1A: Dt 15 - 2

Front 1

Provide the normal gas values (including pH).

Back 1

pH: 7.35-7.45
Drop the 7
pCO2: 35-45
Multiply 45 x 2
pO2>90
Divide 45 by 2
HCO3 = 22 (up to 28)

Front 2

What is the Henderson-Hasselbalch equation?

Back 2

pH=HCO3/pCO2

Front 3

Acid-Base Disorder:
pH 7.40
HCO3 23
pCO2 40

Back 3

pH nl
HCO3 nl
pCO2 nl

Normal ABG

Front 4

Acid-Base Disorder:
pH 7.50
HCO3 35
pCO2 42

Back 4

pH Basic (Alkalosis)
HCO3 Elevated (Must be metabolic)
pCO2 Normal (No compensation)

Thus, it's a metabolic alkalosis without compensation.

Front 5

Acid-Base Disorder:
pH 7.33
HCO3 13
pCO2 28

Back 5

pH: Acidic
HCO3: Low
pCO2: Low--must be compensatory mechanism because don't have an alkalosis

Metabolic acidosis with respiratory compensation.

Front 6

Acid-Base Disorder:
pH 7.42
HCO3 32
pCO2 64

Back 6

pH Normal
HCO3 High--metabolic alkalosis
pCO2 High--respiratory acidosis

Mixed disorder; combined metabolic alkalosis and respiratory acidosis

Front 7

Acid-Base Disorder:
pH 7.20
HCO3 18
pCO2 40

Back 7

pH Low--Acidosis
HCO3 Low
pCO2 Low

Metabolic acidosis without compensation. (normal pCO2 is 35-45)

Front 8

Acid-Base Disorder:
pH 7.20
HCO3 24
pCO2 54

Back 8

pH: Acidosis
HCO3: Normal
pCO2: Elevated

Respiratory acidosis without compensation.

Front 9

Acid-Base Disorder:
pH 7.52
HCO3 22
pCO2 22

Back 9

pH: Alkalosis
HCO3: Normal
pCO2: Low

Respiratory alkalosis without compensation.

Front 10

Acid-Base Disorder:
pH 7.66
HCO3 36
pCO2 30

Back 10

pH: Alkalosis
HCO3: Elevated
pCO2: Normal/Low

Combined metabolic and respiratory alkalosis.

Front 11

Acid-Base Disorder:
pH 7.47
HCO3 14
pCO2 22

Back 11

pH Alkalosis
HCO3 Low
pCO2 Low

Respiratory alkalosis with compensation.

Front 12

Acid-Base Disorder:
pH 7.46
HCO3 35
pCO2 53

Back 12

pH Alkalosis
HCO3 Elevated
pCO2 Elevated

Metabolic alkalosis with compensation

Front 13

Acid-Base Disorder:
pH 7.39
HCO3 12
pCO2 22

Back 13

pH Normal
HCO3 Low--Met acidosis
pCO2 Low--Resp alkalosis

Mixed: Metabolic acidosis and respiratory alkalosis

Front 14

Acid-Base Disorder:
pH 7.34
HCO3 31
pCO2 62

Back 14

pH Acidosis
HCO3 Elevated
pCO2 Elevated--acidosis

Respiratory acidosis with compensation

Front 15

Acid-Base Disorder:
pH 7.10
HCO3 15
pCO2 50

Back 15

pH Acidosis
HCO3 Low--acidosis
pCO2 High--acidosis

Combined metabolic and respiratory acidosis.

Front 16

Respiratory acidosis vs alkalosis:
Causes

Back 16

Resp acidosis:
Hypoventilation:
-Airway obstruction
-Lung dz
-Opioids, narcotics, sedatives
-Weakening of respiratory mm

Resp alkalosis:
-Hyperventilation (early high altitude exposure)
-ASA ingestion (early)

Front 17

Metabolic acidosis vs alkalosis:
Causes

Back 17

Met acidosis:
CHECK ANION GAP (Na+ - (Cl + HCO3); nl range is 8-12

If normal gap****:
Diarrhea
Glue sniffing
Renal tubular acidosis
Hyperchloremia

If anion gap:
MUDPILES*****
Methanol
Uremia
DKA
Paraldehyde/Phenformin
Iron tablets or INH
Lactic acidosis
Ethylene glycol
Salicylates

Met alkalosis:
Diuretic use
Vomiting
Antacid use
Hyperaldosteronism

Front 18

Rental tubular acidosis:
Type I vs Type II vs Type IV

Back 18

Type I (distal)-Defect in CD's ability to excrete H+. Assocd w/hypokalemia and risk for Ca2+ kidney stones

Type II: Proximal; defect in proximal tubule HCO3- reabsorption. Assocd w/hypokalemia and hypophophatemic rickets.

Type IV: Hyperkalemia; hypoaldosteronism or lack of CD response to aldosterone; assocd w/hyperkalemia, inhibition of ammonium excretion in proximal tubule. Leads to acidic urine due to dec'd buffering capacity.

Front 19

How does acidosis/alkalosis affect extracellular K concentrations?

Back 19

Because of H+/K+ pump:

Acidosis: increases extracell K+
Alkalosis: decreases extracell K+

Front 20

A patient with recent kidney transplant on cyclosporin for immunosuppression requires an antifungal agent for candidiasis

What drug would result in cyclosporin toxicity?

Back 20

Ketoconazole (interferes with cyp450)

Front 21

A patient presents with renal insufficiency

What alterations need to be made in his doses of digoxin
and digitoxin respectively?

Back 21

Digoxin is renally excreted, so decrease dose.

Digitoxin not renally excreted, so don't have to change dose.

Front 22

What effect will a renal stone that obstructs the ureter have on GFR and FF?

Back 22

Dec GFR
Dec FF

Front 23

What is the maximal serum glucose concentration at which glucose can be absorbed in the tubules?

Back 23

Will start to spill glucose around 200 mg/dL, but will saturate at 350 mg/dL

Front 24

What change in a basic metabolic panel might you expect in a young pt being treated for status asthmaticus?

Back 24

beta-agonists will shift K+ into cells-->hypokalemia

Front 25

MUD PILES

Back 25

Methanol
Uremia
DKA
Paraldehyde or phenformin
Iron tablets or INH
Lactic acidosis
Ethylene glycol
Salicylates

Front 26

A patient taking lisinopril complains of new onset, constant coughing

What medication class should
this patient be switched to?

Back 26

Angiotensin receptor blocker (sartan)

Front 27

A patient with heart failure exacerbation needs medical diuresis but has a sulfa allergy

What diuretic can be used?

Back 27

Loop & thiazide are both sulfa drugs, so use Ethacrynic acid

Front 28

A patient presents with hypertension, hypokalemia, metabolic alkalosis, and low plasma renin.

What is the diagnosis, and how do you treat it?

Back 28

Primary hyperaldosteronism

Treat w/spironolactone

Front 29

Type of diuretic:
Triamterene

Back 29

K+ sparing

Front 30

Type of diuretic:
Acetazolamide

Back 30

Carbonic anyhydrase inhibitor

Front 31

Type of diuretic:
Hydrochlorothiazide

Back 31

Thiazide

Front 32

Type of diuretic:
Bumetanide

Back 32

Loop

Front 33

Type of diuretic:
Spironolactone

Back 33

K+ Sparine--aldost antag

Front 34

Type of diuretic:
Chlorothiazide

Back 34

Thiazide

Front 35

Type of diuretic:
Ethacrynic acid

Back 35

Loop, not a sulfa drug

Front 36

Type of diuretic:
Mannitol

Back 36

Osmotic

Front 37

Type of diuretic:
Metolazone

Back 37

Thiazide

Front 38

Type of diuretic:
Chlorthalidone

Back 38

Thiazide

Front 39

Type of diuretic:
Furosemide

Back 39

Loop

Front 40

Type of diuretic:
Amiloride

Back 40

K+ sparing

Front 41

Type of diuretic:
Torsemide

Back 41

Loop

Front 42

Appropriate diuretic:
Acute pulmonary edema

Back 42

Heart failure-->LMNOP
Loop

Front 43

Appropriate diuretic:
Idiopathic hypercalciuria

Back 43

Thiazide to retain Ca2+

Front 44

Appropriate diuretic:
Glaucoma

Back 44

Acetazolamide, Mannitol

Front 45

Appropriate diuretic:
Mild to moderate CHF with expanded ECV

Back 45

Mild: Thiazide
Classically for HF: Loop

Front 46

Appropriate diuretic:
In conjunction with loop or thiazide diuretics to retain K+

Back 46

Any K+ sparing diuretic

Front 47

Appropriate diuretic:
Edema a/w nephrotic syndrome

Back 47

Loop

Front 48

Appropriate diuretic:
Increased intracranial pressure

Back 48

Mannitol

Front 49

Appropriate diuretic:
Mild to moderate hypertension

Back 49

Thiazide--HCTZ

Front 50

Appropriate diuretic:
Hypercalcemia

Back 50

Loop to lose Ca2+

Front 51

Appropriate diuretic:
Altitude sickness

Back 51

Acetazolamide

Front 52

Appropriate diuretic:
Hyperaldosteronism

Back 52

Spironolactone or eplerenone

Front 53

What is the equation for the renal clearance of any substance?

Back 53

Renal clearance = UxV/Px

Front 54

A 40 year-old pt of yours weighs 100 kg.
What is her estimated plasma volume?

Back 54

20% x 100 kg x 1/4 L/kg = 5L

Front 55

What factors/substances cause hyperkalemia?

What factors/substances cause hypokalemia?

Back 55

Hyperkalemia:
K+ sparing diuretics
ACE inhibitors
Acidosis
Insulin-deficiency
Beta-agonists
Hyperosmolarity
Digitalis
Cellular lysis

Hypokalemia:
Loop diuretics
Thiazides
Insulin
Beta-agonists
Alkalosis
Hyposmolarity
DKA
Heart/Renal failure

Front 56

What are the actions of angiotensin II?

Back 56

Direct vasoconstricting effect

Raises aldosterone levels-->Inc
Na and H2O reabsorption in proximal tubule

Dec'd renal blood flow, but inc'd GFR and FF

Front 57

What is the site of action of mannitol?

What is the site of action of the thiazides?

Back 57

Mannitol: Woks at proximal convoluted tubule

Thiazides: Early distal tubule

Front 58

What substances can be used to estimate GFR?

What substances can be used to estimate renal plasma flow?

Back 58

GFR: Cr, Inulin

RPF: PAH

Front 59

What do the presence of casts indicate?

Back 59

Hematuria/pyuria is of renal origin

Front 60

Proliferative vs Membranous Glomerular Disorders

Back 60

Proliferative: hypercercellular glomeruli

Membranous: thickening of glomerular BM

Front 61

Nephritic Syndrome:
Pathophys
Presentation

Back 61

NephrItic = Inflammatory process. When involves glomeruli-->hematuria and RBC casts in urine

a/w azotemia--elevated BUN/Cr, oliguria, HTN, proteinuria (<3.5 g/day)

Front 62

Azotemia vs Uremia

Back 62

Azotemia: elevated BUN/Cr

Uremia: azotemia + systemic effect (pleuritis, pericarditis, EKG changes, etc.)

Front 63

Acute Poststreptococcal Glomerulonephritis:
Pathophys
LM/EM presentation

Back 63

Glomeruli enlarged, hypercellular, nphils, lumpy-bumpy appearance

Subepithelial immune complex humps

Frequently seen in children. Resolves spontaneously

Front 64

Rapidly progressive glomerulonephritis:
Pathophys
LM/EM presentation
IF presentation

Back 64

LM--crescent-moon shape; crescents consist of fibrin and plasma proteins (e.g., C3b) w/glomerular fn parietal cells, monocytes, macs

Severe causes:
-Goodpasture Syndrome (type II hypersens); Abs to GBM and alveolar BM-->linear immunofluorescence
-Wegener's granulomatosis (c-ANCA)
-Microscopic polyangitis (p-ANCA)

Front 65

Diffuse proliferative glomerulonephritis:
LM/EM presentation
Pathophys

Back 65

Most common cause of death in SLE, Membranoproliferative GN

EM: subendothelial DNA-anti-DNA IC's

Front 66

Berger's Disease:
Pathophys

Back 66

Inc'd synthesis of IgA with IC's deposit in mesangium

Often presents/flares with URI or acute gastroenteritis

Front 67

Alport's syndrome;
Pathophys
Presentation

Back 67

Mutation in type IV collagen-->split BM

Can't see, can't pee, ca'n't hear (Nerve disorders, ocular disorders, deafness)

Front 68

What is nephrotic syndrome?

Back 68

NephrOtic syndrome presents with massive prOteinuria (>3.5g/day, frothy urine), edema, hyperlipidemia, fatty casts

Front 69

Membranous glomerulonephritis:
Pathophys
LM/EM presentation

Back 69

Diffuse capillary and GBM thickening

Spike and dome appearance with subepithelial deposits
(nephrotic syndrome)

Caused by drugs, infections, SLE; most common adult cause of nephrotic syndrome

Front 70

Minimal change disease:
Pathophys
LM/EM presentation

Back 70

LM--normal glomeruli
EM--foot process effacement

May be triggered by recent infection or immune stimulus. Most common in children. Responds to steroids.

Front 71

Back 71

Minimal change dz; normal glomeruli on LM but effacement of foot processes on EM (arrowhead). The full arrow points to a normal foot process.
Treatment consists of steroids.

Front 72

Back 72

Amyloidosis--congo red stain demonstrates amyloid deposits in artery wall that show apple-green birefringence under polarized light.

Front 73

Amyloidosis is associated with _______.

Back 73

Multiple myeloma, TB, RA

Front 74

Diabetic glomerulonephropaty:
Pathophys

Back 74

Nonenzymatic glycosylation of GBM-->inc'd permeability, thickening

Nonenzymatic glycosylation of efferent arterioles-->inc'd GFR-->mesangial expansion

Front 75

Back 75

Diabetic glomerulosclerosis--nodular diabetic glomerulosclerosis (also known as Kimmelstiel-Wilson syndrome); characterized by acellular ovoid nodules in periphery of glomerulus.

Front 76

Membranoproliferative GN:
Type I vs Type II--
EM appearance
Causes

Back 76

Type I: tram-track appearance due to GBM splitting caused by mesangial ingrowth

Most common cause; HBV, HCV, SLE (more association than cause)

Type II: Dense dposits
Associated with C3 nephritic factor

Front 77

What renal conditions are associated with hypocomplementemia?

Back 77

Post-strep GN
Membranoproliferative GN (Type II)
Lupus nephritis

Front 78

Which glomerular disease:
Most common nephrotic syndrome in children ·

Back 78

Minimal Change Dz

Front 79

Which glomerular disease:
IF: granular pattern of immune complex deposition; LM: diffuse capillary thickening

Back 79

Membranous GN

Front 80

Which glomerular disease:
IF: granular pattern of immune complex deposition; LM: hypercellular glomeruli

Back 80

Acute post-strep GN

Front 81

Which glomerular disease:
IF: linear pattern of immune complex deposition

Back 81

Anti-GBM Abs with Goodpasture's

Front 82

Which glomerular disease:
IF: deposition of lgG, lgM, lgA, and C3 in the mesangium

Back 82

IgA nephropathy

Front 83

Which glomerular disease: Kimmelstiei-Wilson lesions (nodular glomerulosclerosis)

Back 83

Diabetic glomerulonephropathy

Front 84

Which glomerular disease:
Most common nephrotic syndrome in adults

Back 84

Membranous GN

Front 85

Which glomerular disease:
EM: loss of epithelial foot processes

Back 85

Minimal Change Dz

Front 86

Which glomerular disease:
Nephrotic syndrome associated with hepatitis B

Back 86

Membranoproliferative GN

Front 87

Which glomerular disease:
Nephrotic syndrome associated with HIV

Back 87

Focal segmental glomerulosclerosis

Front 88

Which glomerular disease:
Anti-GBM antibodies, hematuria, hemoptysis

Back 88

Goopasture's

Front 89

Which glomerular disease:
EM: subendothelial humps and tram-tack appearance

Back 89

Membranoproliferative GN

Front 90

Which glomerular disease:
Nephritis, deafness, cataracts

Back 90

Alport Syndrome

Front 91

Which glomerular disease:
LM: crescent formation in the glomeruli

Back 91

Crescentic GN (aka Rapidly progressive GN)

Front 92

Which glomerular disease:
LM: segmental sclerosis and hyalinosis

Back 92

Focal segmental GN

Front 93

Which glomerular disease:
Purpura on back of arms and legs, abdominal pain, lgA nephropathy

Back 93

Henoch-Schloei Purpura

Front 94

Which glomerular disease:
LM: wire-loop appearance

Back 94

SLE

Front 95

Which glomerular disease:
Apple-green birefringence with Congo-red stain under polarized light

Back 95

Renal amyloidosis

Front 96

Which glomerular disease:
EM: spiking of the GBM due to electron dense subepithelial deposits

Back 96

Membranous GN

Front 97

Under what circumstances would you see:
RBC Cast

Back 97

Acute GN

Front 98

Under what circumstances would you see:
WBC Cast

Back 98

Pyelonephritis, acute interstitial nephritis

Front 99

Under what circumstances would you see:
Bacterial cast

Back 99

Acute pyelonephritis

Front 100

Under what circumstances would you see:
Epithelial cell cast

Back 100

Renal tubular damage

Front 101

Under what circumstances would you see:
Waxy cast

Back 101

Waxy = stasis of urine flow, so much be chronic renal failure

Front 102

Under what circumstances would you see:
Fatty cast

Back 102

Nephrotic syndrome

Front 103

Under what circumstances would you see:
Granular cast

Back 103

Non-specific, can be seen with acute tubular necrosis

Front 104

Glomerular histology reveals multiple mesangial nodules.

This lesion is indicative of what disease?

Back 104

Diabetic glomerulonephropathy

Front 105

A teenager presents with nephrotic syndrome and hearing loss.

What is the disease?

Back 105

Alport's Syndrome

Front 106

A 4 year-old boy presents with facial edema and proteinuria.

What is the appropriate treatment?

Back 106

Steroids (this is Min Change Dz)

Front 107

What is the only radiolucent kidney stone?

Back 107

uric acid stones

Front 108

Calcium kidney stones:
Frequency
Causes

Back 108

75-85% of all kidney stones

Consists of calcium oxalate, calcium phosphate, or both.

Caused by conditions that cause hyperCa2+ (cancer, hyperPTH)

Oxalate crystals can result from ethylene glycol (antifreeze) or Vitamin C abuse

Front 109

Ammonium magnesium phosphate kidney stones:
Frequency
Causes

Back 109

15% of kidney stones

Caused by infection with urease-positive bugs (Proteus, Staph, Klebsiella)

can form staghorn calculi that can be nidus for UTIs

Front 110

Uric acid kidney stones:
Frequency
Causes

Back 110

RADIOLUCENT

5% of stones

Strong assocn w/gout; often seen in dz w/inc'd cell turnover such as leukemia

Front 111

Which kidney stones can be treated by alkalinization of urine?

Which stone would be worsesned by alkaluria?

Back 111

Use alkaluria to tx Cystine stones (only 1% of renal stones)

DO NOT use alkaluria to tx ammonium magnesium phosphate stones

Front 112

Back 112

Calcium oxalate outlining a large right renal collecting duct system creating a "staghorn" calculus--can be calcium stone OR ammonoium magnesium phosphate (which present as STAGHORN)

Front 113

Back 113

Calcium oxalate crystals in kidney, viewed with polarizers. Tubular failure in oxalate nephropathy can result from vitamin C or antifreeze abuse.

Front 114

Renal cell carcinoma:
Histologic features
Risk factors
Presentation
Site of Mets
Associated disorders

Back 114

Polygonal clear cells in renal tubular cells

Inc'd incidence w/smoking and obesity

Manifests with hematuria, palpable mass, secondary polycythemia, flank pain, fever, weight loss

Paraneoplastic syndromes (ectopic EPO, ACTH, PTHrP, prolactin)

INvades IVC and spreads hematogenously; mets to lung and bone


Assocd w/von Hippel-Lindau syndrome and gene deletion in chromosome 3

Front 115

Wilms' Tumor:
AKA
Presentation
Cause

Back 115

AKA nephroblastoma

(Most common renal malignancy of early childhood)

Contains embryonic glomerular structures

Presents with huge, palpable flank mass, andn/or hematuria

Deletion of tumor suppressor gene WT1; may be part of WAGR complex (Wilms tumor, Aniridia, GU malformn, MR)

Front 116

Back 116

Renal cell carcinoma. Histology shows polygonal cells with small nuclei and abundant clear cytoplasm with a rich, delicate branching vasculature.

Front 117

Transitional cell carcioma:
Presentation
Risk Factors

Back 117

Most common tumor of urinary tract system, can occur in renal calyces, renal pelvis, ureters, bladder

Painless hematuria suggests bladder cancer

Risk factors in your Pee SAC:
Phenacetin
Smoking
Aniline Dyes
Cyclophosphamide

Front 118

Pyelonephritis:
Acute vs Chronic--
Histologic features
Presentation

Back 118

Acute pyelonephritis:
-Affects cortex w/sparing of glomeruli/vessels
Presents w/fever, CVA tenderness, nausea, vomiting

WHITE CELL CASTS CLASSIC for this

Chronic:
Coarse, asymmetric corticomedullary scarring, blunted calyx
Tubules can contain eosinophilic casts (thyroidization of kidney)

Front 119

Back 119

Acute pyelonephritis characterized by nphilic infiltration and abscess formation within renal interstitium. Abscesses may rupture, introducing collections of white cells to tubular lumen.

Front 120

Back 120

Chronic pyelonephritis with lymphocytic invasion and fibrosis.

Front 121

Acute Interstitial Nephritis:
Cause
Presentation
Treatment
Urinalysis finding

Back 121

Most common cause of acute renal failure; mostly drug-induced

Cause:
Drugs--NSAIDS, PCN/cephalosporins (methicillin), sulfonamides (TMP-SMX, foresmide), cipro, cimetidine, allopurinol

Tx w/2 weeks steroids

Presentation: fever, rash, ephilia, azotemia

Muddy brown (granular) casts = key finding

Front 122

Acute Tubular Necrosis:
Cause
Presentation

Back 122

Cause:
aminoglycosides, cephalosporins, polymixins
Contrast dye
Rhabdomyolysis/myoglobinuria from seizures, cocaine, crush injuries

FIndings: 4+ blood in urine, no RBC on urine cell count (because it's myoglobin in urine), renal failure

Front 123

Renal Papillary Necrosis:
Causes
Pathophys

Back 123

Sloughing of papillae-->gross hematria, proteinuria

May be triggered by recent infection or immune stimulus

A/W:
DM
Acute pyelonephritis
Chronic acetaminophen use
Sickle cell anemia

Front 124

Acute renal failure:
Definition
Prerenal vs Intrinsic vs Postrenal--
Pathophys and Examples

Back 124

Acute renal failure--abrupt decline in renal fn w/inc'd Cr and BUN over several days

1) Prerenal azoetmia--due to dec'd RBF (HYPOTENSION, dehydration, hypovolemia, shock, renal vasoconstricion as with NSAIDs)-->dec'd GFR, Na/H2O and Urea retained by kidney to reserve volume so, BUN/Cr ratio increases

Intrinsic renal: Acute tubular necrosis or ischemia/toxins; necrosis leads to debris obstructing tubule and fluid backflow across necrotic tubule; results in dec'd GFR. Urine has epithelial/granular casts. BUN reabsorption impaired-->dec'd BUN/Cr ratio

Postrenal--outflow obstruction (stones, BPH, neoplasia, congenital anomalies); develops ONLY with BILATERAL obstruction

Front 125

Acute vs Chronic Renal Failure:
Most common causes

Back 125

Acute: Acute tubular necrosis
Chronic: HTN, DM

Front 126

What is uremia?

Back 126

Clinical syndrome marked by inc'd BUN and inc'd Cr
Presents with nausea, anorexia
Pericarditis
Asterixis (hand-flapping tremor)
Encephalopathy
PLT dysfn

Front 127

UTI caused by Proteus vulgaris.

Associated renal stone?

Back 127

Ammonium Magnesium Phosphtate Stone-->Staghorn calculi

Front 128

A patient reports a long-term history of acetaminophen use.

What is she at increased risk of?

Back 128

Renal papillary necrosis--but NSAIDs can do this too!

Front 129

What artery prevents a horseshoe kidney from ascending in the abdomen?

Back 129

IMA

Front 130

Back 130

CT Scan of ADPKD

Front 131

ADPKD:
Pathophys
Presentation
At risk of?

Back 131

AD mutation in APKD1/2-->multiple, large, b/l cysts that ultimately destroy kidney parenchyma

Presents w/flank pain, hematuria, HTN (inc'd renin production), urinary infection, progressive renal failure

Risk of polycystic liver dz, berry aneurysms, mitral valve prolapse

Front 132

ARPKD:
Presentation

Back 132

Infantile presentation of ADPKD in parenchyma.

ASsocd w/hepatic fibrosis.

Can lead ot Potter's if develop renal failure in utero.

Front 133

Central pontine myelinosis:
Cause

Back 133

Rapid correction of hyponatremia

Front 134

How does EKG reflex K+ levels?

Back 134

Low K+ - Flat T waves
High K+ - Peak T waves

Front 135

What is the WAGR complex?

Back 135

Wilms' Tumor
Aniridia
GU malformn
Retardation (mental)

Front 136

Which glomerular disease:
IF: granular pattern of immune complex deposition; LM: diffuse capillary thickening

Back 136

Membranous GN

Front 137

Which glomerular disease:
IF: granular pattern of immune complex deposition; LM: hypercellular glomeruli

Back 137

Acute poststrep GN

Front 138

Which glomerular disease:
IF: linear pattern of immune complex deposition

Back 138

Goodpasture's

Front 139

Which glomerular disease:
IF: deposition of lgG, lgM, lgA, and C3 in the mesangium

Back 139

IgA neprhopathy

Front 140

Which glomerular disease:
EM: subendothelial humps and tram-tack appearance

Back 140

Membranoproliferative GN

Front 141

Which glomerular disease:
Nephritis, deafness, cataracts

Back 141

Alport Syndrome

Front 142

Which glomerular disease:
LM: crescent formation in the glomeruli

Back 142

Crescentic/Rapidly Progressive GN

Front 143

Which glomerular disease:
LM: segmental sclerosis and hyalinosis

Back 143

Focal segmental glomerulosclerosis

Front 144

Which glomerular disease:
Purpura on back of arms and legs, abdominal pain, lgA nephropathy

Back 144

Henock Schonlein Purpura

Front 145

Which glomerular disease:
EM: spiking of the GBM due to electron dense subepithelial deposits

Back 145

Memranous GN

Front 146

Diagnose:
pH 7.50
HCO3 35
pCO2 42

Back 146

Metabolic alkalosis w/o compensation

Front 147

Diagnose:
pH 7.33
HCO3 13
pCO2 28

Back 147

Metabolic acidosis w/compensation

Front 148

Diagnose:
pH 7.20
HCO3 18
pCO2 40

Back 148

Metabolic acidosis w/o compensation

Front 149

Diagnose:
pH 7.66
HCO3 36
pCO2 30

Back 149

Metabolic and respiratory alkalosis

Front 150

Diagnose:
pH 7.47
HCO3 14
pCO2 22

Back 150

Resp alkalosis w/compensation

Front 151

Diagnose:
pH 7.10
HCO3 15
pCO2 50

Back 151

Combined metabolic and respiratory acidosis

Front 152

Risk factors for transitional cell carcinoma?

Back 152

PSAC
Smoking---
Phenacetin (acetaminophen)
Smoking
Aniline dyes
Cyclophosphamide

Front 153

What are the causes of acidosis with an elevated anion gap?

Back 153

MUDPILES
Methanol
Uremia
DKA
Paraldehyde/phenformin
Fe tables or INH
Lactic acidosis
EtOH or ethylene glycol
Salicylates

Front 154

What changes will be seen in a basic metabolic panel in a patient with renal failure?

Back 154

High K+
High PO4
Low Ca2+
High BUN/Cr

Front 155

CT scan reveals massively enlarged kidney bilaterally.

Diagnosis?

Back 155

ADPKD

Front 156

Which electrolyte disturbance:
Correcting too rapidly may result in central pontine myelinosis

Back 156

Hyponatremia

Front 157

Which electrolyte disturbance:
Peaked T waves

Back 157

Hyperkalemia

Front 158

Which electrolyte disturbance:
Tetany

Back 158

Hypocalcemia

Front 159

Which electrolyte disturbance:
Arrhythmias

Back 159

High/low K+
Low Mg2+

Front 160

Which electrolyte disturbance:
Decreased deep tendon reflexes

Back 160

Hypermg2+

Front 161

Which electrolyte disturbance:
Flattened T waves, U waves on EKG

Back 161

Low K+

Front 162

Which renal pathology:
Most common tumor of the urinary tract system

Back 162

Transitional cell ca

Front 163

Which renal pathology:
Most common renal malignancy of early childhood (ages 2-4)

Back 163

Wilms' Tumor

Front 164

Which renal pathology:
Histologic appearance of renal cell carcinoma

Back 164

Clear cell carcinoma

Front 165

Which renal pathology:
Histological appearance of chronic pyelonephritis

Back 165

Thyroidization of kidney

Front 166

Which renal pathology:
Fever + rash + hematuria + eosinophilia

Back 166

AIN

Front 167

Which renal pathology:
Cancer associated with Schistosoma haematobium

Back 167

Squamous cell carcinoma of bladder

Front 168

Which renal pathology:
Treatment for cystine kidney stones

Back 168

Alkalinization of urine