First Aid Renal

Front 1

which kidney is used for donor transplantation

Back 1

left kidney because it has a longer renal vein

Front 2

this structure passes under uterine artery and ductus deferens

Back 2

ureters
*water under the bridge

Front 3

how are plasma volume and extracellular volume measured respectively

Back 3

plasma volume - radiolalbeled abmunim
ECV - inulin

Front 4

60-40-20 rule

Back 4

60% body weight is water
40% ICF
20% ECF
*1/4 of 20% is plasma and 3/4 is interstitium

Front 5

what is lost during nephrotic syndrome resulting in albuminuria, generalized edema, and hyperlipidemia

Back 5

charge barrier of BM

Front 6

what gives the BM its negative charge

Back 6

heparan sulfate

Front 7

calculate renal clearance of a substance (x)

Back 7

Cx = (Ux)(V)/Px

Front 8

what substance can be used to calculate GFR because it is freely filtered and is neither reabsorbed nor secreted

Back 8

inulin
GFR = U(inulin) x V/P(inulin)

Front 9

what substance can be used to estimate effective renal plasma flow because it is both free filtered and actively secreted

Back 9

PAH
All PAH entering the kidney is excreted

Front 10

ERPF underestimates true RPF by about 10%

Back 10

**

Front 11

calculate RBF using RPF and HCT

Back 11

RBF = RPF/(1-HCT)

Front 12

calculate Filtration Fraction (FF)
normal value

Back 12

FF = GFR/RPF
normal FF = 20%

Front 13

calculate filtered load of a substance

Back 13

GFR x plasma concentration

Front 14

what drug would inhibit efferent arteriole constriction and therefore decrease FF

Back 14

ACE inhibitor
ATN II constricts efferent arteriole

Front 15

what happens to the RPF, GFR, and FF when efferent arteriole is constricted

Back 15

RPF decreases
GFR increases
FF increases

Front 16

what does increased/decreased plasma protein concentration do to the GFR and FF

Back 16

increased protein- decreased GFR and FF
decreased protein - increase GFR and FF

Front 17

at what plasma glucose does glucosuria begin and when are all transporters fully saturated in PCT

Back 17

plasma glucose 160-200 - glucosuria begins
plasma glucose 350 - all transporters are fully saturated

Front 18

deficiency of the neutral amino acid (tryptophan) transporter in the PCT resulting in pellagra

Back 18

Hartnup's disease

Front 19

this hormone inhibits Na/phosphate cotransport increasing phosphate excretion

Back 19

PTH

Front 20

this part of the kidney induces the paracellular reabsorption of Mg and Ca

Back 20

ascending loop of Henle

Front 21

this part of the renal tubule is impermeable to water and therefore makes urine less concentrated

Back 21

ascending loop of Henle

Front 22

this is the concentrating segment of the kidney making urine hypertonic

Back 22

descending loop of Henle

Front 23

this is the diluting part of the renal tubule making urine hypotonic

Back 23

early distal convoluted tubule

Front 24

this hormone increases Ca/Na exchange and therefore increaes Ca reabsorption in DCT

Back 24

PTH

Front 25

this hormone leads to insertion of Na channels in collect tubule

Back 25

Aldosterone

Front 26

this segment of the kidney has isotonic absorption

Back 26

PCT

Front 27

affects baroreceptor function and limits reflex bradycardia which normally accompanies pressor effects

Back 27

ATN II

Front 28

release in response to increased volume, relaxes vascular smooth muscle via cGMP causing increased GFR and decreased renin

Back 28

ANP

Front 29

responds to increased osmolarity and decreased volume

Back 29

ADH
*volume takes precedence over osmolarity

Front 30

functions of ATN II

Back 30

1. vasoconstriction - increased BP and FF (efferent arteriole)
2. upregulates aldosterone
3. upregulates ADH
4. increases PCT Na/H activity
5. stimulates thirst

Front 31

secrete renin in response to decreased renal blood pressure or stimulation of B1 receptor

Back 31

JG cells

Front 32

two parts of juxtaglomerular apparatus

Back 32

JG cells - modified smooth muscle of afferent arteriole that secrete renin
macula densa - Na sensor in the DCT

Front 33

released in response to hypoxia from endothelial cells of peritubular capillaries

Back 33

erythropoietin

Front 34

two functions of PTH on the kidney

Back 34

1. directly increases renal calcium reabsorption
2. indirectly stimulates PCT to make 1,25-OH Vit. D

Front 35

can cause acute renal failure by inhibiting production of prostaglandins

Back 35

NSAIDs

Front 36

secreted in response to increased atrial pressure

Back 36

ANP

Front 37

secreted in response to decreased serum calcium or Vit. D, or increased serum phosphate

Back 37

PTH

Front 38

where is ACE found

Back 38

lung

Front 39

secreted in response to decreased blood volume or increased plasma K

Back 39

aldosterone

Front 40

6 things that cause hyperkalemia (potassium shift out of cells)

Back 40

1. insulin deficiency (decreased Na/K ATPase)
2. B-antagonists (decreased Na/K ATPase)
3. acidosis
4. hyperosmolarity
5. digitalis
6. cell lysis

Front 41

4 things that cause hypokalemia (postassium shift into cells)

Back 41

1. Insulin
2. B-agonists
3. Alkalosis
4. hypo-osmolarity

Front 42

associated with U waves on ECG and flattened T waves

Back 42

hypokalemia

Front 43

associated with peaked T waves and wide QRS complex on ECG

Back 43

hyperkalemia

Front 44

associated with tetany

Back 44

hypocalcemia

Front 45

associated with neuromuscular irritability and arrhythmias

Back 45

hypomagnesia

Front 46

shortcut for respiratory compensation in response to metabolic acidosis

Back 46

PCO2 increases by 0.7 mmHg for every 1 mEq/L increase in HCO3

Front 47

causes of anion gap metabolic acidosis

Back 47

KUSMALE:
ketoacidosis
uremia
salicylates
methanol
acetominophen
lactic acidosis
ethylene glycol

Front 48

causes of non-anion gap metabolic acidosis

Back 48

diarrhea
renal tubular acidosis
hyperchloremia

Front 49

causes of metabolic alkalosis

Back 49

vomiting
antacids
hyperaldosteronism

Front 50

defect distally in collecting tubules ability to excrete H

Back 50

type 1 RTA

Front 51

RTA associated with hypokalemia and risk for calcium kidney stones

Back 51

type 1 RTA

Front 52

proximal defect in PCT ability to reabsorb HCO3, associated with hypokalemia and hypophosphatemic rickets

Back 52

type 2 RTA

Front 53

hypoaldosteronism due to lack of collecting tubule response to aldosterone, associated with hyperkalemia and inhibition of ammonium excretion in PCT

Back 53

type 4 RTA

Front 54

what are granular (muddy brown) casts associated with

Back 54

acute tubular necrosis

Front 55

what are WBC casts associated with

Back 55

tubulointerstitial inflammation
acute pyelonephritis
transplant rejection

Front 56

what are RBC casts associated with

Back 56

glomerulonephritis
ischemia
malignant HTN

Front 57

two conditions associated with hematuria but no casts

Back 57

bladder cancer
kidney stones

Front 58

associated with pyuria but no casts

Back 58

acute cystitis

Front 59

an inflammatory process involving the glomeruli resulting in hematuria and RBC casts in urine

Back 59

nephritic syndrome

Front 60

enlarged and hypercellular glomeruli with subepithelial immune complex humps

Back 60

acute poststreptococcal glomerulonephritis

Front 61

what do the crescents consist of in RPGN

Back 61

fibrin, C3b, parietal cells, monocytes, and macrophages

Front 62

3 diseases associated with RPGN

Back 62

1. goodpasture syndrome (anti-GBM)
2. Wegener's granulomatosis (c-ANCA)
3. microscopic polyangiitis (p-ANCA)

Front 63

type II hypersensitivity reaction involving GBM (with linear staining) and alveolar BM

Back 63

Goodpasture syndrome

Front 64

most common cause of death in SLE

Back 64

diffuse proliferative glomerulonephritis

Front 65

associated with wire looping of capillaries and subendothelial anti-DNA immune complexes

Back 65

diffuse proliferative glomerulonephritis due to SLE

Front 66

associated with IgA IC deposits in the mesangium

Back 66

Berger's disease (IgA glomerulopathy)

Front 67

mutation in type IV collagen resulting in split basement membrane

Back 67

Alport's syndrome

Front 68

X-linked dominant disorder associated with nerve disorder, ocular disorder, deafness, and split BM

Back 68

Alport's syndrome

Front 69

presence with massive proteinuria, hyperlipidemia, fatty casts, edema; associated with thromboembolisma and increased risk of infection

Back 69

nephrotic syndrome

Front 70

most common form of adult nephrotic syndrome

Back 70

diffuse membranous glomerulopathy

Front 71

associated with diffuse capillary and GBM thickening with spiked and dome appearance with supepithelial deposits

Back 71

diffuse membranous glomerulopathy

Front 72

normal glomeruli with foot process effacement; selective loss of albumin due to GBM polyanion loss

Back 72

minimal change disease

Front 73

what treatment does minimal change disease response to

Back 73

corticosteroids

Front 74

cause of congo red stain with apple-green birefringence nephrotic syndrome

Back 74

amyloidosis due to chronic conditions such as MM, TB, RA

Front 75

nonenzymatic glycosylation of GBM and efferent arteriole leading to mesangial expansion and nodular sclerosis

Back 75

diabetic glomerulonephropathy

Front 76

most common glomerular disease in HIV patients

Back 76

focal segmental glomerulsclerosis

Front 77

this glomerular disease can present as either nephritic or nephrotic and has "tram-track" appearance

Back 77

membranoproliferative glomerulonephritis

Front 78

differentiate type 1 and 2 membranoproliferative glomerulonephritis

Back 78

type 1 - GBM splitting caused by mesangial growth
type 2 - dense deposits

Front 79

what are type 1 and 2 membranoproliferative glomerulonephritis associated with

Back 79

type 1 - HBV and HCV
type 2 - C3 nephritic factor

Front 80

glomerular disease associated with smooth linear pattern on immunofluorescence

Back 80

Goodpasture's syndrome

Front 81

associated with lump bumpy pattern on immunofluorescence

Back 81

acute postreptococcal glomerulonephritis

Front 82

prevention of kidney stones

Back 82

fluid intake

Front 83

what can lead to hypercalcemia resulting in kidney stones

Back 83

increased PTH from parathyroid
cancer

Front 84

what two things can lead to oxalate crystals forming kidney stones

Back 84

ethylene glycol
vitamin C

Front 85

what is the only kidney stone that is radiolucent (cannot seen in x-ray)

Back 85

uric acid

Front 86

kidney stone caused by infection of urease-positive bug

Back 86

ammonium magnesium phosphate

Front 87

what type of kidney stone can form staghorn calculi

Back 87

ammonium magnesium phosphate

Front 88

kidney stone seen in gout or increased cell turnover such as leukemia

Back 88

uric acid

Front 89

hexagonal kidney stone that can be treated with alkalinization of urine

Back 89

cystine stone

Front 90

renal malignancy associated with von Hippel-lindau syndrome and gene deletion in chromosome 3

Back 90

renal cell carcinoma

Front 91

where does renal cell carcinoma metastasize to

Back 91

lung and bone

Front 92

4 hormones associated with the paraneoplastic syndrome or renal cell carcinoma

Back 92

EPO
ACTH
PTHrP
prolactin

Front 93

childhood renal malignancy associated with deletion of tumor suppressor gene WT1 on chromosome 11

Back 93

wilms' tumor

Front 94

most common tumor of urinary tract system

Back 94

transition cell carcinoma

Front 95

what does painless hematuria suggest

Back 95

bladder cancer

Front 96

4 potential causes of bladder cancer

Back 96

phenacetin
smoking
aniline dyes
cyclophsophamide

Front 97

what is classic of pyelonephritis

Back 97

WBC casts in urine with fever and CVA tenderness

Front 98

associated with tubules containing eosinophilic casts (thyroidization of kidney)

Back 98

chronic pyelonephritis

Front 99

infection affecting cortex of kidney with relative sparing of glomeruli/vessels

Back 99

acute
*chronic has both corticomedullary scarring and blunted calyx

Front 100

associated with fever, rash, hematuria, and CVA tenderness 1-2 weeks after drug administration

Back 100

drug-induced interstitial nephritis

Front 101

drugs associated with drug-induced interstitial nephritis

Back 101

NSAIDs
penicillin derivatives
sulfonamides
rifampin

Front 102

most common cause of acute renal failure in hospital

Back 102

acute tubular necrosis

Front 103

4 things associated with renal papillary necrosis

Back 103

1. diabetes mellitus
2. acute pyelonephritis
3. chronic phenacetin use (acetominophen is phenatcetin derivative)
4. sickle cell anemia

Front 104

prerenal azotemia

Back 104

due to decreased renal blood flow so urea is retained by kidney to conserve volume; BUN/creatinine ratio increases

Front 105

intrinsic renal azotemia

Back 105

generally due to acute tubular necrosis that is either ischemic or toxic; BUN/creatinine ratio decreases because BUN cannot be reabsorbed

Front 106

postrenal azotemia

Back 106

due to outflow obstruction, develops only with bilateral obstruction

Front 107

causes of postrenal azotemia

Back 107

stones
BPH
neoplasia
congenital anomalies

Front 108

associated with volume overload, hyperkalemia, metabolic acidosis, anemia, secondary hyperparathyroidism due to phosphate retention, dyslipidemia (increased triglycerides)

Back 108

renal failure

Front 109

autosomal-dominant kidney mutation associated with berry aneurysms and mitral valve prolapse

Back 109

Adult PKD

Front 110

autosomal-recessive kidney mutation associated with Potter's sequence

Back 110

Infantile PKD

Front 111

small kidneys associated dilated cortical collecting ducts that sometimes leads to fibrosis and progressive renal insufficiency

Back 111

medullary cystic disease

Front 112

can result in cortical and medullary cysts

Back 112

dialysis

Front 113

where are simple kidney cysts found

Back 113

cortex