6.6 Renal

Front 1

1. Which kidney goes for transplant?

2. Where is the macula densa and where is the juxtaglomerular apparatus?

3. What does it mean if Clx<GFRx?

Back 1

1. left

2. MD: is the distal tubule, JG is afferent arteriole

3. x is reabsorbed

Front 2

1. What does it mean if Clx>GFRx?

2. What is the glomerular basement membrane made of and how is it charged?

3. What is the difference between RPF and RBF? (HINT: Equation)

Back 2

1. x is secreted

2. heparin sulfate: is negatively charged

3. RPF=RBF(1-Hct)

Front 3

1. What stat does Creatinine/inulin estimate and is it an over or under estimate?

2. What affect do prostaglandings and AT-II have on the renal arteries?

3. At what level does glucosuria begin and at what level is reaborption saturated?

Back 3

1. Creatinine: GFR (overestimate), PAH:eRPF (underestimate)

2. prostaglandin: dilates afferent, AT-II: constricts efferents

3. begins at 200, saturated at 350

Front 4

1. What causes the rate of πGC increase in the tubule to increase?

2. What affect does ADH have on free water clearance in the urine?

3. Show an equation that has the relationship between urine output and free water clearance?

Back 4

1. either constriction of afferent or efferent

2. Free Water clearance < 0

3. V= C(H20) + C(osm)

Front 5

1. What effect do loop diuretics have on free water clearance in the urine?

2. What two things can stimulate renin release?

3. AT-II stimulates the release of what two hormones?

Back 5

1. Free water clearance = 0 (isotonic urine)

2. Low BP, Low Na+ in distal tubule

3. ADH and Aldosterone

Front 6

1. Why might NSAIDS promote acute renal failure?

2. Which of the following does DIC consume: platelets, clotting factors?

3. What things cause an anion gap metabolic acidosis?

Back 6

1. They prevent the formation of prostaglandins that keep the afferent arterioles dilated

2. BOTH

3. MUDPILES: Methanol, Uremia, DKA, Phenformin, INH/Iron, Lactic acidosis, Ethylene glycol, Salicylates

Front 7

1. What type of metabolic disturbance does hyperaldosteronism cause?

2. What Is RTA Type I? Where does it happen?

3. What does a granular cast indicate?

Back 7

1. Metabolic alkalosis

2. defect in distal K+/H+

3. acute tubular necrosis

Front 8

1. Generally, what do urine casts indicate?

2. What does a muddy brown cast indicate?

Back 8

1. Problem at site of glomerulus?

2. acute tubular necrosis

Front 9

1. What is RTA Type IV?

2. Describe a UA with bladder cancer? (Cells?Casts?)

3. What does a hyaline cast indicate?

Back 9

1. hypoaldosteronism

2. RBCs, no casts

3. Nonspecific

Front 10

1. What is RTA Type II?

2. Describe a UA with acute cystitis (cells?casts?)

3. What does a waxy cast indicate?

Back 10

1. Defect in proximal HCO3- reabsorption

2. WBCs, no casts

3. advanced or chronic renal disease

Front 11

1. Nephrotic or nephritic: acute poststreptococcal glomerulonephritis?

2. What are I, II, III RPGNs?

3. What is the most common glomerulopathy of HIV patients?

Back 11

1. nephritic

2. I: anti-GBM, II: immune complex deposition, III: pauci-immune (c-anca/p-anca)

3. FSGS

Front 12

1. Nephrotic or nephritic: membranous glomerulonephritis?

2. In an IgA glomerulopathy, where are the deposits seen?

3. #1 and #2 most common kidney stones?

Back 12

1. nephrotic

2. In the mesangium

2. calcium, struvite

Front 13

1. Nephrotic or nephritic: rapidly progressive (crescent) glomerulonephritis?

2. Which stone is opaque and which is translucent?

3. How does RCC spread?

Back 13

1. nephritic

2. Calcium: opaque, uric acid: translucent

3. Invades IVC: heme

Front 14

1. Nephrotic or nephritic: Berger's disease?

2. Which kidney stones cause staghorns?

3. Which paraneoplastics are associated with RCC?

Back 14

1. nephritic

2. struvite and cystine

3. EPO and rPTH

Front 15

1. Nephrotic or nephritic: Alport's disease?

2. What stone should be acidified? Which stone should be alkalosed?

3. Diagnose: fever, rash, eosinophilic urine?

Back 15

1. nephritic

2. acidfy the struvite; alkalose the cystine

3. drug induced interstitial nephritis

Front 16

1. Nephrotic or nephritic: SLE?

2. What are the characteristics of VHL?

3. Most common pediatric kidney tumor and the chromosome/gene associated with it?

Back 16

1. nephrotic

2. ↑RCC, Hemangiomas, Liver cysts

3. Wilm's tumor: WT1/Chr 11

Front 17

1. Nephrotic or nephritic: amyloidosis?

2. What is the defect in Alport's syndrome?

3. What Chr is related to VHL?

Back 17

1. nephrotic

2. Mutation in collagen IV

3. Chr. 3

Front 18

1. Nephrotic or nephritic: diabetic nephropathy?

2. What is Berger's disease?

3. What is the WAGR complex?

Back 18

1. nephrotic

2. IgA nephropathy

3. Wilm's, Aniridia, GU malformation, Retardation

Front 19

1. Nephrotic or nephritic: focal segmental glomerulosclerosis?

2. Diagnose: thyroidization of the renal tubules?

3. 2 etiologies of ATN?

Back 19

1. nephrotic

2. chronic pyelonephritis

3. toxins, ischemia

Front 20

1. Neprotic or nephritic: membranoproliferative glomerulonephritis?

2. Compare the sites affected by acute and chronic pyelonephritis?

3. Three conditions associated with renal papillary necrosis?

Back 20

1. nephrotic

2. acute: cortex only, chronic: cortex+medulla

3. Sickle Cell, DM, Acute Pyelonephritis

Front 21

1. Where are the renal papillae located?

2. Where are renal simple cysts located?

3. What electrolyte abnormality will result in U waves?

Back 21

1. junction between medulla and calyces

2. cortex only

3. hypokalemia

Front 22

1. Difference between medullary sponge disease and medullary cystic disease?

2. Chromosomes associated with ADPKD and ARPKD?

3. What is Fanconi's Syndrome?

Back 22

1. medullary cystic: cystic medulla/bad prognosis, medullary sponge: collecting duct cysts/good prognosis

2. AD: 16/4, AR:6

3. proximal renal tubule can't reabsorb all the stuff it normally reabsorbs

Front 23

1. Where are dialysis cysts located?

2. Why would hypokalemia result from Fanconi's syndrome?

3. S/S of renal failure?

Back 23

1. both cortical and medullary

2. distal tubule will compensate for decreased Na+ by increasing Na/K pump

3. ABCDEFGH: Anemia, Bone, Cardiac (K/pericarditis), vitD, Electrolytes, f, g, HTN

Front 24

1. How is the BUN/Cr ratio in prerenal disease? Why?

Back 24

1. ↑ because the body is trying to maintain volume

Front 25

1. How is the BUN/Cr ratio in renal disease? Why

Back 25

1. ↓ because the kidney is letting everything go (can't do it's job)

Front 26

1. How is the BUN/Cr ratio in post-renal disease? Why?

Back 26

1. ↑ because everything is backing up

Front 27

1. What is the difference in MOAs between Spironolactone and the other K+ sparing diuretics?

2. What affect do ACE inhibitors have on the renal arterioles?

Back 27

1. spirono is an aldosterone receptor inhibitor, the rest selectively block lumenal Na+ channels

2. prevent AT-II mediated constriction of efferents

Front 28

1. Which diuretics cause an alkalosis and which cause an acidosis?

2. Describe the embryonic formation of the kidneys and the fate of each part?

Back 28

1. acidosis: acetazolamide, K+ sparing; alkalosis: thiazide, loop

2. pronephros (degrades at week 4), mesonephros (becomes glomerulus), metanephros (becomes collecting duct on)

Front 29

1. What CN's are associated with each of the branchial arches?

2. Describe the embryologic development of the ear?

Back 29

1. 1: V2/V3, 2: VII, 3: IX, 4/6: X

2. Crest1: external ear, Arch 1: tympanic membrane, Pouch 1: middle ear

Front 30

1. Which branchial derivative becomes the thymus?

2. Describe etiology of branchial cleft cysts?

3. Describe what muscles are involved with each branchial arch?

Back 30

1. 3rd POUCH

2. 2nd arch doesn't obliterate 2-4 clefts

3. 1: mastication, 2: facial expression, 3: stylopharyngeal, 4: swallowing, 6: speaking

Front 31

1. Which branchial derivatives do the bones of the ear come from?

Back 31

1. arch1: malleus/incus, arch2: stapes