```
acidosis**
digoxin**
B-blockers
low insulin
ACE-I
```
66
normal bicarb
22-28
67
RTA
I - low K, urine pH >5.5, a-intercalated cell H fail
| II - low K, low P, pH
68
MUDPILES
```
methanol
uremia
DKA
propylene glycol
Iron, isoniazid
lactic acid
ethylene glycol
salicylates
```
69
splitting BM
Alport
70
diffuse proliferative glomerulonephritis
lupus
71
subepithelial
spike-dome of membranous nephropathy
72
subendothelial
humps of membranoproliferative tram-track
73
cause membranoproliferative glomerulonephritis
Hep B/C
lupus
subacute endocarditis
74
complex renal cysts
lead to RCC
75
WAGR
Wilms
aniridia
GU malformation
retardation
chr 11
76
struvite stones
Proteus
Klebsiella
Staph
Pseudomonas
77
Ca stones
ethylene glycol
| vitamin C
78
AIN
eosinophilia, azotemia
fever, rash
causes ARF
79
AIN caused by
PPI, indinavir, ciprofloxacin, allopurinol, cimetidine, mesalamine, sulfonamides, cefs, penicillins, NSAID
80
ATN caused by
```
aminoglycosides
cephalosporins
polymyxins
contrast dye (bicarb prevents)
rhabdomyolysis
myoglobinuria
```
81
renal papillary necrosis causes
```
sickle cell
acetominophen
NSAIDS
diabetes
pyelonephritis
```
82
labs in renal failure
```
low Ca
low pH
high K
high uric acid
high BUN
high Cr
```
83
pronephros
week 4, degenerates
84
retrognathia
Potter sequence
85
ARPKD causes
Potter sequence
86
Horseshoe kidney associated with
stones
| aneuploidy
87
Y shaped bifid ureter
= duplex collecting system
| get reflux, UTI, obstruction
88
longer renal vein on
left kidney - take in transplant
89
total body water/mass
42 L = 42 kg
90
HCT
3 * Hb in g/dL
91
normal osmolarity
285-295 mOsm/kg
92
fused with glomerular BM
heparan sulfate
93
V in equation
urine flow rate mL/min
94
normal GFR
100 mL/min
95
Creatinine and GFR
overestimate since secreted slightly
96
GFR
Kf * [(P-P) - (n-n)]
97
RBF
RPF / 1-Hct
98
PAH and RPF
underestimate by 10%
99
NSAIDS
| ACE-I
constrict afferent arteriole
| dilate efferent arteriole
100
Glucose renal clearance
threshold for glycosuria = 200 mg/dL
saturation = 375
glucosuria and AAuria in normal pregnancy
101
treatment Hartnup disease
nicotinic acid
| high protein
102
defect Hartnup disease
proximal tubule neutral AA transporter
| enterocyte neutral AA transporter
103
resorbs bicarb and secretes NH3
early PCT
104
ATII causes
Na in/H out at apical early PCT
saves Na, water, and bicarb
contraction alkalosis
105
bicarb transport
exchange with Cl
out of cell
BL a-intercalated cell
apical B-intercalated cell
106
Fanconi syndrome
PCT general defect
lose AA, glucose, bicarb, P
renal tubular acidosis possible
107
Fanconi syndrome causes
```
Wilson
tyrosinemia
glycogen storage disease
ischemia
multiple myeloma
expired tetracycline
tenofovir
lead poisoning
```
108
Gitelman syndrome
distal CT Na-Cl
low magnesium
109
Liddle syndrome
collecting tubule GOF in Na resorption
treat with amiloride
110
Bartter syndrome
thick AL
low blood K
hpercalcuria
111
glycyrrhetic acid
in licorice
causes syndrome of apparent mineralicoticoid excess by blocking 11-B-hydroxysteroid dehydrogenase
112
Syndrome of apparent mineralicorticoid excess
CT excess cortisol (no 11-B-hydroxysteroid DH to convert to cortisone) activated mineralicorticoid R like aldosterone
113
low serum aldosterone
Liddle syndrome
| syndrome of apparent MC excess
114
PCT chart
urea up
P down
Cl under urea
bicarb under P
115
ATII actions
increase ADH
| stimulate thirst via hypothalmus
116
ANP/BNP actions
increase GFR
| decrease renin
117
JGA
low NaCl in DCT?
release adenosine to vasoconstrict
B1 receptors/low BP release renin
118
Ca reabsorption
DCT via PTH
119
hyperkalemia from...
B blocker
low insulin
renal failure
120
low Mg causes
hypokalemia, torsades
121
metabolic acidosis
diarrhea
Addison
acetazolamide, spironolactone
122
metabolic acidosis
vomiting
loop/thiazides
hyperaldosteronism
123
type 4 RTA has...
hyperkalemia
124
granular cast
ATN
125
PSGN hypersensitivity type
type III HS reaction
126
increased anti-DNase B
PSGN
127
type 1 MPGN
tram track
after hep B/C
subendothelial
128
type II MPGN
low C3
intramembranous
dense deposits
129
lymphoma can cause
minimal change disease
130
SLE can cause
membranous nephropathy
| DPGN - death - wire looping
131
calcium oxalate precipitates at
low pH
132
abdominal mass with painless hematuria
renal oncocytoma
133
Beckwith-Wiederman
Wilms
macroglossia
organomegaly
hemihypertrophy
134
urine with ammonia scent
Proteus mirabilis UTI
135
thyroidization of kidney
chronic pyelonephritis
136
diffuse cortical necrosis
infarcts in both kidneys from abrupt placentae, septic shock etc
137
maintanance phase of ATN
oliguric
| risk of hyperkalemia
138
urine osmolality >500
prerenal - but low FeNa
139
HT in ADPKD
from high renin
