Renal

Front 1

Why is the left kidney taken during transplantation?

Back 1

It has a longer renal vein

Front 2

Water breakdown?

Back 2

Water is 60% of body weight

2/3 is intracellular
1/3 is extracellular

1/4 of extracellular volume is plasma
3/4 of extracellular volume is interstitial

Front 3

How can you measure plasma volume?

Back 3

Radiolabeled albumin

Front 4

Formula for clearance

Back 4

Cx = UxV/Px

Front 5

What does the glomerular filtration barrier block, and how?

Back 5

Large, negative particles

1. Fenestrated capillary (size)
2. Heparin on basement membrane (charge)
3. Podocyte foot processes

Front 6

Calculation for free water clearance

Back 6

C = V - (Uosm*V/Posm)

it is the volume of water per unit time that is cleared by the kidneys... you get at it by taking the urine flow rate and subtracting out the volume of osmole-containing fluid.

Front 7

What is the renal threshold for glucose?

Back 7

around 200 mg/dL

this is when you start to see symptoms

Front 8

Why does acidosis decrease K secretion?

Back 8

It causes a shift of K outside the cell (thus decreasing the amount of K available for transport to the lumen)

Front 9

Actions of AII

Back 9

Vasoconstriction
Aldosterone synthase induction
ADH release
Stimulates hypothalamus for increasing thirst

Front 10

ANP actions

Back 10

Decreases renin

Increases GFR

Front 11

What part of the kidney secretes EPO?

Back 11

Endothelial cells of peritubular capillaries

Front 12

What stimulates renin secretion?

Back 12

Beta 1

Front 13

Winter's formula

Back 13

PCO2 = 1.5 (HCO3) + 8 +/-2

Front 14

Metabolic alkalosis

Back 14

PCO2 increases .7 for every 1 mEq/L increase in HCO3

Front 15

Respiratory alkalosis

acute
chronic

Back 15

2 mEq/L decrease for every 10mmHg decrease in PCO2

5 mEq/L for every 10mmHg decrease in PCO2

You're pretty good at peeing out excess base.

Front 16

Respiratory acidosis

acute
chronic

Back 16

1mEq/L increase for every 10 mmHg increase

3.5 mEq/L increase

Front 17

Delta delta

<1
1
>2

Back 17

change in AG from normal of 12 / change in HCO2 from normal of 24

<1 = Acid + AG acid
1 = pure AG
>2 = Alk + AG acid

Front 18

WBC casts

Back 18

virtually pathognomonic for pyelo, and not seen in cystitis

Front 19

Granular casts

Back 19

ATN

Front 20

What stone is radiolucent

Back 20

Uric acid

Front 21

Renal cell carcinoma

Host
Histology
Genetics
Paraneoplastics

Back 21

Men 50-70

Likes upper pole, originates in renal tubule cells (clear cells)

Associated with VHL gene on 3

EPO, ACTH, PTHrP, prolactin

Front 22

WAGR complex

Back 22

Wilms' tumor
Aniridia
Genitourinary malformation
mentomotor Retardation

Front 23

What does Wilms' tumor originate from?

Back 23

Primitive metanephric tissues

Front 24

Causes of transitional cell carcinoma

Back 24

Phenacetin, Smoking, Aniline dyes, Cyclophosphamide, Schistosomiasis

Front 25

Where can TCC occur?

Back 25

Calyces, pelves, ureters, bladder

Front 26

Chronic pyelonephritis

Back 26

Coarse, asymmetric, corticomedullary scarring, blunted calyx, thyroidization of kidney

Usually from chronic UT obstruction

Front 27

What causes diffuse cortical necrosis?

Back 27

combination of vasospasm and DIC, usually in sepsis or obstetric catastrophes

Front 28

What is the mechanism by which drugs induce interstitial nephritis

Back 28

Haptenation

Front 29

Nephrocalcinosis

Back 29

diffuse deposition of calcium in the kidney parenchyma which can lead to renal failure. CAused by hypercalcemia or hyperphosphatemia (this is assoc. w/ renal failure)

Front 30

Causes of ATN

Back 30

ischemia, myoglobinuria, toxins (mercuric chloride, aminoglycosides, ethylene glycol (oxalosis))

Front 31

2 phases

Back 31

oliguric phase : worry hyperkalemia (deadly arrhythmia)

recovery phase : vigorous diuresis

Front 32

Causes of renal papillary necrosis

Back 32

DM (infxn and vascular disease)

Acute pyelonephritis

Chronic phenacetin use (acetaminophen, too)

Sickle cell anemia

Front 33

In what condition can you see bleeding 2/2 platelet dysfunction, skin pigmentation, and fibrinous pericarditis?

Back 33

uremia

Front 34

What conditions are associated with dominant mutations of APKD1.

Back 34

polycystic liver disease, berry aneurysms, mitral valve prolapse, secondary polycythemia

Front 35

What are dialysis cysts?

Back 35

cortical and medullary cysts resulting from long-standing dialysis. Increased risk of renal cancer.

Front 36

Which has a better prognosis: medullary cystic disease or medullary sponge kidney?

Back 36

Medullary sponge kidney; multiple small cysts in the collecting ducts, associated with moderately impaired tubular function and occasional infection, but otherwise good prognosis.

Medullary cystic disease pts. have small kidneys. Also known as nephronopthisis.

Front 37

What do thiazides do to urinary calcium?

Back 37

They decrease urinary calcium excretion!

They retain calcium!

Good for idiopathic hypercalciuria.

Front 38

What drug do you use for nephrogenic DI?

Back 38

THIAZIDES!

Front 39

enlarged, hypercellular glomeruli, PMNs, lumpy bump EM

subepithelial humps

granular pattern

Back 39

PSGN

Front 40

Crescentic GN

Back 40

RPGN

I: goodpasture's
II: Post strep in 50% of all cases
Lupus IV
III: Pauci immune (ANCA)

Front 41

subendothelial humps

tram tracking

Back 41

Membranoproliferative GN

tram tracks are the reduplication of the GBM ("proliferative of the membrane")

Front 42

mesangial deposits of IgA

no complement

Back 42

Berger's disease

Front 43

defect in alpha-5 type IV collagen

Back 43

Alports

sensorineural deafness, hematuria, anterior lenticonus

Front 44

Membranous GN (nephritis/nephropathy)

Associations?

Back 44

Oddly, this is a NEPHROTIC syndrome.

- capillary and BM thickening
- granular pattern
- spike and dome (reactive BM forms spikes)

Unknown etiology: lupus, HBV, syphilis, malaria, gold salts, penicillamine, cancers.

Often accompanied by azotemia

Front 45

normal glomeruli, foot process effacement, lipid laden renal cortices

Back 45

minimal change disease

responds well to steroids

Front 46

segmental sclerosis and hyalinosis

clinically similar to minimal change

Back 46

FSGS

Front 47

subendothelial and mesangial deposits of apple green birefringent material... what diseases are associated?

Back 47

Amyloidosis.

Myeloma
Chronic inflammation
TB
Rheumatoid arthritis

Front 48

Lupus glomerulonephropathy
I
II
III
IV
V

Back 48

I: no renal involvement

II: mesangial form (like FSGS)

III: focal proliferative

IV: diffuse proliferative (nephrotic and nephritic presentations; crescents, mesangial hypertrophy, endothelial proliferation, subendothelial deposits)

V: membranous