Term
| What diuretic can help prevent stone formation? |
|
Definition
| Thazides - only one that decreases Ca excretion (hypercalcemia AE) |
|
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Term
|
Definition
Hypercellular with IC deposits.
Granular IF |
|
|
Term
| Wegner's granulomatosis GN? |
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Definition
|
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Term
| Membranous glomerulopathy vs. Membranoproliferative glomerulonephritis? |
|
Definition
MG: Nephrotic only, no hypercellularity, assoc. with drugs, infxn, cancer, SLE.
MPGN: Nephrotic or nephritic, hypercellular. Associated with HBV, HCV, C3 nephritic factor. |
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Term
| What causes hypercoagualbility in nephrotic syndrome? |
|
Definition
| Loss of ATIII and other anticoag factors. |
|
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Term
| Where is lowest osmolality in nephron? |
|
Definition
| DCT, after electrolyte reabsorption in ascending limb. |
|
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Term
|
Definition
Benign, congenital.
Cysts in collecting ducts, increase in kidney stones.
Not related to ADPKD. |
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Term
| What 2 settings will you see BM splitting? |
|
Definition
| MPGN or Alport's syndrome. |
|
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Term
| What bone complication is seen in ESRD? |
|
Definition
| Osteitis fibrosis cystica. Low vitamin D leads to low Ca, increased PTH - bone reabsorption. |
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Term
|
Definition
| Fibrin deposition in glomerulus |
|
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Term
| Where is most water reabsorbed in nephron? |
|
Definition
| PCT, >60%, *regardless of hydration status! |
|
|
Term
Renal clearance equation?
What does it mean with Cr clearance? |
|
Definition
Cx = UxV/Px
Cx = clearance of x
Ux = urine concentration of x
V = urine flow rate
Px = plasma conc of x
Cr clearance approximates GFR, *slight overestimate b/c kidneys secrete Cr also |
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Term
What do you use to estimate renal plasma flow?
How do you then calculate renal blood flow? |
|
Definition
Use PAH clearance: totally filtered and secreted. = Estimated Renal Plasma Flow (EPRF) (underestimates true RPF by ~ 10%)
RBF = RPF/(1-Hct)
i.e. renal plasma flow plus RBCs |
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|
Term
What causes K shift into cell?
Out of cell? |
|
Definition
Into cell: Insulin, B-adrenergic stimulation (both by Na/K ATPase), Alkalosis (H/K exchange), Hypotonicity.
Out of cell: Lack of insulin, NOT beta-blockers, acidosis, hypertonicity. Digitalis (blocks Na/K ATPase), cell lysis. |
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Term
| What causes low Cl-? High Cl-? |
|
Definition
Low: metabolic alkalosis (kidneys trade for HCO3 retention)
High Cl: non-anion gap acidosis (saved in exchange for HCO3 dumping) |
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|
Term
What situation do you check urine Cl?
What does it mean? |
|
Definition
Check in metabolic alkalosis.
High urine Cl = diuretics, hyperaldosteronism (kidney alkalosis)
Low urine Cl = vomiting or nasogastric tube (upper GI alkalosis) |
|
|
Term
|
Definition
High: Irritability, delirium, coma
Low: Disorientation, stupor, coma
NB: neuro effects predominate! |
|
|
Term
|
Definition
High: Peaked T waves, wide QRS, arrythmias
Low: Flat T waves, U waves, arrythmias, paralysis
NB: cardiac signs predominate |
|
|
Term
|
Definition
High: Delirium, renal stones, abdominal pain, not necessarily calciuria.
Low: Tetany, neuromuscular irritability (Chvostek, Trousseau signs) |
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|
Term
| Formula for respiratory compensation to metabolic acidosis? |
|
Definition
|
|
Term
| 3 types of renal tubular acidosis? |
|
Definition
Distal: defect in collecting tubule ability to secrete H+. Hypokalemia, kidney stones.
Proximal: defect in PCT HCO3 absorption. Hypokalemia, hypophosphatemic rickets.
Hyperkalemic: Hypoaldosteronism. Mild acidosis. Hyperkalemia, inhibition of ammonium excretion in proximal tubule. Low urine pH due to low buffering capacity. |
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Term
|
Definition
Cresent formation.
Due to Goodpasture's, Wegener's (pauci-immune), or Microscopic polyangiitis (pauci-immune). |
|
|
Term
| Diffuse proliferative glomerulonephritis |
|
Definition
Wire looping
Subendothelial anti-DNA ICs
Granular IF
Due to SLE - most common cause of SLE death.
diffuse, nephritic form of MPGN |
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|
Term
|
Definition
IgA nephritis
IgA in mesangium |
|
|
Term
|
Definition
X-linked dominant.
Mutation in type IV collagen, split BM.
With nerve disorders, ocular disorders, deafness. |
|
|
Term
| Membranous glomerulonephritis |
|
Definition
Nephrotic only!
Diffuse capillary and GBM thickening, not hypercellular.
"spike and dome" with subepithelial deposits.
Granular.
SLE's nephrotic presentation, also drugs, infections, tumors. |
|
|
Term
| Diabetic glomerulonephropathy |
|
Definition
Nonezymatic glycosylation of GBM, efferent arterioles.
Leads to mesangial expansion, nephrotic syndrome.
Kimmelstein-Wilson lesions: PAS+ eosinophilic goobers in glomerulus. |
|
|
Term
| Focal segmental glomerulosclerosis |
|
Definition
Segmental sclerosis and hyalinosis.
Most common glomerular disease in HIV patients. |
|
|
Term
|
Definition
Nephroblastoma.
Early childhood.
Deletion of tumor suppressor gene WT1 on 11p.
WAGR syndrome: Wilm's tumor, Aniridia, GU malformation, mental Retardation. |
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|
Term
Prerenal ARF
Uosm?
UNa?
FeNa?
Serum BUN/Cr? |
|
Definition
Uosm: high (>500)
UNa: low (<10)
FeNa: low (<1%)
Serum BUN/Cr: high (>20) |
|
|
Term
Renal ARF
Uosm?
UNa?
FeNa?
Serum BUN/Cr? |
|
Definition
Uosm: normal/low (<350)
UNa: high (>20)
FeNa: high (>2%)
BUN/Cr: low (<15) |
|
|
Term
Postrenal ARF
Uosm?
UNa?
FeNa?
Serum BUN/Cr? |
|
Definition
Uosm: normal (<350)
UNa: very high (>40)
FeNa: very high (>4%)
Serum BUN/Cr: normal (>15) |
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