Renal Path

Question 1

What controlls blood flow into the bowmans capsule and how does NSAIDs change it (afferent)

Answer 1

controlled by PGE2 (vasodialater)

-NSAIDs reduce PGE2- lead to vasoconstriction of afferent arteriole and increased risk of ischemic damage to the medulla

Question 2

What controlles effect of bowmans

Answer 2

Angiotensin type 2 (contractor)

Question 3

Renal functions

Answer 3

Excrete harmful waste products
maintain acid base homeostasis 
reabsorb essential substances
Regulate water/sodium
maintain vascular tone
produce erythropoietin
calcium homeostasis

Question 4

Generalized signs of kidney pathology (+mc)

Answer 4

blood in urine (mc)*

• Abdominal swelling
• stroke
• fever
• itching
• thirst
• tiredness
• chest pain
• weight gain

Question 5

Major clinical manifestations of renal diseases

Answer 5

Proteinura

Azotemia (elevation of Blood Urea nitrogen and createin levels as a result of decreased GFR)

Question 6

What is pre renal azotemia and cause

Answer 6

cause: decreased cardiac
- patient loses ability to perfuse kidney structures-> leads to decreased GFR

*There will be no intrinsic renal parenchymal disease (will return to normal once cause is treated)

Question 7

What is post renal azotemia + causes

Answer 7

Urinary tract obstruction below the kidney (prostate hyperplasia, ureter block, tumor)

-initially no renal parenchymal disease, but over time will (causes increased tubular pressure causes back diffusion of urea into the blood)

Question 8

What is renal azotemia

Answer 8

Caused by parenchymal to kidney (acute tubular necrosis, chronic renal failure)

Question 9

What are other minifistations of renal diseases other than proteunuria and azotemia

Answer 9

• Hematuria
• urinary mucrospoic changes
• hypertension
• electrolyte disorders
• casts
• oliguria/anuria/polyyria

Question 10

What is renal agenesis

Answer 10

-Absence of one or both kidneys (bilateral deadly)

Question 11

What is renal hypoplasia

Answer 11

• Usually unilateral

- presence of underdeveloped kidney unilat, other side is normall/fully developed kidney

Question 12

What is horeshoe kidney and what is it associated with

Answer 12

• one of the mc kidney abnormalities
• kidney fusion of lower pole usually
• associated with turners syndorme

Question 13

What is ectopic kidney/renal ectopia- and what can the symptoms mimic/what are you predisposed to

Answer 13

birth defect where kidney develops normally but is located below or above or contralateral of its usual pos

• symptoms may mimic urinary tract obstruction
• predisposed to pyleonephritis

Question 14

What is a duplex kidney

Answer 14

they duplex kidney has a single renal parenchyma that is drained by 2 pyelocaalceal systems

Question 15

What is autosmal recescive polycystic kidney- age, cause

Answer 15

dx in infnacy

-disorder is linked to an abnormal fibrocystic protein produced by the PKHD1 gene

Question 16

Autosomal dominant polycystic kidney- age, caue

Answer 16

Autosomal dominant inheritance

-mc polycystic kidney disease 1 (PKD1) gene mutation

Question 17

Clinical manisfitations of atosomal dominant kidney

Answer 17

Asymptomatic with norma; renal functins until middle age (delop slowly over time)

-hematuria, hypertension, abdominal mass (bilaterally) etc

Question 18

What is renal dysplasia- etiology, pathophysiology

Answer 18

genetic
iatrogenic- mutation cased by ACE inhibitors and angiotension receptor blockers

• the tubules fail to branch out and urine has nowhere to go
• the urine collects inside the kidney and forms cysts

Question 19

What is medullary sponge kidney kidney

Answer 19

Benign congenital disorder
-characterized by dialation of collecting tubules in 1 or more renal papillae affecting 1 or both kidneys

-usually asymptomatic (can rarely lead to chronic kidney disease/renal failure)

Question 20

Wht is acuired cystic kidney disease and how do u get it

Answer 20

consequence of hemodialysis

Question 21

3 stages of aquired cystic disease

Answer 21

1. Tubue block- development of cysts is due to tubular abnormalities
2. Compensatory growth- profound loss of renal tissue in endstage kidney disease promotes tubular cell hypertrophy and hyperplasia. Growth factors and activation of oncogenes
3. Ishemia- kidney atrophy

Question 22

What is simple retention cysts

Answer 22

Arise from glands by retention of their secreteion due to obstruction or obliteration of the ducts

-obstruction of the urinary duct can cause a kidney retention cyst