Renal Final Details Flashcards

(41 cards)

1
Q

The permenent primitive kidney develops from what primitive structure

A

Metanephros–> uteric bud

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2
Q

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

A

uretopelvic junction

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3
Q

horseshoe kidney is associated with what genetic condition?

A

Turner syndrome

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4
Q

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

A

Multi-cystic dysplastic kidney

(because the metenephric mesenchyme differentiates into the glomerulus)

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5
Q

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

A

Cortex

Medulla

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6
Q

JG cells release what molecule under what stimulation?

A

Renin

Low Na in DCT

Low BP

Increased B-stimulation

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7
Q

What is the 60-40-20 rule

A

Body weight is:

60% TBW

40% of that is ICF and 20% is ECF

Of ECF–> 25% plasma volume

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8
Q

What molecule used to measure GFR? RPF?

A

GFR- inulin

RPF- PAH

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9
Q

RBF=?

A

RPF/(1-HCT)

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10
Q

Filtration Fraction=?

A

GFR/RPF

(fraction of plasma flowing through that gets filtered)

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11
Q

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

A

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

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

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12
Q

What affect do NSAIDs and ACEi have on the FF?

A

NSAID decrease the RPF and the GRF therefore FF is unchanged

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

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13
Q

Hartnup disease is characterized by what pathology and findings?

A

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

Decreased Trp=decreased Niacin production=pallegra

pallegra=diarrhea, dimentia, dermatits, death

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14
Q

PTH acts on this part of the nephron

A

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

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15
Q

Function of Intercalated cell?

A

Active H+ secretion

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16
Q

ADH acts on ____ reveptors which are coupled to _____.

A

V2 receptors Coupled to Gs

(V1 on cascular endotheium is coupled to Gq)

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17
Q

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

A

JG cells: modified smooth muscle cells of the afferent arteriole

macula densa: part of the DCT

18
Q

PTH stimulates this enzyme in the proximal tubule cells

A

1alpha-hydroxylase

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

19
Q

Difference between the net effect of ANP v. ATII

A

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
Q

Increased anion gap acidosis causes

A

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
Q

Type I RTA

A

Think “Primary” or “1 letter”

Primary **Impaired H+ **secretion by intercalated cells

aka distal RTA

Low urine pH

22
Q

Type 2 RTA

A

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
Q

Type 4 RTA

A

4 Letters “ALDO”

Primary hypoaldosteronism–>hyperkalemia

Excess potassium results in decreased aminogenisis and buffering by proximal tubule

Low Urine pH

24
Q

Nephrotic syndrome associated with HIV and heroin abuse

A

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 **P**ee **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"