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Flashcards in Renal, USMLE Deck (90):
1

Embryologic kidney in week 4 AOG

Pronephros

2

Functions as interim kidney for first trimester

Mesonephros

3

Mesonephros also contributes to which organ system

Male genital system

4

Embryologic kidney which is PERMANENT and first appears at 5th week AOG

Metanephros

5

Derived from the caudal end of the metanephros

Ureteric bud

6

Ureteric bud gives rise to (4)

1) Ureters
2) Pelvises
3) Calyces
4) Collecting tubules

7

Ureteric bud is fully canalized at

10th week AOG

8

Aberrant interaction of ureteric bud with this tissue may result in several congenital malformations of the kidney

Metanephric mesenchyme

9

Portion of the ureter that is the last to canalize and is the most common site of obstruction (hydronephrosis in fetus)

Ureteropelvic junction

10

Syndrome of oligohydramnios > fetal compression > limb and facial deformities + pulmonary hypoplasia

Potter's syndrome

11

Cause of death in Potter's syndrome

Pulmonary hypoplasia

12

To which structure is the horeshoe kidney trapped

IMA

13

T/F: Horseshoe kidney is dysfunctional

F

14

Syndrome with which horseshoe kidney is associated

Turner syndrome

15

Condition due to abnormal interaction between ureteric bud and metanephric mesenchyme leading to a nonfunctional kidney

Multicystic dysplastic kidney

16

Most common form of multicystic dysplastic kidney

Unilateral (asymptomatic)

17

Which kidney is taken during living donor transplantation

Left

18

Why is the left kidney preferred in living donor transplantation

Longer renal vein

19

Parietal layer of glomerulus

Bowman's capsule

20

Visceral layer of glomerulus

Podocytes

21

JG cells are found ___

At the wall of afferent arteriole

22

Macula densa is found

At the wall of the DCT

23

Ureters in relation to the uterine artery and ductus deferens (retroperitoneal)

Under

24

Vessels and ureter at the renal hilum

Vein, artery, ureter

25

The glomerular filtration barrier is composed of

1) Fenestrated capillary endothelium (size barrier)
2) Fused basement membrane with heparan sulfate (negative charge barrier)
3) Epithelial layer consisting of podocyte foot processes

26

Hydrostatic pressure in glomerular capillaries

60 mmHg

27

Effect of afferent arteriole constriction on RPF

Decreases RPF

28

Effect of efferent arteriole constriction on RPF

Decreases RPF

29

Effect of ureteral constriction on GFR

Decrease GFR

30

Transporter at the PCT responsible for complete reabsorption of glucose

Na-glucose cotransport (SGLT-2)

31

Increase vs Decrease: Effect of pregnancy on reabsorption of glucose and aa at the PCT

Decrease

32

Transporter responsible for reabsorption of aa from PCT

Na-dependent transporters

33

Deficiency of neutral amino acid transporter at the PCT

Hartnup's disease

34

AA wasted in Hartnup's disease

Tryptophan

35

Hartnup's disease is associated with this nutrient deficiency state

Pellagra

36

Hormone acting on PCT to increase phosphate excretion by inhibiting Na/phosphate cotransport

PTH

37

Hormone acting on PCT to increase Na, H2O, and HCO3 reabsorption by stimulating Na/H exchanger

ATII

38

Transport mechanism by which water is reabsorbed from the thin descending LOH

Passive diffusion via medullary hypertonicity

39

Transport mechanism by which Mg and Ca are reabsorbed in the thick ascending LOH

Paracellular transport via (+) lumen potential generated by K backleak

40

Means by which PTH increases Calcium reabsorption in the kidneys

Increases activity of Na/Ca exchanger in the early DCT

41

How aldosterone exerts its mineralocorticoid effect on kidneys

Insertion of Na channel in luminal side of principal cell

42

How ADH exerts its effect on kidneys (receptor; action)

Acts at V2 receptor>insertion of aquaporin H2O channels on luminal side of principal cell

43

Effects of ATII

1) Vascular smooth muscle constriction via AT1 receptors
2) Efferent arteriole constriction
3) Increase absorption of Na, HCO3 and water from PCT
4) Production of aldosterone by adrenals
5) Stimulates thirst via hypothalamus

44

Tubuloglomerular feedback fails once SBP falls below

80mmHg

45

Stimulus for release of ANP

Increased atrial pressure

46

Shift K out of cells causing hyperkalemia (6)

DO Insulin LAb
1) Digitalis
2) Hyperosmolarity
3) Insulin deficiency
4) Lysis of cells
5) Acidosis
6) b-adrenergic antagonist

47

How insulin and b-adrenergic agonists cause K shift into cells

Stimulation of Na-K ATPase pump

48

ECG changes in hypokalemia

1) U waves
2) Flattened T waves

49

Shift K into cells causing hypokalemia (4)

1) Hypoosmolarity
2) Insulin
3) Alkalosis
4) b-adrenergic agonist

50

Hypocalcemia vs hypercalcemia: Tetany

Hypocalcemia

51

Hypocalcemia vs hypercalcemia: Seizures

Hypocalcemia

52

Symptoms of hypercalcemia (4)

1) Stones
2) Bones
3) Groans
4) Psychiatric overtones

53

Hypomagnesemia vs hypermagnesemia: Tetany

Hypomagnesemia

54

Hypomagnesemia vs hypermagnesemia: Decrease DTR

Hypomagnesemia

55

Hypomagnesemia vs hypermagnesemia: Bradycardia

Hypomagnesemia

56

Hypomagnesemia vs hypermagnesemia: Hypotension

Hypomagnesemia

57

Predicted respiratory compensation can be calculated using

Winter's formula

58

Winter's formula

PCO2 = 1.5 (HCO3) + 8 +/-2

59

Normal anion gap

8-12 mEq/L

60

Type 1 vs Type 2 RTA: Distal

Type 1

61

Type 1 vs Type 2 RTA: Defect in COLLECTING TUBULE's ability to EXCRETE H+

Type 1

62

Type 1 vs Type 2 RTA: Defect in PCT's ability to REABSORB HCO3

Type 2

63

Type 1 vs Type 2 RTA: Risk for calcium phosphate formation in kidney

Type 1

64

Type 1 vs Type 2 RTA: Rickets

Type 2

65

Type 1 vs Type 2 RTA: Urine pH >5.5

Type 1

66

Type 1 vs Type 2 RTA: Urine pH less than 5.5

Type 2

67

Pathophy of Type 4 RTA

Lack of collecting tubule response to aldosterone resulting in hyperkalemia

68

Hyperkalemia in Type 4 RTA results in impaired

Ammoniagenesis in PT, decreasing buffering capacity, decreasing urine pH

69

RBC casts are seen in (3)

1) GN
2) Ischemia
3) Malignant HTN

70

WBC casts are seen in

1) Tubulointerstitial inflamm
2) Acute pyelonephritis
3) Transplant rejection

71

Casts seen in ATN

Granular/muddy casts

72

Casts seen in advanced renal disease/chronic renal failure

Waxy casts

73

Glomerular disorders with hypercellular glomeruli

Proliferative

74

Glomerular disorders with thickening of GBM

Membranous

75

Nephritic syndromes (4)

1) APGN
2) RPGN
3) Berger's IgA glomerulonephropathy
4) Alport syndrome

76

Both nephritic and nephrotic (2)

1) Diffuse proliferative GN
2) MPGN

77

In nephrotic syndrome, risk of infection is increased due to

Loss of Igs in urine

78

Segmental sclerosis and hyalinosis on LM

FSGS

79

Effacement of foot processes similar to MCD on EM

FSGS

80

Normal glomeruli on LM

MCD

81

Type of proteins lost in MCD

Albumin, not globulins

82

Congo red stain shows apple-green birefringence under polarized light

Amyloidosis

83

MPGN type with tram-track appearance

I

84

MPGN type with dense deposits

II

85

Type I MPGN is associated with what infections (2)

1) HBV
2) HCV

86

Type II MPGN is associated with what factor

C3 nephritic factor

87

Pathophysiology of DM nephropathy

Non-enzymatic glycosylation of GBM increasing permeability and thickening

88

Kimmelsteil-Wilson lesion can be seen on LM as

Eosinophilic nodular glomerulosclerosis

89

Lumpy-bumpy appearance of APGN is seen under

LM

90

Subepithelial humps of APGN is seen under

EM