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Flashcards in Renal Deck (139):
1

PLA2R antibodies

membranous nephropathy, usually IgG4

2

Renal angiomyolipoma

BL in tuberous sclerosis

AD disease, get brain hamartomas, seizures, retardation, cardiac rhabdomyoma, skin angiofibroma, ash leaf spots with no pigment

3

VHL syndrome

BL renal cell carcinoma
cerebellar hemangioblastomas
retinal hemangiomas
liver cysts

4

descending loop
ascending loop

water permeable
water impermeable --> dilute DCT

5

death in Potter sequence

lung immaturity - pulmonary hypoplasia

6

hemophilia C

factor 11 deficiency

7

spike and dome

membranous nephropathy

8

Berger disease

after URI
IgA nephropathy

Henoch-Schonlein has...
GI pain, migratory arthralgias

9

ATII site of action

efferent arteriole

10

tumor lysis syndrome

uric acid precipitates in CD from low pH

11

non lactose fermenting gram negative rod

Pseudomonas

12

lactose fermenting gram negative rod

E coli
Enterobacter cloacae (Abx resistance)
Klebsiella

13

Gram positive coccus

Enterococcus faecalis

14

struvite

magnesium aluminum phosphate
"coffin lids" pH > 7

15

uric acid stone

rhombus

16

primary aldosteronism

low renin, high aldosterone

17

V2 receptor

water and urea (medullary CD) permeability

18

mesonephros

metanephros

male Wolffian ducts, female Gartner ducts

true kidney
ureteric bud - CD forward
metanephric blastema/mesoderm - rest

19

loop diuretics also...

cause renal PG release

20

Fabry disease

alpha galactosidase deficiency
ceramide trihexoside accumulation

hypohidrosis, acroparesthesia, angiokeratomas on abdomen, progressive renal insufficiency!

21

Diabetic autonomic neuropathy

Type 1 DM, overflow incontinance, incomplete emptying

22

nephrotic syndrome

activates RAAS

23

FF

GFR/RPF

=20%

24

c-ANCA

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