Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
65 Cards in this Set
- Front
- Back
|
renal blood flow equation?
|
RBF = RPF / (1-Hct)
|
|
|
FF?
|
FF = GFR/RPF
= creatine/PAH normal = 20% |
|
|
filtered load?
|
GFR + plasma concentration
|
|
|
afferent arteriole constriction?
|
RPF decreases
GFR decrease FF NC ex = NSAIDS |
|
|
efferent arteriole constriction?
|
RPF decreases
GFR increases FF increases ex = ANG II |
|
|
increase plasma protein concentration?
|
RPF = NC
GFR = decrease FF = decrease |
|
|
decrease in plasma protein?
|
RPF = NC
GFR = increases FF = increases |
|
|
constriction of ureter?
|
RPF = no change (maybe inc)
GFR = decreases FF = decrease |
|
|
dehydration?
|
RPF = decrease a lot
GFR = decrease - efferent arteriole constriction ANG II FF = decreases |
|
|
afferent arteriole dilation?
|
RPF = increase
GFR = increases FF = NC ex = prostaglandins |
|
|
efferent arteriole dilataion?
|
RPF = increase
GFR = decrease FF = decrease ex = ACE inhibitors |
|
|
excretion rate?
|
V X Ux
filtration rate - total tubular reabsorption rate |
|
|
reabsoprtion?
|
filtered - excreted
|
|
|
secretion?
|
excreted - filtered
|
|
|
hartnup's disease
|
deficiency of neutral AA (tryptophan) transportor --> pellegra
|
|
|
causes shift of K+ out of cell causing hyperkalemia
|
insulin deficiency
beta adrenergic antagonists acidosis, severe exercise hyperosmolarity digitalis cell lysis |
|
|
shift K+ into the cell --> hypokalemia
|
insulin
beta adrenergic agonists alkalosis hypo-osmolarity |
|
|
what's winter's formula?
|
PC02 = 1.5 (HCO3) + 8 +/- 2
|
|
|
anion gap calculation?
|
NA+ - (cl + hco3)
|
|
|
type 1 RTA?
|
DISTAL
defect in CT's ability to excrete H+ hypokalemia and risk for calcium containing kidney stones |
|
|
type 2 RTA?
|
PROXIMAL
defect in PT HCO3 reabsorption hypokalemia and hypophasphatemic rickets |
|
|
type 4 RTA?
|
hyperkalemic
hypoaldosteronism or lack of CT response to aldosterone --> hyperkalemia --> inhibition of ammonia excretion in PT...leads to decrease urine pH due to decreased buffering capacity |
|
|
RBC casts
|
glomerulonephritis
ischemia malignant hypertension |
|
|
WBC casts
|
tubulointerstitial inflammation
acute pyelonephritis transplant rejection |
|
|
granular casts?
|
muddy brown --> acute tubular necrosis
|
|
|
waxy casts
|
advanced renal disease
CRF |
|
|
hyaline casts?
|
nonspecific
|
|
|
how does renal cell carcinoma spread?
|
hematogenously --> metastasize to lung and bone
|
|
|
WAGR complex?
|
wilms tumor
aniridia genitourinary malformation mental-motor retardation |
|
|
some risk factors for transitional cell carcinoma?
|
phenacetin
smoking aniline dyes cyclophosphamide rubber aromatic amine dye textile leather |
|
|
drug induced interstitial nephritis symptoms?
|
acute interstitial renal inflammation
pyuria - typically eosinophils azotemia - 1-2 weeks after administration fever rash hematuria CVA tenderness |
|
|
drugs that cause interstitial nephritis?
|
diuretics
NSAIDs penicilin derivative sulfonamides rifampin they act as happens inducing hypersensitivity |
|
|
most common cause of cute renal failure in hospital?
|
acute tubular necrosis
|
|
|
causes of acute tubular necrosis?
|
renal ischemia - shock, sepsis
crush injury - myoglobinuria toxins aminoglycosides amphotericin B dye heavy metals death mose often during initial oliguric phase |
|
|
symptoms of acute tubular necoriss?
|
loss of cell polarity
epithelial cell detachment necrosis granular muddy brown casts affects PT and TALH |
|
|
what's associated with renal papillary necorisis?
|
DM
acute pyelonephritis chronic phenacetin use - acetaminophen is a phenacetin derivative sickle cell anemia + trait |
|
|
causes of fanconi's syndrome?
|
wilsons disease
glycogen storage disease drugs - cisplatin, expired tetracyclines heavy metal exposure |
|
|
Fanconi's syndrome defects and complications?
|
dec phosphate reabsorption --> rickets
dec bicarb reabsorption --> metabolic acidosis type 2 RTA dec early Na reabsorption --> increase distal Na+ resoprition --> hypokalemia |
|
|
associations of ADPKD?
|
polycystic liver disease
berry aneurysms MV prolapse |
|
|
what happens if u correct hyponatermia too quickly?
|
central pontine myelinosis
|
|
|
signs of low Na+
|
disorientation
stupor coma |
|
|
signs of high Na+
|
neurologic
irritability deliruim coma |
|
|
low Cl- signs
|
secondary to metabolic alkalosis
hypokalemia hypovolemia increase aldosterone |
|
|
high cl- signs
|
secondary to non-anion gap acidosis
|
|
|
K+ low signs?
|
u waves on ECG
flattened T waves arrythymias paralysis |
|
|
high K+ signs?
|
peaked T waves
widened QRS arrythmias |
|
|
Ca2+ low signs?
|
tetany
neuromuscular irritability chevotks, troussoues |
|
|
Ca2+ high signs?
|
deliruim, stones, ab pain, non necessarily calciuria
stones bones groans moans affects concentrating ability = DI symptoms |
|
|
low Mg2+ signs?
|
neuromuscular irritability
arrhythmias |
|
|
high Mg2+ signs?
|
delirium
dec deep tendon reflexes cardiopulmonary arrest |
|
|
low phosphate signs?
|
low mineral ion product causes bone loss
osteomalacia |
|
|
high phosphate signs?
|
high mineral ion product causes renal stones
metastatic califications |
|
|
mannitol MOA?
|
osmotic diuretic - inc urine flow
increase tubular fluid osmolarity = inc serum osmol --> increase ADH secretion |
|
|
mannitol a/e?
|
pulm edema
dehydration contraindicated in anuria, CHF |
|
|
acetazolamide a/e?
|
hyperchloremic metabolic acidosis
neuropathy NH3 toxicity sulfa allergy |
|
|
furosemide effects medullary how?
|
decrease ohm of medullary interstium => decrease H20 absorption in descending loop of Henle
|
|
|
what diuretic stimulates prostaglandin release and what does that do?
|
furosemide
increase RBF --> inc GFR --> inc drug delivery by vasodilation of afferent arteriole |
|
|
a/e of furosemide?
|
OH DANG
otoxicity hypokalemia dehydration allergy nephritis - intersitial gout dec Ca2/K/Mg2 |
|
|
Ethacrynic acid MOA?
|
phenoxyacetic acid same moa as furosemide but not a sulfa so used for pts allergic to sulfa
-can also be used in acute gout but not for treatment |
|
|
what diuretic can u use for nehprogenic DI?
|
hydrochlorothiazide
|
|
|
a/e of hydrochlorothiazide?
|
hpokalemic metabolic alkalosis --> muscle weakness + cramping
hyponatremia hypotension hyperGLUC = glycemia, lipidemia, uricemia, calcemia sulfa allergy |
|
|
K+ sparing diuretics MOA?
|
spironalactone and eplerone = aldosterone antagonis
triamterene and amiloride = block Na+ channels in CCT |
|
|
what diuretic can lead to dec morbidity and mortality in HF patients
|
dec vent remodiling and cardiac fibrosis by spironalactone
|
|
|
diuretics that cause academia?
|
carbonic anhydrase inhibitors
K+ sparing aldosterone blockers |
|
|
a/e of ace inhibitors?
|
CAPTOPRIL
cough angioedema proteinemia taste changes hypotension pregnancy problems - fetal renal damage rash increase renin lower ang 2 avoid w/ bilateral renal artery stenosis because ACE inhibitors decrease GFR a lot by preventing constriction of efferent arterioles can get 1st dose hypotension -- potentiated by loop or thiazide directcs increase K+ so don't give K+ sparing diuretics |
