Renal Random Flashcards
(117 cards)
1
Q
pronephros
A
degenerates
2
Q
mesonephros
A
interim kidney in first trimester
contributes to male genital system
3
Q
ureteric bud
A
ureter pelvises, calyces, collecting ducts
canalized by 10th week
4
Q
metanephric mesenchyme (blastema)
A
glomerulus through DCT
5
Q
last to canalize
A
ureteropelvic junction
most common site of obstruction-hydronephrosis
6
Q
causes Potter sequence
A
ARPKD, obstructive uropathy, bilateral renal agenesis, chronic placental insufficiency
7
Q
associations horseshoe kidney
A
chromosomal aneuploidy
Turner, trisomy 13, 18, 21
8
Q
unilateral renal agenesis
A
ureteric bud fails to develop, fails to induce diff of metanephric
leads to complete absence of kidney and ureter
9
Q
multicystic dysplastic kidney
A
ureteric bud fails to induce diff
cysts and connective tissue in kidney
nonhereditary and unilateral
10
Q
posterior urethral valves
A
remnant of posterior urethra in males leading to obstruction
11
Q
kidney in transplant
A
left due to longer renal vein
12
Q
renal blood flow
A
seg interlobar arcuate interlobular afferent arteriole glomerulus efferent vasa recta
13
Q
damage to ureter
A
gynecologic procedures
ureters pass under uterine artery or vas
14
Q
measure plasma volume
A
albumin
15
Q
measure ECF
A
inulin or mannitol
16
Q
composition glomerular filtration barrier
A
fenestrated capillary endothelium
basement membrane
epithelial layer
17
Q
basement membrane composition
A
heparan sulfate and type IV collagen
18
Q
clearance and GFR
A
lower-reabsorption
higher-secretion
19
Q
measurement RPF
A
PAH
20
Q
RBF
A
RPF/1-hematocrit
21
Q
location prostaglandins
A
dilate arteriole
22
Q
increase FF
A
efferent arteriole constriction (increase GFR, decrease RPF)
decrease plasma concentration (increase GFR)
dehydration
23
Q
pregnancy and glucose clearance
A
decrease PCT ability to reabsorb glucose and AA
24
Q
splay
A
between threshold and Tm
due to heterogeneity of nephrons
25
isotonic absorption
PCT
26
makes hypotonic (dilute) urine
Early DCT
27
concentrating segment
thin descending loop of henle
| makes urine hypertonic
28
defect in PCT
Fanconi syndrome
increased excretion of AA, glucose, HCO3, PO4
results in metabolic acidosis
29
causes Fanconi syndrome
Wilson disease, tyrosinemia, glycogen storage diseases, cystinosis, ischemia, multiple myeloma, toxins, lead poisoning
30
defect in thick ascending loop of Henle
Bartter
hypokalemia and metabolic alkalosis with hypercalciuria
AR
31
defect in NaCl in DCT
Gitelman
hypokalmeia, hypomagnesemia, metabolic hypocalciuria
AR
32
gain of function in Na channel
Liddle syndrome
| hypertension, hypokalmeia, alkalosis, decrease aldo
33
syndrome of apparent mineraldocorticoid excess
```
def in 11b hydroxysteroid
increase mineralocorticoid receptor activity leading to hypertension, hypokalemia, metabolic alkalosis
```
34
treatment syndrome of apparent mineralocorticoid excess
corticosteroids
| cortisol tries to do same as aldo
35
Cl relative to Na
slower than Na in PCT
| matches Na more distally
36
affects baroreceptor function
AT II
helps maintain blood volume and blood pressure
limits bradycardia
37
renin secretion
decrease arterial pressure, increase sympathetic discharge, decrease Na delivery to macula densa
38
modified smooth muscle of afferent arteriole
JG cells
39
release of EPO
interstitial cells in peritubular capillary
40
dopamine in the kidney
secreted by PCT to promote natriuresis
low-dilation
high-vasoconstriction
41
shifts K out of cell
```
digitalis
hyperosmolarity
lysis-crush injury
acidosis
beta blocker
high blood sugar
succinylcholine
```
42
RTA 1
alkaline urine
defect in alpha intercalated (distal)
hypokalemia, risk of CaPO4 stones
43
causes RTA1
ampho B, analgesic nephropathy, congenital anomalies
44
RTA 2
acidic urine, defect in HCO3 reabsorption
metabolic acidosis and hypokalemia
risk of hypophosphatemia rickets
45
causes RTA 2
Fanconi and CA inhibitors
46
RTA 4
urine acidic, hyperkalmeia
| hypoaldo
47
causes RTA 4
```
diabetic hyporeninism, ACEi, ARB, NSAID, heparin, cyclosporine, adrenal insufficiency
aldo resistance (K sparing diuretics, obstruction, TMP/SMX)
```
48
causes WBC casts
tubulointerstitial inflammation, acute pyelonephritis, transplant rejection
49
causes RBC casts
glomerulonephritis, malignant HTN
50
fatty casts
nephrotic syndrome
| Maltese cross sign
51
waxy casts
end stage renal disease/chronic renal failure
52
hyaline casts
concentrated urine samples
53
subepithelial immune complexes nephritic
PSGN
54
depositions along GBM and mesangium in PSGN
IgM, IgG, C3
55
components crescent in RPGN
fibrin and plasma proteins with glomerular parietal cells, monocytes, macrophages
56
treatment Goodpasture
emergent plasmapheresis
57
pauci immune RPGN
Wegener, microscopic polyangiitis
58
wire looping of capillaries
diffuse proliferative glomerulonephritis
| SLE or membranoproliferative as cause
59
Alport EM
basket weave appearance
60
type I membranoproliferative
hep B/C
| tram tracking
61
type II membranoproliferative
C3 nephritic factor (IgG Ab that stabilizes C3 convetase leading to decreased C3)
62
cause of hypercoag in nephrotic
loss of anti-thrombin III
63
cause of infection risk in nephrotic
loss of immunoglobulins
64
causes of secondary minimal change disease
lymphoma (cytokine-damage)
65
secondary FSGN
HIV, sickle, heroin, obesity, IFN, CKD
66
spike and dome EM
membranous glomerulonephritis
67
causes membranous glomerulonephritis
Ab to phospholipase A2 receptor, drugs, HBV, HCV, syphilis, SLE, tumors
68
steps in diabetic glomerulonephropathy
nonenzymatic glycosylation of GBM leading to increase GFR and mesangial expansion
69
envelope shaped stone causes
ethylene glycol, vitamin C abuse, hypocitraturia (Crohn)
| calcium oxalate stone
70
wedge shaped stone
calcium posphate
71
coffin lid shaped stone
ammonium magneisum phospahte
72
radiolucent stone
uric acid
73
cause cystine stone
hexagonal stone
| defective COLA transport
74
test for cystine-reabsorbind defect
sodium cyanide nitroprusside test +
75
treatment cystine stones
low sodium diet, alkalinization
| chelating agent
76
labs hydronephrosis
increase serum creatinine if bilateral
77
origin renal cell carcinoma
PCT cells
78
histology RCC
polygonal cells with lipids and carbohydrates
79
mets RCC
lung and bone
80
treatment RCC
surgery
aldesleukin
resistant to chemo and radiation
81
association RCC
VHL
82
paraneoplastic syndromes RCC
EPO, ACTH, PTHrP, renin
83
origin renal oncocytoma
from collecting ducts
84
histology renal oncocytoma
eosinophilic cells with abundant mitochondria without perinuclear clearing
85
genetics Wilms tumor
loss of tumor suppressor WT1/2 on ch 11
86
Beckwith-Wiedemann
Wilms, macroglossia, organomegaly, hemihyperplasia
| WT2
87
Denys-Drash
Wilms, early nephrotic syndrome, male pseudohermaphroditism
88
location transition
calyces, pelvis, ureters, bladder
89
associations transitional cell carcinoma
phenacetin, smoking, aniline dyes, cyclophosphamide
90
risk factor squamous carcinoma of bladder
S haematobium, chronic cystitis, smoking, chronic nephrolithiasis
91
stress incontinence
urethral hypermobility or intrinsic sphincter deficiency
| leak with increase intra-abdominal pressure
92
causes stress incontinence
obestiy, vaginal delivery, prostate surgery
93
urgency incontinence
overactive due to detrusor instability
| leak with urge to void immediately
94
treatment urgency incontinence
oxybutynin
95
overflow incontinence
incomplete emptying due to detrusor underactivity or outlet obstruction
leak with overfilling
96
lab findings UTI
+ leukocyte esterase
+ nitrites-indicates gram negative
sterile cultures-indicates gonorrhea or chlamydia
97
CT acute pyelonephritis
striated parenchymal enhancement
98
xanthogranulomatous pyelonephritis
grossly orange nodules that can mimic tumor nodules
| granulomatous tissue containing foamy macrophages
99
thyroidization of kidney
chronic pyelonephritis
100
cause of diffuse cortical necrosis
infarct of both kidneys
due to vasospasm or DIC
associated with obstetric catastrophes (placental abruption, septic shock)
101
renal osteodystrophy
hypocalcemia, hyperphosphatemia, failure of vitamin D hydroxylation leading to secondary hyperparathyroidism
causes subperiosteal thinning of bones
102
consequences of renal failure
```
metabolic aidosis
dyslipidemia (increase TG)
hyperkalemia
uremia
Na retention
growth retardation
EPO failure
renal osteodystrophy
```
103
systemic causes of acute interstitial nephritis
mycoplasma, Sjogren, SLE, sarcoidosis
104
drugs interstitial nephritis
```
diuretics
NSAID
penicillins and cephalosporins
PPO
rifampin
```
105
maintenace phase
hyperkalemia, metabolic acidosis, uremia
| 1-3 weeks
106
recovery phase
BUN and creatinine fall
| risk of hypokalemia
107
associations renal papillary necrosis
sickle cell disease, acute pyelonephritis, NSAIDs, diabetes
108
PKD1
ch 16
109
PKD2
ch 4
110
assocations ADPCKD
berry aneurysms, mitral valve prolapse, benign hepatic cysts, diverticulosis
111
cystic dilation of collecting ducts
ARPCKD
112
associations AR
congential hepatic fibrosis
113
inheritied disease causing tubulointerstitial fibrosis
medulalry cystic disease
| shrunken kidneys on ultrasound
114
complex cysts
septated, enhanced, have solid components
| removal due to risk of RCC
115
contraindications mannitol
anuria, HF
116
more ototoxic loop
ethacrynic acid
117
endocrine effects
spironolactone-gynecomastia, anti-androgen
