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29 Cards in this Set
- Front
- Back
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renal caliculi
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calcium oxalate=octahedral crystals, due to hypercalcemia
mg ammonium=rectantangular prisms, due to urease splitting bacteria uric acid=yellow/red/brown diamonds, due to gout, myeloproliferative diseases, lesch-nyhan, cystine=colorless hexagonal due to cystinuria all form in acidic urine except mg ammonia forms in alkaline all radioopaque except uric acid |
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body fluid compartments
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60% of tbw is water
2/3 icf 1/3 ecf: 3/4 = interstitial 1/4= plasma |
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effect of efferent arteriole constriction
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inc gfr
dec rpf inc ff |
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thin descending loop of henle
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passive water absorbtion via medullary hypertonicity
impermeable to salt |
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where does PTH work on nephron?
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early distal convoluted tubule (absorbtion of Calcium). pth stimulates basolateral Na/K pump which leads to lower con. of Na in the tubule cell. Ca flows passively into tubule but needs a Ca/Na exchanger to be reabsorbed into blood
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Intercalated cells
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secrete H+, absorb K+
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JGA
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JG cells=modified smooth muscle cells of afferent tubule which secrete renin inresponse to low renal bp, low Na delivery to distal tuble, and sympathetic tone (B1)
Macula Dense=Na+ sensor in distal convoluted tubule |
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Effect of Alkalosis on ions
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causes hypokalemia and hypocalcemia
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signs of hypokalemia
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weakness
Uwaves(positive wave after Twave) polyuria rhabdomyolysis (due to less insulin) |
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assoc between potassium and insulin
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insulin causes uptake cellular uptake of potassium (1st defense against hyperkalemia)
therefore low potassium results in low insulin and high potassium results in high insulin and insulin def (dm type1) results in hyperkalemia |
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causes of normal anion gap acidosis
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diarrhea
glue sniffing rta CA inhibitors gap is 8-12mEq/L |
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Types of RTA
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1=defect in H+ pump, cant acidify urine. defect in a-intercalated cells
2=renal loss of bicarb, due to failure of proximal tubule to reabsorb HCO3- 4=hypoaldosteronism causing hyperkalemia and inhibition of ammonia excretion (NOT a tubular problem) |
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Potter's syndrome
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bilateral renal agenesis causing oligohydramnios, limb deformaties, facial deformaties, and pulmonary hypoplasia (cause of death)
due to malformation of ureteric bud |
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Casts vs Cells in urine
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casts suggest renal origin
cells suggest distal origin |
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granular casts
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acute tubular necrosis
"muddy brown casts" |
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causes of RPGN
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#1=Goodpastuer's (anti-GBM)
or systemic vasculitiies |
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Split BM histo
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seen in Alport's and MPGN
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Berger's Disease
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mesangial deposits of IgA
"IgA nephropathy" often post infection. can be present with HSP |
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Acute Post-streptococcal GN
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lumpy-bumpy
subepithelial humps granular pattern |
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Membranous GN
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diffuse capillary and BM thickening
"spike and dome" subepithelial spikes most common adult nephrotic syndrome think adults have spikes (subelithelial) |
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Von Hipple Lindau
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autodominat VH1 deletion on ch3
RCC retinal angiomatosis hemangioblastomas of cerebellum, brainstem, spinal cord pheochomycytoma pancreatic cancer |
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Paraneoplastic syndroms assoc with RCC
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epo
acth pthrp prolactin |
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Wilm's Tumor
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WT1 deletion on chrom 11
renal malignancy at early age (2-4) contains embyronic glomerular structures |
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WAGR complex
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w=wilms
a-aniridia g=gu malformation r=retraded (mental and motor) |
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Urine findings of pyelonephritis
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acute=white cells
chronic=eosinophilic casts (thyroidization of kidney) |
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Causes of Renal Papillary Necrosis
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POST CARD
Pyelonephritis Obstruction Sickle Cells Dz TB Cirrhosis Analgesic Nephropathy Radiation DM |
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Fanconi's Syndrome
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defect in proximal tubule transport of aa, glucose, phosphate, uric acid, protein, and electrolytes
causes rickets, osteomalacia, hypokalemia, metabolic acidosis |
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Hemolytic Uremic Syndrome
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in kids with e.coli 0157:H7 infection. verotoxin binds Gb3 of endothelial cells and causes cell death by blocking 60s protein synthesis
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TTP
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antibodies to vWF cleaving protein ADAMTS13 causing coagulation
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