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179 Cards in this Set
- Front
- Back
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where is second hydroxylation of vit D? |
proximal tubule
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most common UUT cause of hematuria
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renal stone
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most common LUT cause of hematuria
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infection
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most common noninf cause LUT hematuria
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transitional cell carcinoma
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most common cause microscopic hematuria in adult males
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benign prostatic hyperplasia
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most common Rx causing hematuria
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anticoag
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persistent proteinuria usu indicates
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intrinsic renal dz
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causes functional proteinuria 4
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fever, exercise, CHF, orthostatic
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patho of overflow proteinuria
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amt filtered > reabsorption of LMW proteins
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causes overflow proteinuria 3
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MM (BJ proteins), Hburia, myoglobinuria
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glomerular proteinuria types 2
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nephritic 150 mg-3.5g; nephrotic > 3.5h
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causes glomerular proteinuria 2
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damage to GBM; loss of negative charge (selective for albumin)
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tubular proteinuria patho
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defect prox tubule reabosrption of LMW proteins
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causes tubular proteinuria 3
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Heavy metal poisoning; Fanconi syndrome; Hartnup dz
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with very high [BUN] serum, loss occurs where
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extra-renally
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serum levels of BUN depend on
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GFR (inverse), protein content in diet (direct), PCT reaborption (direct), urea cycle fxn (direct)
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inc in BUN & Cr
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azotemia
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BUN/Cr ratio norm indicate which type of azotemia
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renal azotemia
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BUN/Cr ratio inc indicate which type of azotemia
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pre or postrenal
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prerenal azotemia caused by
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dec CO -> dec GFR (affect BUN > Cr)
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postrenal azotemia caused by
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obstruction (urea backdiffusion not Cr)
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age fx on CCr
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age dec CCr (adjust Rx)
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status where CCr inc 2
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pregnancy, early DM glomerulopathy
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gold standard for renal dz eval
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UA
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black urine after expo to light
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alkaptonuria
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smoky-colored urine
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acidic urine convert Hb -> hematin; nephritic GN
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red/pink urine 5
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hematuria, Hburia, Mburia, Rx, prophyria
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first sign of renal dz
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inc specific gravity
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when take UA?
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morning (more concentrated)
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alkaline pH + smell of ammonia
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urease organism (Proteus)
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for MM UA, use which test?
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SSA
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lowered renal threshold for glucose 2
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norm pregnancy; benign glucosuria
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first sign DM nephropathy
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microalbuminuria
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ketones detected in UA
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acetone, acac (NOT b-OHB)
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ketones in urine norm finding in
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preg
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bilirubinuria 2
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viral hepatits, obstructive jaundice
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inc UBG + bilirubinuria
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hepatitis
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inc UBG
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extravasc hemolytic anemia
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sterile pyuria 4
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chlamydia, urethritis, TB, Rx-induced interstitial nephritis
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renal tubular cells w/ lipid indicate
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nephrotic syndrome
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ghost-like cast of proteins
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hyaline cast; no significance
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RBC cast indicate
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nephritic GN
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WBC cast indicate 2
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acute pyelonephritits; acute tubulointerstitial nephritis
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renal tubular cast
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acute tubular necrosis
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waxy broad cast indicate
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chronic renal failure
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Ca oxalate crystals (rhomboid) 3
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pure vegan diet, ethylene glycol, stone
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Uric acid crystals (needle)
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hyperuricemia
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Cysteine crystals (hexagonal)
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cystinuria
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kidney receive how much blood supply
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25% of cardiac output; 90% blood supply
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renal PGE2 fx
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dialtes afferent arteriole
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A-II fx on renal
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constrictions efferent arteriole
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GBM properties that determine protein filtration 2
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size, charge
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loss of negative charge causes
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selective proteinuria for albumin
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2 causes GBM thickening
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IC deposition; inc collagen IV synth
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fusion of podocytes sign of
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nephrotic syndrome
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what cells make up Bowman's capsule
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parietal epithelial cell
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what cells make up glomerulus
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visceral epithelial cell
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primarily responsible for GBM production
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visceral epithelial cell
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contain podocytes & slit pores
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visceral epithelial cell
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contracts the glomerulus lumen
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mesangial cell
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produces matrix of glom
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mesangial cell
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fenestrated initial segment of filtration
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endothelial cell of glom
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glom cell that releases cytokines and prolif
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mesangial cell
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crescentic glom is prolif of
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parietal epithelial cell
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inc incidence of horsehoe kidney in
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Turner's syndrome
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most common cystic dz in children
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renal dysplasia
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b/l cystic kidneys in child
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ARPKD
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b/l cystic kidneys in adult
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ADPKD
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ARPKD assoc with what liver defects 2
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cysts, congenital hepatic fibrosis
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ADPKD also have cysts in 3
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liver, panc, spleen
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most common cause of death in ADPKD
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CRF
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CVS assoc of ADPKD 4
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MVP; HTN -> ruptured berry aneurysm, intracerebral hemorrhage, lacunar infarcts
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GI assoc of ADPKD 1
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sigmoid diverticulosis
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swiss cheese medulla
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medullay sponge kidney
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most common cause renal dialysis
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acquired polycystic kidney dz
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most common adult renal cyst
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simple retention cysts
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only few glomeruli affected
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focal
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all glomeruli affected
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diffuse
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> 100 nuc/affected glom
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proliferative
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thickened GBM
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membranous
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only part of single glom affected
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segmental
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parietal proliferation
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crescentic
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linear immunoflor for GBM
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anti-GBM Ab -> Goodpastures
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what type of HSR is Goodpasture's
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Type 2
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granular immunoflor on GBM
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immune complex deposition
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what type of HSR is IC deposition
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type 3
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EM allows you detect what glom changes
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where IC deposited, fusion of podocytes, damage to visceral epithelial cells
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IC fx on glom
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activate complement -> attracts neutrophils
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Mnemonic for nephritic Sx
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RiCHO: RBC Casts, HTN/Hematuria w/ dysmorphic RBC, Oliguria/orbital puffiness
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Mnemonic for nephritic dz
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Please I don’t remember: PSGN, IgA, DP GNk, RPCGN
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Mnemonic for nephrotic Sx
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FART: Fatty casts, Ascites/edema, Reduced IgG/alb, Thrombotic
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Mnemonic for nephrotic dz
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Don't make me forget: DMG/DMM, MCD, MPGN, FSGS
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patho of nephritic syndromes
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neutrophilic destruction
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patho of nephrotic syndromes
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cytokines fuse podocytes & destroy neg charge
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most common nephropathy
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IgA nephropathy
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IgA patho
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mesangial IgA deposits -> IC activate complement
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IgA fx on glom
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focal, proliferative
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IgA presentation 2
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episodic bouts of hematuria & HTN; assoc w/ Henoch-Schnolein purpura
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Tx for IgA
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steroids, HTN Rx
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Ab in PSGN 2
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anti-DNAse B; anti-ASO
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Deposits in PSGN
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IC subepithelial
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PSGN presentation
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hematuria 1-3 wk after strep inf
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Tx for PSGN
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goes away usu; Tx HTN if develops
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most common nephropathy of SLE
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DPGN
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deposits in DPGN
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IC subendothelial
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most common cause of death in SLE
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DPGN-induced CRF
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Tx DPGN
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steroids, cyclophosphamide
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worst nephritic syndrome to get
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RPCGN
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RPGN assoc w/ 3
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Goodpastures, microscopic polyarteritis, Wegner's granulomatosis
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Tx RPGN
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plasma exchange; renal transplant
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MCD patho
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fused podocytes
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Tx MCD
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steroids
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most common nephrotic syndrome in kids
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MCD
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MCD 2o to
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Hodgkin's lymphoma
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most common nephrotic syndrome in adults
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FSGS
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FSGS most commonly seen in 2
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AIDS, IVDU
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worst nephrotic syndrome to get
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FSGS
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deposits in DMG
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IC subepithelial
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spike and dome pattern on silver stain
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DMG
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deposits in MPGN
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IC subendothelial
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MPGN 1 assoc with
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HCV, HBV, cyroglobulinemia
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MPGN 2 assoc with
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C3 nephritic factor (auto Ab to C3 convertase)
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DM glomerulopathy is
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Nodular glomerulosclerosis, Kimmelstein-Wilson
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most common cause CRF in US
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Nodular glomerulosclerosis, Kimmelstein-Wilson
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DM glomerulopathy more common in which DM
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T1DM
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NGS patho 4
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glycosylation of GBM lose neg charge;
efferent hyaline arteriolosclerosis -> hyperfiltration damage -> inc collagen IV |
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what slows progression of NGS
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ACE-I (prevents efferent arteriole constriction)
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genetics of Alport's syndrome
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XR
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Alport's Sx 3
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hereditary nephritis, sensorineural deafness, ocular defects
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most common cause chronic GN
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RPGN
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most common cause ARF
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ATN
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most common type of ATN
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ischemic ATN
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most common cause of ischemic ATN
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prerenal azotemia
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key cast of ATN
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renal tubular cell
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Ischemic ATN patho 3
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detachment of tubular cell into lumen -> inc intratubular pressure -> oliguria w/ fluid in interstitium
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main sites of ischemic ATN 2
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straight segment of prox tubule; medullary segment of TAL
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most common cause nephrotoxic ATN
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aminoglycosides
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pH disturbance of ATN
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inc AG met acidosis (hyperkalemia)
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most common cause TIN (tubulointerstitial nephritis)
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APN (acute pyelonephritis)
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why APN F > M
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women have shorter urethras
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Sx of APN and not UTI
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fever, WBC cast, flank pain
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most common cause APN
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Vesicourethral reflux esp during micturition
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organisms of UTI, PN (if play odds)
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E. coli
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hematagenous spread to kidneys causing APN
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s. aureus
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causes of CPN 2
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VUR (young F), chronic hydronephrosis from obstruction
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reflux type CPN on IVP shows
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U-shaped cortical scars overlie blunt calyces
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thyroidization of tubules
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CPN
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reflux nephropathy causes what in kids
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HTN
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Rx-induced TIN assoc w/ 4
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methicillin, NSAIDs, rifampin, sulfonamides
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eosinophiluria
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Rx-induced TIN
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patho of analgesic nephropathy
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acetaminophen release ROS, aspirin inh PGE2
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urate nephropathy may produce
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ARF
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ring defect on IVP
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renal papillary necrosis (sloughing papilla)
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PCT have nuc acid-fast inclusions
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chronic Pb poisoning
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casts with foreign body giant cell rxn
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BJ proteinuria
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first thing to go in renal failure
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ability to concentrate urine
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end-stage renal dz defined as
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GFR < 10
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heme fx of CRF 2
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normocytic anemia w/ retic < 3%, qualitative plt defect
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3 types renal osteodystrophy
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osteitis fibrosa cystica, osteomalacia, osteoperosis
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CVS fx of CRF 4
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HTN, pericarditis, CHF, atherosclerosis
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pH disturbance of CRF
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inc AG met acidosis (hyperkalemia)
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biomarker of kidney fxn
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cystatic C
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free water clearance in CRF
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zero
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BNS
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essential HTN (hyaline arteriolosclerosis)
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most common cause renal infarct
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embolization
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Sx renal infarct 2
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hematuria, flank pain
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sickle trait nephropathy 4
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hematuria, loss conc, renal pap necrosis, APN
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anuria in preg woman followed by ARF
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diffuse cortical necrosis
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most common complication of upper UT obstruction
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hydronephrosis
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Tx for hypercalcemia-induced stones
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thiazides
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staghorn calculus made of
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MgNH4 from proteus
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i/l colicky flank pain radiating to groin + hematuria
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renal stone
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harmatoma assoc w/ tuberous sclerosis
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angiomyolipoma
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yellow tumor w/ renal vein invasion
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renal cell carcinoma
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most common cause renal cell carcinoma
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smoking
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renal carcinoma triad
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hematuria, flank pain, abd mass
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paraneoplastic syndrome of renal cell 2
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EPO, PTHrP
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causes transitional cell carcinoma 3
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smoking, aniline dyes, cyclophosphamide
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child w/ u/l flank mass & HTN
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Wilm's tumor
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