Renal Exam

Front 1

Hypertonic Soln leads to both

Back 1

Increased water intake (thirst) and Renal Water Retention (incr. ADH)

Front 2

What stimulates ADH release?

Back 2

Osmoreceptors and Baroreceptors

Front 3

Small cell lung carcinoma

Back 3

SIADH-inappropriate secretion of ADH-->hyponatremia and hypoosmolarity

Front 4

Primary determinant of ECF osmolarity

Back 4

Serum Na

Front 5

Large hyperechoic kidneys, oligohydramnios, Cuboidal epithelium

Back 5

ARPKD

Front 6

Hepatic cysts and Intracranial aneurysms

Back 6

ADPKD

Front 7

Increased incidence of papillary renal cell carcinoma

Back 7

Acquired cystic disease

Front 8

Develop in patients on dialysis

Back 8

Acquired cystic disease

Front 9

Characteristics of Nephrotic Syndrome

Back 9

Proteinuria, Hyperlipidemia, lipiduria, hypercoagulability, Edema

Front 10

Characteristics of Nephritis

Back 10

Mild proteinuria, Hematuria-RBC casts, dysmorphic RBC's, Edema

Front 11

Diffuse

Back 11

All of the glomeruli

Front 12

Focal

Back 12

Some of the glomeruli

Front 13

Global

Back 13

All of each individual glomerulus

Front 14

Hematuria in conjunction with upper respiratory infection (synpharyngitic)

Back 14

IgA nephropathy-Most most common; nephritis

Front 15

IgA deposition in multiple organs

Back 15

Henoch-Schonlein Purpura

Front 16

EM-->Mesangial and large subepithelial "hump-like" deposits

Back 16

Post infectious GN, Group A strep; nephritis; cola colored urine

Front 17

Linear IgG and C3 on IF

Back 17

Rapidly progressive GN (Goodpasture's Anti-GBM); Classic Nephritic syndrome with RAPID progression to renal failure

Front 18

EM-->Podocyte foot processes effacement/fucion
can be d/t NSAIDS

Back 18

Minimal Change Disease; Nephrotic syndrome

Front 19

HBV infection

Back 19

Membranous nephropathy-most common cause of nephrotic syndrome in caucasian adults

Front 20

Carcinoma of lung, colon, stomach, breast, non-hodgkins lymphoma

Back 20

Membranous nephropathy-most common cause of nephrotic syndrome in caucasian adults

Front 21

LM-->diffues thickening of GBM-Spikes; and Subepithelial deposits on EM

Back 21

Membranous nephropathy-most common cause of nephrotic syndrome in caucasian adults

Front 22

African americans

Back 22

Focal segmental glomerulosclerosis-nephrotic syndrome; LM-->focal and segmental glomerular sclerosis

Front 23

HIV

Back 23

Focal segmental glomerulosclerosis-nephrotic syndrome-LM-->focal and segmental glomerular sclerosis

Front 24

Hepatitis C

Back 24

Membranoproliferative Glomerulo-Nephritis; both Nephrotic and Nephritic Features; Subendothelial deposits on EM

Front 25

Increases number of capillary loop and mesangial cells (also expansion)

Back 25

Diabetic Nephropathy

Front 26

Widening of GBM d/t proteinuria; increased width of foot processes (also apoptosis, and reduced migration)

Back 26

Diabetic Nephropathy

Front 27

Lambda light chains

Back 27

Amyloidosis-Enlarged kidney; NO HTN

Front 28

Purpura around eyes, splenomegaly, joint pain

Back 28

Amyloidosis-Enlarged kidney; NO HTN

Front 29

Kappa chains

Back 29

Light chain deposition disease

Front 30

EM-->Granular deposits along GBM; LM-->Nodular Glomerulosclerosis

Back 30

Light chain deposition disease

Front 31

Defect in Basement Membrane (Type IV collagen)

Back 31

Alport syndrome-HTN, ESRD, X-linked, Hematuria, COL4A5 gene

Front 32

Cochlear and ocular defects

Back 32

Alport syndrome-HTN, ESRD, X-linked, Hematuria, COL4A5 gene

Front 33

Dominant; microhematuria, NO proteinuria, HTN or ESRD!

Back 33

Thin Basement Membrane Disease; EM-->THIN GBM (usually <200 nm)

Front 34

Medulla+surrounding cortex

Back 34

Lobe

Front 35

Medullary Ray+Surrounding cortex

Back 35

Lobule

Front 36

Heparan sulfate proteoglycan is on...

Back 36

GBM

Front 37

attach podocytes to BM

Back 37

A3B1 integrin

Front 38

Location: passive reabsorbion of Na+, Cl- & water; facilitated reabsorbtion of glucose, amino acids & proteins

Back 38

Proximal Tubule

Front 39

Fewer mitochondria and intedigitations-location

Back 39

Convoluted distal tubule

Front 40

Produce Renin

Back 40

Juxtaglomerular Cells

Front 41

Produce Erythropoietin

Back 41

Cortical interstitial cells-transported by bone marrow

Front 42

ADH sites of action

Back 42

Kidney's collecting duct and distal convoluted tubule-absorbs urine

Front 43

Aldosterone sites of action

Back 43

Distal tubules and collecting ducts of nephron

Front 44

Filled bladder cell type

Back 44

Squamous (flattened)

Front 45

Smooth muscle cells that lie between the capillaries and regulate blood flow

Back 45

Mesangial Cells

Front 46

Visceral layer of Bowmans' Capsule

Back 46

Simple squamous epithelium lined by podocytes

Front 47

Precursor tissue of Kidney

Back 47

Intermediate Mesoderm

Front 48

Solid cell cord that fuses with Cloaca

Back 48

Mesonephric Duct

Front 49

Immature Nephrons; Gets signals from Mesophrinc Duct

Back 49

Mesonephric Tubules

Front 50

Result in Nephron formation

Back 50

Branching of Metanephrogenic Mesenchyme

Front 51

Distal to 6th generation of metanephrogenic mesenchyme

Back 51

Collecting ducts

Front 52

prevent MM cell apoptosis and induce MM to aggregate around ampulla

Back 52

MD signals FgF2 and Bmp7

Front 53

Proximal S-shaped tubule-->

Back 53

Distal tubule and loop of henle

Front 54

Middle S-shaped tubule-->

Back 54

Proximal tubule

Front 55

Distal S-shaped tubule-->

Back 55

Renal Corpuscle

Front 56

Primary UG sinus is located-->

Back 56

Ventrally

Front 57

The mesonephric ducts in males connect to?

Back 57

Gonads

Front 58

Interactions between metanephrogenic Mesenchyme and metanephirc diverticulum are altered in?

Back 58

Renal Agenesis

Front 59

Failure of medial mesenchymal migration

Back 59

Bladder Extrophy

Front 60

Mucosal folds which obstruct the lumen of the urethra in boys

Back 60

Posterior Urethral Valves

Front 61

Functions of Amniotic Fluid

Back 61

Physical (shock absorber); Nutritive, Excretory

Front 62

Diarrhea leads to?

Back 62

Metabolic Acidosis

Front 63

Diuretics or excess aldosterone cause? (acidosis or alkalosis?)

Back 63

Metabolic alkalosis

Front 64

Metabolic Acidosis: What is the compensatory change for CO2?

Back 64

1.3 x the change in HCO3 (will be a decrease)

Front 65

Metabolic Alkalosis: What is the compensatory change for CO2?

Back 65

0.6 X the change in HCO3 (will be an increase)

Front 66

Respiratory Acidosis: What is the compensatory change for HCO3 ( Acute and Chronic)?

Back 66

Acute: increase CO2 10-->increase HCO3 by 1
Chronic: Increase CO2 10-->increase HCO3 by 4

Front 67

Respiratory Alkalosis: What is the compensatory change for HCO3 ( Acute and Chronic)?

Back 67

Acute: decrease CO2 10-->decrease HCO3 by 2
Chronic: decrease CO2 10-->decrease HCO3 by 5

Front 68

Anion Gap calculation

Back 68

[Na+] − ([Cl-] + [HCO3−]); >12 is metabolic acidosis

Front 69

Angiotensin Change in GFR

Back 69

No change (typically prevents change); Decrease at high concentrations

Front 70

When Arterial pressure increases...

Back 70

RBF and GFR remain the same; URINE output increases

Front 71

Decreased NaCl to macula densa affects arterioles how?

Back 71

Constrict Efferent arteriole and dilate afferent arteriole

Front 72

Thick ascending loop transporter

Back 72

Reabsorbs 25% of filtered Na+ by the Na/K/2Cl transport

Front 73

Where does Ag-II increase NaCl reabsorption?

Back 73

Proximal tubule, thick ascending loop of Henle/distal tubule, collecting tubule

Front 74

Where does PTH increase Ca+2 reabsorption?

Back 74

Proximal tubule, thick ascending loop of henle/distal tubule

Front 75

GBM in proteinuria

Back 75

Thicker!

Front 76

defective 11beta-HSD2 enzyme

Back 76

Apparent Mineralocorticoid Excess; low aldosterone levels; HIGH cortisol levels

Front 77

Directly increase ENaC channels; Dominant mutation

Back 77

Liddle Syndrome; Low plasma aldosterone

Front 78

Hyperaldosteronism; mimic thiazide diuretic (problem with NaCl transport); Adolescence/adulthood

Back 78

Gitelman syndrome

Front 79

Hyperaldosteronism; Mimic loop diuretic (ascending loop of Henle); Childhood

Back 79

Barter Syndrome

Front 80

Renal clearance (equation)

Back 80

Cx = (Ux) x (UF) / Px

Front 81

Fractional excretion of sodium=

Back 81

(urinary concentration of sodium x urine flow rate)/(GFR x plasma concentration of sodium)

Front 82

Excretion rate of X =

Back 82

Ux x UF

Front 83

Hypertonic soln cause high?

Back 83

Cosm

Front 84

Hypotonic soln cause high?

Back 84

CH20

Front 85

Acetazolamide makes the urine...

Back 85

Basic

Front 86

Elevation of nitrogen waste products

Back 86

Azotemia

Front 87

AKI d/t Volume Depletion

Back 87

Pre-renal: Elevated BUN:Creatinine; FENa <1%

Front 88

Post renal AKI results in-->

Back 88

Hydronephrosis

Front 89

AKI with brown muddy casts

Back 89

Renal

Front 90

Eosinophils/hypersensitivity reaction; NO positive urine culture

Back 90

Acute Interstitial Nephritis

Front 91

Yellowish raised abscesses-->Neutrophils; Bacterial infection

Back 91

Acute Pyelonephritis

Front 92

History of bone pain; Hypercalcemia, volume depletion, nephrotoxins

Back 92

Multiple Myeloma; LM-->Crystalline, fractured casts

Front 93

Finely cortical surface; Arteriolar hyaline nephrosclerosis

Back 93

Hypertensive Nephrosclerosis

Front 94

Nephrocalcinosis what part of nephron is spared?

Back 94

Proximal tubules

Front 95

Renal artery stenosis d/t

Back 95

Atherosclerosis or FMD; Clinicall presents as resistant HTN or kidney dysfunction

Front 96

Most common cause of CKD and ESRD

Back 96

Diabetes

Front 97

Triad of renal cell cardinoma

Back 97

Painless hematuria, palpable abdominal mass, dull flank pain, Polycythemia (EPO producing tumor)

Front 98

Type I papillary carcinoma

Back 98

Cuboidal cells with Small amount of cytoplasm

Front 99

RCC in African americans; sickle cell disease

Back 99

Medullary carcinoma

Front 100

RCC where cytoplasm is clear and nuclei is toward the apex of the cells

Back 100

Clear cell(tubulo) Papillary

Front 101

Mahogeny brown yellow mass w/ central scarring

Back 101

Oncocytoma

Front 102

Contains premelanosomes; consists of blood vessels, smooth muscle and fat

Back 102

Angiomyolipoma

Front 103

Mesoderm derived tissue

Back 103

Wilms Tumor

Front 104

Reactive cells; bladder wall irregularity

Back 104

VonBrunn Nests/ Cystitis Cystica/ Glandularis

Front 105

Blunt projections; arise from catheter, stone, etc

Back 105

Polypoid Cystitis

Front 106

Following GU surgery associated with chronic cystitis

Back 106

Nephrogenic Adenoma (nephrogenic metaplasia)

Front 107

SE: Nephrotoxicity, Cardiovascular effects (HTN & Hyperlipidemia), Hirsutism

Back 107

Cyclosporine

Front 108

SE: Diabetes/glucose intolerance, Nephrotoxicity, Neurotoxicity

Back 108

Tacrolimus

Front 109

SE: Cytopenias (BMS), Hyperlipidemia (more than Cyclosporin), Mouth Sores & Poor Wound Healing, Pneumonitis

Back 109

Sirolimus

Front 110

SE: Cushingoid facial appearance

Back 110

Prednisolone

Front 111

Maintenance agent that inhibits signal 1 (inhibit NFAT activation)

Back 111

Cyclosporine and Tacrolimus

Front 112

Maintenance agent that inhibits signal 3 at mTOR

Back 112

Sirolimus

Front 113

Induction agent that inhibit signal 3 at IL-2R

Back 113

Basdiliximab and Daclizumab

Front 114

Induction agent that inhibit signal 1 at TCR/CD3

Back 114

Muromonab

Front 115

What drug decreases PTH w/o an increase in Ca or PO4?

Back 115

Calcimimetics

Front 116

Calcitonin mechanism

Back 116

Inhibs Ca resorption from bone, & incr PO4 excretion in urine