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Flashcards in Renal Final Details Deck (41):
1

The permenent primitive kidney develops from what primitive structure

Metanephros--> uteric bud

2

Which are is the last of the urogenital system to canalize and is therefore the most common location of fetal obstruction

uretopelvic junction

3

horseshoe kidney is associated with what genetic condition?

Turner syndrome

4

abnormal interaction between the ureteric bud and the metanephric mesenchyme can result in what deformity?

Multi-cystic dysplastic kidney

(because the metenephric mesenchyme differentiates into the glomerulus)

5

The glomerulus is located within the ______ and the nephron is located within the _______.

Cortex

Medulla

6

JG cells release what molecule under what stimulation?

Renin

Low Na in DCT

Low BP

Increased B-stimulation

7

What is the 60-40-20 rule

Body weight is:

60% TBW

40% of that is ICF and 20% is ECF

Of ECF--> 25% plasma volume

8

What molecule used to measure GFR? RPF?

GFR- inulin

RPF- PAH

9

RBF=?

RPF/(1-HCT)

10

Filtration Fraction=?

GFR/RPF

(fraction of plasma flowing through that gets filtered)

11

What molecules affect the afferent arteriole? How about the efferent?

Aferent arteriole is dilated by prostaglandins (therefore it is constricted by NSAIDS)

Efferent arteriole is constricted by Angiotensin (therefore relaxed by ACEi)

12

What affect do NSAIDs and ACEi have on the FF?

NSAID decrease the RPF and the GRF therefore FF is unchanged

ATII decreases the RPF while increasing the GFR leading to increased FF

13

Hartnup disease is characterized by what pathology and findings?

Decreased transport of tryptophan (neutral)--> results in lack to Tryptophan

Decreased Trp=decreased Niacin production=pallegra

pallegra=diarrhea, dimentia, dermatits, death

14

PTH acts on this part of the nephron

Early DCT--> Na/Ca antiporter on the basolateral side establishes Ca gradient for passive resorbtion of Ca from the tubular lumen

15

Function of Intercalated cell?

Active H+ secretion

16

ADH acts on ____ reveptors which are coupled to _____. 

V2 receptors Coupled to Gs

(V1 on cascular endotheium is coupled to Gq)

17

JG cells are derived from ____ which the macula densa is derived from _____

JG cells: modified smooth muscle cells of the afferent arteriole

macula densa: part of the DCT

18

PTH stimulates this enzyme in the proximal tubule cells

1alpha-hydroxylase

(Converts 25-OH Vitamin d-----> 1,25-(OH)2-vitamin D)

19

Difference between the net effect of ANP v. ATII

ANP--> Increaed GFR with NO compensatory increase in Na resorbtion (Lowers BP through loss of water and Na)

ATII--> Increased GFR with a compensatory incrased in Na resorbtion (matintains renal function while raising BP)

20

Increased anion gap acidosis causes

MUDPILES

M: methanol

U: uremia

D: diabetic ketoacidosis

P: propylene glycol

I: iron tablets or INH

L: lactic acidosis

E: ethylene glycol

S: salicylates (aspirin)

21

Type I RTA

Think "Primary" or "1 letter"

Primary Impaired H+ secretion by intercalated cells

aka distal RTA

Low urine pH

22

Type 2 RTA

Think "Secondary"

Proximal tubule loss of bicarb--> Fanconi syndrome (lack of proximal tubular resorbtion of all kinds of junk)

aka proximal RTA

High Urine pH

23

Type 4 RTA

4 Letters "ALDO"

Primary hypoaldosteronism-->hyperkalemia

Excess potassium results in decreased aminogenisis and buffering by proximal tubule

Low Urine pH

24

Nephrotic syndrome associated with HIV and heroin abuse

focal segmental golmerulonephritis (effacement of foot processes)

25

GBM thinkening with spike and dome appearence

membranous nephropathy

asoociated with SLE

26

Kid with massive proteinurea (selectively albumin) and effacement of foot processes

Minimal change disease

Looks normal on LM

27

Congo-red stain showing apple green birefringence

amyloidosis

28

tram track appearance or mesangium splitting the GBM

Membranoproliferative glomerulonephritis

Associated with HBV, HCV, subacute endocarditis, and lupus

29

Large eosinophillic nodules on light microscopy

Kimmelsteil-wilson nodule

Diabetic nephropathy

nonenzymatic glycosylation of the GBM

30

Lumpy-bumpy

Name?

What is causing the lumps and bumps

Acute poststreptococcal glomerulonephritis

caused by deposition of C3 along the GBM

(decreased serum C3 with elevated ASO-titer)

31

Crescent shapped deposits of C3b

RPGN

-->Goodpasture (anti-GBM), Wegner (c-ANCA), Microscopic polyangiitis (p-ANCA)

32

Deposition of IgA in the mesangium

Berger nephropathy

Henoch-Scholein purpura

33

Glomerulonephritis, deafness and vision abnormalities

Alport syndrome

Defect in type IV collagen

Can't see, can't pee, can't hear high C

34

Pt with staghorn calliculi

Type and cause

Amonium magnesium phosphate "Struvite"

Klebiseall and Proteus--> urease +

35

Hexagonal crystals in the urine

Cystine

36

Most common renal malignancy in children

Wilms Tumor

37

Cause of Wilms tumor

What is WAGR syndrome

Deletion of WT1 (tumor suppressor)

WAGR

Wilms tumor

Aniridia

G/U malformations

Retardation

38

Most common tumor of urinary tract

Causes?

Transiotional cell carcinoma

Pee SAC

Phenacatin, Smoking, Analine dyes, Cyclophosphamide

39

Interstital nephritis associated with_____

ATN associated with _______

Interstital Nephritis: Drugs mostly--> hematuria and pain

ATN--> Ischemia, drugs, crush injuries (myoglobinuria)--> muddly casts

40

Sickel cell or phenacetin use with gross hematuria and proteinuria

renal papillary necrosis

41

Other pathologies associated with ADPKD

Cystic Kidney

Berry aneurysm

Hepatic cysys

Mitral valve prolapse

"Cysts in kidney, cysts in liver, cysts in heart, cysts in brain"