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Nefrologia PT > Tables > Flashcards

Tables Flashcards

1
Q

Na transport in the tubules

A

PCT - 60%
LOH - 30%
DCT - 7%
CD - 2-3%

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2
Q

Proximal tubule Na transporters

A

A: Cl/IOH, NHE3
B: NaKATPase, KCC3/4

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3
Q

LOH Na transporters

A

A: NKCC2, ROMK, Claudin
B: NaKATPase, KCC4, ClC-NKB

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4
Q

DCT Na transporters

A

A: NCC, NHE2, ROMK, HCO0/Cl; ENac, ROMK
B: NaKATPase, ClCK-2, Kir, KCC4

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5
Q

K transport in tubules

A

DCT 65%
TAL 25%

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6
Q

Ca transport in tubules

A

PCT 70% → Ca transport proximal tubule paracellular, TRPV5, V6

TAL 20% → Clauding 16, 19
DT 8%

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7
Q

Mg transport tubules

A

PT 20%
TAL 70% paracellular 16, 19
DT 5%

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8
Q

Mg transport DCT

A

TRPM6/7

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9
Q

Phos transport proximal tubule

A

NaPiIIa/IIc

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10
Q

Bicab reabsorption tubules

A

PT 80% A: NHE3, AQP1
B: NBce1, NaKATPase
TAL 15%
CD 5%

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11
Q

DCT Type A intercalated cell Hco3 reabsorption

A

A: HKATPase, HATPase
B: kAE1, KCC4, Clc-2-K-Barttin

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12
Q

DCT Type B Intercalated cell Hco3 reabsorption

A

A: Cl/HCO3, NDCBe, HKATPase
B: HATPase, Clc-K2, AE4

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13
Q

IgA: predictive of ESKD or 50% decline in GFR

A

Mesangial hypercellularity, tubular atrophy./interstitial fibrosis

IgA: not predictive endocapillary hypercellularity

IgA: predictive of rate of decline in kidney function segmental sclerosis

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14
Q

Chronic lesions in SLE

A

GIFT - Glomerular sclerosis, Interstitial fibrosis, fibrous crescents, tubular atrophy

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15
Q

Acute lesions in SLE

A

Fibrinoid necrosis, cellular crescents karyorrhexis, endocapillary hypercellularity, subendothelial deposits, wireloop lesions, rupture of GBM

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16
Q

Treatment of SLE Class II

A

proteinuria >3g, steroids + CNI

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17
Q

Class 3 SLE Treatment

A

Corticosteroids + cyclophosphamide/MMF

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18
Q

Class IV SLE treatment

A

Azathioprine 1.5-2.5 mkd
MMF 1-2 g/day
low dose steroids
or CNI if intolerant to aza and MMF

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19
Q

Class V SLE treatment

A

corticosteroids + cyclophosphamide, CNI, MMF, azathioprine

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20
Q

1st line initial therapy in SLE

A

cyclophosphamide or MMF

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21
Q

Maintenance therapy in SLE

A

AZA or MMF

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22
Q

Class 3 or 4 initial therapy options for cyclophosphamide

A

IV 0.5-1 g/m2 monthly for 6 months, 500 mg q2 weeks for 3 months, 1-1.5 mkd po 2-4 months

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23
Q

Cause of hypercalcemia: High PTH, Uca less than 100 mg/24h, FeCa < 0.01

A

FHH, NSHPT, Lithium

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24
Q

Cause of hypercalcemia: High PTH, UCa>200 mg/24h, FeCa> 0.01

A

primary or tertiary hyperparathyroidism

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25
Q

Cause of hyperCa: low PTH, low PTHRP, high 25(OH), high 25 (OH)2

A

Vitamin D overodse

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26
Q

Cause of hyperCa: low PTH, low PTHrP, low 25 (OH), high 25 (OH)2

A

Granulomatous disorders

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27
Q

Cause of hypercCa: low PTH, low PTHrp, low 25 (OH) and 25 (OH)2

A

LOH, milk alakali syndrome, immobilization, vitamin A, Drugs

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28
Q

Cause of hyperca: Low PTH, high PTHrP

A

HHM

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29
Q

Cause of hypoca: Normal Crea, Low PTH

A

hypoparathyroidism, low Mg, genetic

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30
Q

Cause of hypoca: Normal Crea, High PTH, Low Vitamin D

A

Vitamin D deficiency

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31
Q

Cause of hypoca: Normal Crea, high PTH, normal vitamin D, Normal 1, 25 (OH)2D

A

pseudohypoparathyroidism, Vit D dependent rickets

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32
Q

Cause of hypoca: Normal Crea, high PTH, normal vitamin D, High 1, 25 (OH)2D

A

Vit D resistant rickets

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33
Q

Cause of hyperK: TTKG>8

A

advanced kidney failure; dec ECV

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34
Q

HyperK: TTKG <5, TTKG <8 after fludrocortisone

A

drugs

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35
Q

HyperK: TTKG <5, TTKG > 8 after fludrocortisone, low aldosterone, low renin

A

DM, GN, NSaids, b-blockers

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36
Q

HyperK: TTKG <5, TTKG > 8 after fludrocortisone, low aldosterone, high renin

A

AI, ACE, Ketoconazole

37
Q

HypoK: UrineK < 15 mmol/day, 15 mmol/g/Crea, metabolic acidosis

A

GI K losses

38
Q

HypoK: Urine K < 15 mmol/day, 15 mmol/g/Crea, Normal acid base

A

profuse sweating

39
Q

HypoK: Urine K < 15 mmol/day, 15 mmol/g/Crea, Metabolic alkalosis

A

remote diuretic use, vomiting

40
Q

HypoK: Urine K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic acidosis

A

RTA

41
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl>20, UCa/Crea <0.15

A

Gitelman

42
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl>20, UCa/Crea > 0.20

A

Bartter Syndrome

43
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, low/normal BP/volume, Metabolic alkalosis, UCl < 10

A

extrarenal losses

44
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, Low aldosterone, normal cortisol

A

Liddle, licorice, AME

45
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, low aldosterone, high cortisol

A

Cushing syndrome

46
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, High aldosterone, Low Renin

A

PA, GRA

47
Q

HypoK: Urnie K > 15 mmol/day, 15 mmol/g/Crea, TTKG >4, high BP/volume, high aldosterone, high renin

A

RAS, Malignant hypertension

48
Q

Metabolic alkalosis, UCl> 20, UK > 30, HTN, low renin

A

primary hyperaldosteronism

49
Q

Normal or micronodularity and B masses in Adrenal CT

A

idiopathic hyperaldosteronim vs GRA

50
Q

Unilateral hypodense nodule > 1 cm in Adrenal CT, > 40 years old, with no lateralization

A

GRA screening

51
Q

Unilateral hypodense nodule > 1 cm in Adrenal CT, > 40 years old, with lateralization

A

adrenal adenoma, primary adrenal hyperplasia

52
Q

Unilateral hypodense nodule > 1 cm in Adrenal CT < 40

A

adrenal adenoma, PAH

53
Q

Hyponat, hypovolemic, UNa < 30

A

Extrarenal losses

NAURINARIO >30= DIURETICOS , DEFICIENCIA MINERALOCORTICOIDE

54
Q

Hyponat, euvol, UNa>30

A

glucocorticoid deficiency, hypothyroidism, SIADH

55
Q

Hyponat, Hypervol, UNa < 30

A

Nephrotic syndrome, cirrhosis, heart failure

>30 nsuf renal

56
Q

Metabolic alkalosis, UCl < 2o

A

nonrenal

57
Q

Met alk, UCl>20, UK < 30 meq

A

laxative

58
Q

Met alk, UCl>20, UK > 30 meq, normal BP

A

Barter, Gitelman, Diuretics

59
Q

Met alk, UCl>20, UK > 30 meq, high BP, high renin, high cortisol

A

cushing syndrome

60
Q

Met alk, UCl>20, UK > 30 meq, high BP, high renin, normal cortisol, high renin in renal vein

A

renovascular htn. JGA tumor

61
Q

Met alk, UCl>20, UK > 30 meq, high BP, high renin, normal cortisol, normal renin in renal vein

A

malignant hypertension

62
Q

Met alk, UCl>20, UK > 30 meq, high BP, low renin

A

primary aldosteronism, licorice

63
Q

Chains involved in alport syndrome

A

A3.4.5

64
Q

chains involved in tbmd

A

a3,4

65
Q

a chains in anti-gbm

A

a3 chain

66
Q

Tx of MCD

A

corticosteroids (pred 1 mld or 3 mkd for 4-6 weeks)
cycophosphamide 2-2.5 mkd for 8 weeks
cylosporine 3-5 mld
tacrolimus 0.05 - 1 mld for 1-2 years
MMF 500-1000 mg BID 1-2 years

67
Q

Tx FSGS

A

prednisone > 4-16 weeks
CNI 4-6 months
MMF + dexamethasone

68
Q

Tx MN

A

IV/oral steroids + cyclophosphamimde
cyclosporine/tacrolimus

69
Q

MPGN Type 1

A

oral cyclophosphamide/MMF
low dose alternate day or daily corticosteroids < 6 months

70
Q

AntiGBM tx

A

steroids + cyclophosphamide + plasmapharesis

71
Q

Pauci Immune Tx

A

MPP 7 mkd then pred 1 mkd for 1st month then alternate day 4-5 months; oral pred 2 mkd; cyclophosphamide
rituximab + corticosteroids + plasmapharesis

maintainance: azathioprine 1-2 mkd, MMF 1 g BID, methotrexate 0.3 mk/week

72
Q

Predictors of Likely failure of fluid restriction in Hyponatremia

A

UOsm > 500, UNa + UK > Serum Na, 24H Urine vol < 1500 ml/day, Inc in serum Na <2 in 24 hours on fluid restriction < 1 L/day

73
Q

Acute rejection Banff

A

Glomerular inflammation, Interstitial inflammation, Vascular inflammation, Tubulitis

74
Q

Chronic rejection Banff

A

Interstitial fibrosis, Tubular atrophy, allograft glomerulopathy (GBM duplication), Mesangial matrix increase, Arterial fibrointimal thickening, Arterial hyalinosis, peritubular capillary

75
Q

HSP Class Subtypes

A

Class I: Minimal alteration
Class II: Pure mesangial proliferation
Class IIIa: Focal <50% crescents
Class IIIb: Diffuse < 50% crescents
Class IVa: Focal 50-75% Crescents
Class IVb: Diffuse 50-75% crescents
Class Va: Focal > 75% crescents
Class Vb: Diffuse > 75% crescents
Class VI Membranoproliferative

76
Q

RPGN Types

A

Type I: Anti-GBM
Type II: Immune complex
Type III: Pauci-immune
Type IV: Type I + III
Type V: Anca negative, pauci immune renal vasculitis

77
Q

DM Classification

A

Class I: GBM thickening
Class II: Mesangial expansion
Class IIa: mild
Class IIb: severe
CLass III: Nodular sclerosis
Class IV: Advanced DM sclerosis

78
Q

Factors increasing risk of osmotic demyelination

A

Serum Na < 105
Hypokalemia
Alcoholism
Malnutrition
Advanced Liver Disease

79
Q

simple benign cyst

A

Bosniak Cat I

80
Q

benign with thin septa. fine rim like calcification or uniform high density less than 3 cm

A

Bosniak Cat II

81
Q

multiple septa
thick area or nodular calcification
high density ctsts > 3 cm
follow up at 6-12 mos

A

Bosniak Cat IIF

82
Q

thickened irregular walls with enhancement, dense irregular calcficiation

A

Bosniak Cat III

83
Q

clearly malignant
nephrectomy <5-6 cm

A

Bosniak Cat IV

84
Q

absolute contraindications to renal biopsy

A

uncontrolled htn
bleeding diathesus
cystic disease
hydronephrosus
uncooperative patient

85
Q

Bartter Syndrome Type 1

A

NKCC2

86
Q

Bartter Syndrome Type 2

A

ROMK

87
Q

Bartter Syndrome Type 3

A

CLC-Kb

88
Q

Bartter Syndrome Type IV

A

Bartin (B subunit of Clc-Ka and Clc-Kb

89
Q

Bartter Syndrome Type V

A

Clc-Ka and Clc-Kb

Nefrologia PT (112 decks)

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