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Flashcards in Renal Deck (377)
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1
Q

What week does the Pronephros degenerate?

A

4th week

2
Q

What trimester does the mesonephros function as an interim kidney? Does the mesonephros contribute to the male or female reproductive system?

A

1st trimester

male

3
Q

In what week does the mesonephros develop?

A

5th week

4
Q

What week does nephrogenesis finish?

A

36th week

5
Q

What duct is the Ureteric bud developed from?

A

Mesonephric duct

6
Q

From what structure to what structure does the Ureteric bud develop into in the adult kidney?

A

from the collecting duct to the ureter

7
Q

By what week is the ureteric bud fully canalized?

A

10th week

8
Q

The metanephric mesenchyme is responsible for the development of from where to where in the adult kidney?

A

glomerulus to DCT

9
Q

What structure is the most likely to become obstructed during development? Why?

A

uretopelvic junction

last to canalize

10
Q

What are the three causes of Potter Syndrome?

A

ARPKD

Bilateral renal artery agenesis

posterior urethral valves

11
Q

What is the O of POTTER Sequence?

A

Oligohydramnios

12
Q

What is amnion nodosum? What type of epithelium?

A

nodules on the amnion

squamous

13
Q

The association of what two structures is defective during Multicystic Dysplastic Kidney?

A

metanephric mesenchyme

ureteric bud

14
Q

What two components fill the kidney during dysplastic kidney?

A

cysts and cartilage

15
Q

Is dysplastic more common in a bilateral or unilateral pattern?

A

unilateral

16
Q

Do the ureters pass under or over the uterine artery?

A

under

17
Q

Do the ureters pass under or over the ductus deferens?

A

under

18
Q

Does creatinine over-estimate or under-estimate GFR? Why?

A

over-estimate

small amount of creatinine is secreted

19
Q

What equation is used to estimate RPF?

A

PAH clearance

20
Q

What is the equation for Filtration Fraction?

A

GFR/RPF

21
Q

Does low plasma protein increase or decrease the GFR?

A

increase

22
Q

What is the normal osmolality of ECF?

A

290 mOsm/L

23
Q

What is the equation for filtered load?

A

(GFR)([Plasma])

24
Q

At what blood glucose concentration does glucosuria begin to happen?

A

200 mg/dL

25
Q

At what blood glucose concentration do PCT transporters begin to be saturated?

A

375 mg/dL

26
Q

What two metabolites begin to accumulate in the urine during pregnancy?

A

glucose and amino acids

27
Q

What is the mode of inheritance for Hartnup Disease?

A

autosomal recessive

28
Q

Which amino acid specifically is underabsorbed during Hartnup Disease?

A

tryptophan

29
Q

What are the two locations of defective transporters during Hartnup Disease?

A

PCT ad enterocytes

30
Q

Which disease does Hartnup disease mimmic?

A

pellagra

31
Q

What are the two treatments for Hartnup Disease?

A

high protein diet

niacin

32
Q

What is a major complication in patients on long term dialysis? Where does this manifest?

A

amyloidosis

carpal tunnell

33
Q

Where in the nephron is NH3 secreted?

A

PCT

34
Q

Other than aldosterone, how does AII contribute to the reabsorption of sodium?

A

activates Na+/H+ exchanger

35
Q

Can solutes be reabsorbed in the descending LoH?

A

no

36
Q

What mechanism are Mg2+ and Ca2+ reabsorbed in the TAL?

A

paracellular

37
Q

Which ion drives the paracellular reabsorption of Mg2+ and Ca2+ reabsorbed in the TAL?

A

K+

38
Q

Sodium reabsorption in the collecting duct happens in exchange for what two ions?

A

Na+ and H+

39
Q

What are the two ENaC blocking drugs?

A

amiloride and triamterene

40
Q

Which part of the nephron is affected by Fanconi syndrome?

A

PCT

41
Q

What four metabolites are abnormally excreted during Fanconi Syndrome?

A

glucose, AAs, bicarb and phosphate

42
Q

Would Fanconi Syndrome result in metabolic alkalosis or metabolic acidosis?

A

metabolic acidosis

43
Q

Where in the nephron does Barter Syndrome occur?

A

thick ascending limb

44
Q

What two Renal Tubular Defects are Autosomal Recessive?

A

Barter

Gittelman

45
Q

What are the three abnormalities that Barter Syndrome produces?

A

hypokalemia

metabolic alkalosis

hypercalciuria

46
Q

Absorption of what electrolyte is deficient in Gitelman Syndrome? Where in the nephron?

A

NaCl

DCT

47
Q

What are the two abnormalities that Gitelman Syndrome presents with?

A

metabolic alkalosis

hypokalemia

48
Q

What is the difference between Barter Syndrome and Gitelman Syndrome?

A

Gitelman doesnt produce hypercalciuria

49
Q

What is the definition of Liddle Syndrome?

A

increased reabsorption of NaCl in collecting duct

50
Q

What is the only Renal Tubular Defect that is autosomal dominant?

A

Liddle Syndrome

51
Q

What are the three abnormalities that present with Liddle Syndrome?

A

HTN

hypokalemia

metabolic alkalosis

52
Q

What is the treatment for Liddle Syndrome?

A

Amiloride

53
Q

What ions does aldosterone cause the excretion of?

A

K+ and hydrogen

54
Q

What does angiotensin II do to the nephron? What segment?

A

activate Na/H exchanger

PCT

55
Q

How does ANP produce a natriuresis? By what mechanism?

A

vasodilation of vascular smooth muscle

increases in cGMP

56
Q

What cells of the kidney secrete erythropoietin?

A

interstitial peritubular cells

57
Q

What part of the nephron completes the final stage of vitamin D synthesis?

A

proximal tubule cells

58
Q

Which hormone activates 1α-hydroxylase?

A

PTH

59
Q

What molecule is used to maintain patency of the afferent arteriole?

A

prostaglandins

60
Q

What two hormones bidn to the principal cells?

A

ADH and aldosterone

61
Q

What does digitalis do to potassium levels in the blood?

A

hyperkalemia

62
Q

What does hyperosmolarity do to potassium levels in the blood?

A

hyperkalemia

63
Q

What does insulin deficiency do to potassium levels in the blood?

A

hyperkalemia

64
Q

Does Tumor Lysis Syndrome cause hyperkalemia or hypokalemia?

A

hyperkalemia

65
Q

Does acidosis cause hyperkalemia or hypokalemia?

A

hyperkalemia

66
Q

Does alkalosis cause hyperkalemia or hypokalemoa?

A

hypokalemia

67
Q

Are β-blockers known to cause hyperkalemia or hypokalemia?

A

hyperkalemia

68
Q

What ion disturbance cause U-waves to appear on an EKG?

A

hypokalemia

69
Q

What ion disturbance cause T-waves to disappear on an EKG?

A

hypokalemia

70
Q

What does hypocalcemia do to T-wave duration?

A

hypocalcemia = prolonged T-wave

71
Q

What arrhythmia can hypomagnesia cause?

A

Torsades

72
Q

Which ion disturbance can cause a wide QRS?

A

Hyperkalemia

73
Q

What is the mnemonic to remember hypercalcemia?

A

stones, bones, groans and psychiatric overtones

74
Q

Which ion disturbance can cause weakened DTRs?

A

hypermagnesia

75
Q

Which ion disturbance can cause hypotension?

A

hypermagnesia

76
Q

Hypermagnesia can cause which electrolyte disturbance?

A

hypocalcemia

77
Q

What is the mneomonic for variables that can cause a metabolic acidosis with an increased anion gap?

A

MUD PILES

78
Q

What is the M of MUD PILES?

A

methanol poisoning

79
Q

What is the U of MUD PILES?

A

Uremia

80
Q

What is the D of MUD PILES?

A

DKA

81
Q

What is the P of MUD PILES? Why does this cause acidosis?

A

Propylene glycol

propylene glycol is converted into

82
Q

What is the two I’s of MUD PILES?

A

iron tablets of Isoniazid

83
Q

What is the L of MUD PILES?

A

Lactic acidosis

84
Q

What is the E of MUD PILES?

A

Etyhlene glycol

85
Q

What is the S of MUD PILES?

A

Salicylates (late)

86
Q

What is the Mnemonic to remember the cause of acidosis with a normal anion gap?

A

HARD ASS

87
Q

What is the H of HARD ASS?

A

Hyperalimentation

88
Q

What is the A of HARD ASS?

A

Addisons disease

89
Q

What is the R of HARD ASS?

A

renal tubular acidosis

90
Q

What is the D of HARD ASS?

A

Diarrhea

91
Q

What is the A of HARD ASS?

A

Acetozolamide

92
Q

What is the two S’s of HARD ASS?

A

Spironolactone

Saline infusion

93
Q

Why does Addisons disease cause acidosis?

A

lack of aldosterone leads to accumulation of H+

94
Q

Why does spironolactone lead to an acidosis?

A

lack of aldosterone to stimulate Na+ reabsorption and H+ secretion

95
Q

What are the two symporters located on α-intercalated cells?

A

luminal H+ ATPase

luminal H+/K+ exchanger

96
Q

What is the defect during Type 1 Renal Tubular Acidosis effect?

A

α-intercalated fail to secrete H+

97
Q

Would Type 1 Renal Tubular Acidosis cause acidosis or alkalosis?

A

acidosis

98
Q

Is Type 1 Renal Tubular Acidosis associated with hypokalemia or hyperkalemia?

A

Hypokalemia

99
Q

What type of kidney stones would Type 1 Renal Tubular Acidosis be at an increased risk of developing? Why?

A

Calcium phosphate

urine pH > 5.5 precipitates CaPO4

100
Q

What is the mnemonic to remember the causes of Type 1 Renal Tubular Acidosis?

A

the four A’s

101
Q

What are the four A’s of Renal Tubular Acidosis?

A

Amphotericin b

Analgesics

multiple myeloma light chAins

congenital Anomalies

102
Q

What is the cause of Type 2 Renal Tubular Acidosis? What is the pH of the urine?

A

congenital defect in the PCT to reabsorb bicarb

103
Q

Does Type 2 Renal Tubular Acidosis result in a metabolic acidosis or alkalosis?

A

acidosis

104
Q

Is Type 2 Renal Tubular Acidosis associated with hyperkalemia or hypokalemia?

A

hypokalemia

105
Q

What type of cast would be produced during glomerulonephritis?

A

RBC

106
Q

Which type of cast would be present during kidney rejection?

A

WBC cast

107
Q

Which type of cast would be present during nephrotic syndrome?

A

fatty cast

108
Q

Which type of cast would be present during Acute Tubular Necrosis?

A

brown, granular cast

109
Q

What causes a hypercellular glomeruli?

A

mesangial proliferation

110
Q

Would PSGN be nephrotic syndrome or nephritic syndrome?

A

nephritic

111
Q

Would amyloidosis produce a nephritic or nephrotic syndrome?

A

nephrotic

112
Q

Where in the kidney does amyloidosis deposit? What is the result?

A

mesangial cells

mesangial sclerosis

113
Q

Would FSGS produce a nephritic or nephrotic syndrome?

A

nephrotic

114
Q

Would Berger Disease produce nephritic or nephrotic syndrome?

A

nephritic

115
Q

Would Diabetic Glomerulonephropathy produce a nephritic or nephrotic syndrome?

A

nephrotic

116
Q

Would minimal change disease produce a nephritic or nephrotic syndrome?

A

nephrotic

117
Q

Would Alport Syndrome produce a nephritic or nephrotic syndrome?

A

nephrotic

118
Q

Why would nephrotic syndrome produce edema?

A

loss of albumin

119
Q

Why would nephrotic syndrome produce a hypercoaguable state?

A

loss of antithrombin III

120
Q

Why would nephrotic syndrome produce an increased risk of infection ?

A

loss of immunoglobulins in urine

121
Q

How is FSGS similar to MCD?

A

effacement of foot processes

122
Q

What is the most common cause of nephrotic syndrome in AAs?

A

FSGS

123
Q

What is the most common cause of nephrotic syndrome in Hispanics?

A

FSGS

124
Q

What are the three common causes of FSGS?

A

HIV

heroin

sickle cell disease

125
Q

What is the difference between FSGS and MCD regarding their treatment?

A

FSGS doesnt respond well to steroids

126
Q

What disease would be the nephrotic presentation of SLE?

A

Membranous Nephropathy

127
Q

‘Spike and Dome’ correlates to what renal disease?

A

Membranous Nephropathy

128
Q

Membranous Nephropathy most commonly effects which patient group?

A

Caucasians

129
Q

Which antibody can drive Membranous Nephropathy?

A

anti-PLA2 receptor

130
Q

What are the two classic drugs that can cause Membranous Nephropathy?

A

NSAIDs and Penicillamine

131
Q

HBV and HCV cause what kidney disease?

A

Membranous Nephropathy

132
Q

SLE causes what type of nephrotic syndrome?

A

Memrbanous nephropathy

133
Q

Solid tumors causes what type of nephrotic syndrome?

A

membranous nephropathy

134
Q

Lipid inside of proximal tubule cells is indicative of what renal disease?

A

Minimal Change Disease

135
Q

Hodgkin disease can cause what type of kidney pathology?

A

Minimal Change Disease

136
Q

What is the stain for amyloidosis?

A

Congo red

137
Q

Amyloidosis of the kidney is associated with what three disease?

A

TB

rheumatoid

multiple myeloma

138
Q

Which kidney disease has Type I and Type II?

A

Membranoproliferative Glomerulonephritis

139
Q

What is the definition of Type I Membranoproliferative Glomerulonephritis?

A

subendothelial immune complex deposition

140
Q

What is the definition of Type II Membranoproliferative Glomerulonephritis?

A

intramembranous immune complex deposition

141
Q

Is MPGN nephritic, nephrotic or both?

A

both

142
Q

What are the two associations with Type I MPGN?

A

HBV and HCV

143
Q

What is the associative cause of Type II MPGN?

A

C3 nephritic factor

144
Q

What cell is effected during Diabetic Glomerulonephropathy?

A

Mesangial cells

145
Q

What two happenings take place to mesangial cells durnig Diabetic Glomerulosclerosis?

A

expansion

sclerosis

146
Q

What three proteins deposit during PSGN?

A

IgG/IgM/C3

147
Q

What does PSGN look like on EM?

A

Subepithelial Humps

148
Q

What are the three common presenting symptoms during PSGN?

A

HTN

hematuria

periorbital edema

149
Q

What happens to complement levels during PSGN?

A

decrease

150
Q

What happens to anti-DNase B titers during PSGN?

A

increase

151
Q

What kidney disease would Goodpasture Disease present with?

A

RPGN

152
Q

What kidney disease would Wegener Disease present with?

A

RPGN

153
Q

What kidney disease would Goodpasture Disease present with?

A

RPGN

154
Q

What kidney disease would Microscopic Polyangiitis Disease present with?

A

RPGN

155
Q

What kidney disease would Churg-Strauss present with?

A

RPGN

156
Q

What are the two most common presenting symtpoms of Goodpasture Syndrome?

A

Hematuria

Hemoptysis

157
Q

Autoantibodies in Goodpasture Syndrome are produced against what two structures?

A

Glomerular BM

Alveolar BM

158
Q

What two antibodies are present during Wegeners Polyangiitis?

A

PR3-ANCA/c-ANCA

159
Q

What two antibodies are present during Microscopic Polyangiitis?

A

p-ANCA/MPO-ANCA

160
Q

What are the two causes of Diffuse Proliferative Glomerulonephritis?

A

SLE or MPGN

161
Q

Which kidney disease is the most common cause of death in patients with SLE?

A

Diffuse Proliferative Glomerulonephritis

162
Q

What kidney disease presents with ‘Crescents’?

A

RPGN

163
Q

What are three things these crescents composed of?

A

macrophages and fibrin and plasma proteins

164
Q

What is the definition of Berger Syndrome?

A

IgA induced nephropathy

165
Q

Where in the nephron does IgA accumulate during Berger Disease?

A

Mesangium

166
Q

What disease could produce Berger Syndrome?

A

Henoch-Schonlein-Purpura

167
Q

What are the two reasons Berger Syndrome could flare?

A

GI or lung infections

168
Q

What type of collagen mutated in Alport Syndrome? Which chain?

A

type four

α-5

169
Q

What is the most common mode of inheritance for Alport Syndrome?

A

X-linked

170
Q

What are the three most common presenting symptoms of Alport Syndrome?

A

glomerulonephritis

Sensory hearing loss

Visual disturbances

171
Q

Which calcium containing kidney stone precipitates at low pH?

A

calcium oxalate

172
Q

Which calcium containing kidney stone precipitates at high pH?

A

Calcium phosphate

173
Q

What type of kidney stone would ethylene glycol cause the formation of?

A

calcium oxalate

174
Q

What type of kidney stones would Crohns disease produce?

A

Calcium oxalate

175
Q

What type of kidney stone would excessive Vitamin C produce?

A

calcium oxalate

176
Q

What are the two treatments for calcium kidney stones?

A

thiazides and citrate

177
Q

Are calcium oxalate stones radiopaque or radiolucent?

A

radiopaque

178
Q

Are ammonium magnesium phosphate stones radiopaque or radiolucent?

A

radiopaque

179
Q

Does ammonium magnesium phosphate precipitate at high pH or low pH?

A

high pH

180
Q

What two bugs clasically cause AMP stones?

A

Proteus mirabalis and Klebsiella

181
Q

Which Staph species is urease positive? What kind of kidney stone could this cause?

A

saprophyticus

AMP

182
Q

Staghorn caliculi are primarily composed of what constituent?

A

AMP

183
Q

Do uric acid stones precipitate at a high or low pH?

A

low pH

184
Q

What is the mnemonic to remember all the protease positive bugs?

A

BacK PPUNCHeS

185
Q

What is the B of BacK PPUNCHeS?

A

bacteroides

186
Q

What is the K of BacK PPUNCHeS?

A

klebsiella

187
Q

What are the two P’s of BacK PPUNCHeS?

A

Proteus

Providencia

188
Q

What is the U of BacK PPUNCHeS?

A

Ureaplasma

189
Q

What is the N of BacK PPUNCHeS?

A

Nocardia

190
Q

What is the C of BacK PPUNCHeS?

A

Cryptococcus neoformans

191
Q

What is the H of BacK PPUNCHeS?

A

H. pylori

192
Q

What is the S of BacK PPUNCHeS?

A

Staph saprophyticus

193
Q

Are uric acid stones radiopaque or radiolucent?

A

radiolucent

194
Q

What are the two risk factors for uric acid stones?

A

low urine volume

hot/arid climates

195
Q

What is the treatment for uric acid stones?

A

alkalinization of the urine

196
Q

Are uric acid stones visible on CT?

A

yes

197
Q

Are uric acid stones visible on ultra-sound?

A

yes

198
Q

Do cystine stones precipitate at low pH or high pH?

A

low pH

199
Q

Are cystine stones radiopaque or radiolucent?

A

radiopaque

200
Q

What drug is used to diagnose cystine stones?

A

sodium nitroprusside

201
Q

What is the treatment for Cystin Kidney Stones?

A

alkalinization of the urine

202
Q

What is the most common cause of hydronephrosis?

A

urinary tract obstruction

203
Q

Other than obstruction, what are two potential causes of hydronephrosis?

A

retroperitoneal fibrosis

Vesicouretal reflex

204
Q

Where in the kidney does renal cell carcinoma arise from?

A

proximal tubule cells

205
Q

What is the most common patient presentation demographic for the development of renal cell carcinoma?

A

older male

206
Q

What are two kidney specific presentations of renal cell carcinoma?

A

hematuria and polycythemia

207
Q

What are the two most common sites of renal cell carcinoma metastasis?

A

lung and bone

208
Q

What type of cell is an oncocyte?

A

epithelial cell

209
Q

What organelle does an oncocyte contain a large amount of?

A

mitochondria

210
Q

What is a renal oncocytoma?

A

benign epithelial tumor of kidney

211
Q

What is the most common presentation of a renal oncocytoma?

A

painless hematuria

212
Q

What is the treatment for a renal oncocytoma?

A

nephrectomy

213
Q

What are the four causes of transitional cell carcinoma?

A

phenacetin

smoking

Aniline dyes

cyclophosphamide

214
Q

What is the industrial risk factor for a transitional cell carcinoma?

A

aniline dyes

215
Q

Does squamous cell bladder cancer present with painless hematuria or painful hematuria?

A

painless hematuria

216
Q

Where would a person infected with Schistosoma hematobium live?

A

middle east

217
Q

What type of bladder cancer does Schistosoma haematobium cause?

A

squamous cell

218
Q

What type of bladder cancer does chronic cystitis cause?

A

squamous cell carcinoma

219
Q

What type of bladder cancer does long-standing nephrolithiasis cause?

A

squamous cell carcinoma

220
Q

What is the most common bacteria to cause cystitis?

A

E. coli

221
Q

Other than E. coli, what bacteria can cause cystitis in young, sexually active women?

A

S. saprophyticus

222
Q

Which virus can cause hemorrhagic cystitis ?

A

adenovirus

223
Q

What bug would give the urine an ammonia scent during cystitis?

A

Proteus mirabilis

224
Q

What enzyme would be present in the urine of a person suffering from acute cystitis?

A

leukocyte esterase

225
Q

Do nitrites appear for gram positive or gram negative organisms?

A

gram negative

226
Q

If a sterile pyuria is found, what two organisms should be considered?

A

Neisseria gonorrhoeae

Chlamydia trachomatis

227
Q

Pyelonephritis effects which part of the kidney?

A

cortex

228
Q

What disease can pyelonephritis transition to?

A

renal papillary necrosis

229
Q

What type of renal infection can pregnancy cause?

A

pyelonephritis

230
Q

What two conditions are most often met for acute pyelonephritis to progress to chronic pyelonephritis?

A

obstruction

vesiculouretal reflex

231
Q

Which immune cell in the urine is pathogonomic for acute interstitial nephritis?

A

eosinophil

232
Q

How long does it take for acute interstitial nephritis to develop after drug insult?

A

1-2 weeks

233
Q

Which four types of drugs can produce Acute Interstitial Nephritis 1-2 weeks after consumption?

A

penicillins

rifampin

sulfonamides

diuretics

234
Q

What drugs can produce Acute Interstitial Nephritis months after consumption?

A

NSAIDs

235
Q

What are three common presenting symptoms for Acute Interstitial Nephritis?

A

fever, rash and hematuria

236
Q

What is the main cause of Diffuse Cortical Necrosis?

A

deficient arterial perfusion

237
Q

What two causes contribute to Diffure Cortical Necrosis?

A

vasospasm and DIC

238
Q

What obstetric complication can cause Diffuse Cortical Necrosis?

A

Abruptio placentae

239
Q

What are two characteristics of the casts seen during Acute Tubular Necrosis?

A

granular and brown

240
Q

What electrolyte disturbance would be seen during the initial stage of Acute Tubular Necrosis?

A

Hyperkalemia

241
Q

Would Acute Tubular Necrosis produce metabolic alkalosis or metabolic acidosis?

A

acidosis

242
Q

Which electrolyte disturbance could a patient with Acute Tubular Necrosis present with if they are in the recovery phase?

A

hypokalemia

243
Q

Which chemotherapy drug is particularly nephrotoxic?

A

Cisplatin

244
Q

Which class of antibiotics are known to cause Acute Tubular Necrosis?

A

Aminoglycosides

245
Q

Which metal is known to cause Acute Tubular Necrosis?

A

lead

246
Q

Which kidney pathology do myoglobinuria and hemoglobinuria cause?

A

Acute Tubular Necrosis

247
Q

Which drug is known to cause Renal Papillary Necrosis?

A

long-term phenacetin

248
Q

In the normal kidney, is BUN or creatinine reabsorbed?

A

BUN

249
Q

What causes Prerenal Azotemia?

A

decreased RBF

250
Q

What are the two main causes of Intrinsic Renal Failure?

A

Acute Tubular Necrosis

RPGN

251
Q

What is cause of post-renal azotemia?

A

ostruction

252
Q

What chromosome is PKD1 on? PKD2?

A

PKD1 = 16

PKD2 = 4

253
Q

What are three associtions with ADPKD?

A

berry aneuryms

mitral valve prolapse

benign hepatic cysts

254
Q

What liver disease is ARPKD associated with? Leading to?

A

congenital hepatic fibrosis

portal HTN

255
Q

What can neonatal ARPKD lead to?

A

Potter Sequence

256
Q

What is the main use for osmotic diuretics?

A

decrease intracranial pressure

257
Q

Would acetazolamide cause the urine to become acidic or basic?

A

basic

258
Q

Whould acetazolamide cause acidosis or alkalosis?

A

acidosis

259
Q

What type of acidosis would Acetazolamide cause?

A

hyperchloremic metabolic acidosis

260
Q

What type of metabolic toxicity would Acetazolamide cause?

A

hyperammonemia

261
Q

Which of the four Syndromes can WIlsons Disease cause?

A

Fanconi Syndrome

262
Q

Expired tetracyclines are notorious for causing what disease?

A

Fanconi syndrome

263
Q

Where in the nephron does Vitamin D cause reabsorption of Calcium?

A

distal convoluted tubule

264
Q

Where in the nephron does Vitamin D cause decreased reabsorption of phosphate?

A

proximal convoluted tubule

265
Q

What are the three enzymes involved in Phase I metabolism?

A

p450

Alcohol Dehydrogenase

MAO

266
Q

What is the mnemonic to remember the causes of hyperkalemia?

A

DO Insulin LAβ

267
Q

What is the menmonic to remember the four manifestations of hypercalcemia?

A

Stones, Boans, Groans and psychiatric overTONES

268
Q

What are the two metabolic defects associated with Renal Tubular Acidosis?

A

Hyperchloremic

metabolic acidosis

269
Q

What is the definition of Renal Tubular Acidosis?

A

accumulation of acid in the body caused by inability of kidney to properly acidify the urine

270
Q

What does the pH of the urine have to be during Type I Renal Tubular Acidosis?

A

> 5.5

271
Q

What happens to the urine during Type 2 Renal Tubular Acidosis?

A

acidified by α-intercalated cells

272
Q

What type of renal tubular acidosis has an increased risk for hypophosphatemic rickets?

A

Type 2

273
Q

Which of the four renal syndromes can cause Type 2 Renal Tubular Acidosis?

A

Fanconi

274
Q

Carbonic Anhydrase Inhibitors can cause what type of Renal Tubular Acidosis?

A

Type 2

275
Q

What are the three etiologies of Type 4 Renal Tubular Acidosis?

A

Hypoaldosteronism

aldosterone resistance

K+ sparing diuretics

276
Q

Would Type 4 Renal Tubular Acidosis result in hyperkalemia or hypokalemia? pH or urine?

A

Hyperkalemia

pH

277
Q

Synthesis of what compound is deficient in Renal Tubular Acidosis? What causes the impairment? Where in the nephron?

A

Ammonia

hyperkalemia

PCT

278
Q

What are the two most common causes of angiodysplasia?

A

vWF and ESRD

279
Q

Would patients with Nephrotic Syndrome present with hyperlipidemia or hypolipidemia?

A

hyperlipedemia

280
Q

What type of specific kidney damage would interferon therapy induce?

A

FSGS

281
Q

What is the cause of Primary Amyloidosis in the kidney?

A

multiple myeloma

282
Q

What is the general cause of Secondary Amyloidosis in the kidney?

A

Autoimmne disease

283
Q

Which specific kidney disease would a decrease in levels of circulating nephritic factor be indicative of?

A

Type II Membranoproliferative Glomerulonephritis

284
Q

What type of edema is produced during Nephrotic Syndrome? Nephritic?

A

Nephrotic = Systemic

Nephritic = periorbital

285
Q

What immune cell damages the kidney during nephritic syndrome?

A

neutrophil

286
Q

Which kidney disease would produce increase in anti-DNase B titers?

A

PSGN

287
Q

Which kidney disease would produce a decrease in complement levels?

A

PSGN

288
Q

Which two kidney disease can present with both nephritic and nephrotic syndrome?

A

RPGN

DPGN

289
Q

What are the two main causes of Diffuse Proliferative Glomerulonephritis?

A

SLE or MPGN

290
Q

What are the two components of the immune complex during DPGN?

A

IgG and C3

291
Q

What are the five drugs that can cause hyperuricemia?

A

Furesomide

Thiazide

Niacin

Cyclosporin

Pyrizinamide

292
Q

Acidic pH causes what type of kidney stone to form?

A

uric acid

293
Q

What is the mnemonic for protease positive bugs?

A

BacK PPUNCHES

294
Q

What is the B of BacK PPUNCHES

A

Bacteroides

295
Q

What is the K of BacK PPUNCHES

A

Klebsiella

296
Q

What are the P’s of BacK PPUNCHES?

A

Proteus

Providencia

297
Q

What is the U of BacK PPUNCHES

A

Ureaplasma

298
Q

What is the N of BacK PPUNCHES

A

Nocardia

299
Q

What is the C of BacK PPUNCHES

A

Cryptococcus

300
Q

What is the H of BacK PPUNCHES

A

H. pylori

301
Q

What is the S of BacK PPUNCHES

A

S. saprophyticus

302
Q

What are the two intracellular accumulations of Renal Cell Carcinoma?

A

lipid and carbohydrates

303
Q

The three paraneoplastic syndromes associated with Renal Cell Carcinoma are driven by what three cytokines?

A

EPO

ACTH

PTHrp

304
Q

What two diseases produce pancreatic cysts?

A

VHL and ADPKD

305
Q

Why can chronic kidney disease produce a coagulopathy?

A

uremia doesnt allow platelets to adhere properly

306
Q

What parts of the kidney are affected by Chronic Pyelonephritis?

A

cortex and medulla

307
Q

Which five OTC drugs are notorious for causing Acute Tubular Necrosis?

A

Phenacetin

Acetominophen

Caffeine

Codeine

Aspirin

308
Q

What are the chemical reactions that take place during the Sodium Nitroprusside test for cystinuria?

A

cyanide converts cystien to cysteine

nitroprusside turns cysteine purple

309
Q

What molecule do loop diuretics stimulate the synthesis of?

A

PGE

310
Q

Where are loops toxic outside of the kidney?

A

ototoxicity

311
Q

What drug is used in the place of loop diuretics in the patients with sulfa allergies?

A

Ethacyrinic acid

312
Q

What does HTZ do to lipid levels?

A

hyperlipidemia

313
Q

What does HTZ do to glucose levels?

A

hyperglycemia

314
Q

What does HTZ do to uric levels?

A

hyperuricemia

315
Q

What does HTZ do to blood calcium levels levels?

A

hypercalcemia

316
Q

Other than amiloride, what drug is the ENaC blocker?

A

Triamterene

317
Q

Hyperaldosteronism could be caused by what type of diuretic?

A

K+ sparing diuretics

318
Q

Would spironolactone potentially cause acidosis or alkalosis?

A

acidosis

319
Q

Would hyperkalemia cause acidosis or alkalosis? Why?

A

acidosis

high activity of H+/K+ exchanger

320
Q

Would loops and thiazides acidosis or alkalosis? Why?

A

alkalosis

volume contraction causing excess aldosterone release

321
Q

Would a low potassium state be more likely to produce acidosis or alkalosis?

A

alkalosis

322
Q

In what renal situation situation would ACE Inhibitors be contraindicated?

A

bilateral renal artery stenosis

323
Q

What four diseases are associated with Horse Shoe Kidney?

A

Patau

Edward

Down

Turner

324
Q

What is the normal percentage for filtration fraction?

A

20%

325
Q

Where does PTH promote the reabsorption of Calcium in the kidney? What antiporter is used?

A

DCT

Na+/Ca2+

326
Q

What does Angiotensin Two inhibit?

A

reflex bradycardia

327
Q

Which arteriole of the kidney would constrict during NSAID overdose?

A

afferent

328
Q

What type of Renal Tubular Acidosis would chemical damage to proximal convoluted tubule cells cause?

A

Type 2

329
Q

What is recombinant BNP?

A

Nesiritdie

330
Q

What kind of cancer does Analgesic Nephropathy often cause?

A

urothelial carcinoma of renal pelvis

331
Q

In what patient population are pacreatic concretions seen?

A

alcoholics

332
Q

What is the posttranslational modification to mallory bodies?

A

poly-ubiquitinated

333
Q

What are the two causes of mixed hyperbilirubinemia?

A

hepatitis and cirrhosis

334
Q

What are the two electrolyte activities performed by β-intercalated cells?

A

absorb bicarb

secrete chloride

335
Q

Would aldosterone antagonists produce acidosis or alkalosis?

A

acidosis

336
Q

What type of epithelium lines the cysts during ADPKD?

A

cuboid epithelium

337
Q

What kidney disease has subendothelial deposits on EM?

A

DPGN

338
Q

What occurs first during Goodpastures Syndrome, pulmonary or renal symptoms?

A

pulmonary

339
Q

Why can sarcoidosis cause hypercalcemia?

A

macrophages can activate 1α-hydroxylase

340
Q

What molecule gives the glomerulus a negative charge? What part of the nephron?

A

heparan sulfate

basement membrane

341
Q

What two features does a child develop who has untreated CKD?

A

growth retardation

developmental delay

342
Q

Where in the nephron does PTH function to promote phosphate excretion? Which antiporter?

A

PCT

Na+/PO4

343
Q

Where in the nephron does medullary hypertonicity promote water absorption?

A

descending LoH

344
Q

Sodium reabsorption is coupled to the loss of which two ions? Where in the kidney does this occur?

A

potassium and H+

collecing tubule

345
Q

High sodium flow cause the reabsorption of what ion? What syndrome is this seen?

A

Ca2+

Gitelman Syndrome

346
Q

What does hypoosmolarity do to potassium levels in the blood?

A

hypokalemia

347
Q

What kidney disease presents with ‘Tram-Track’ appearance?

A

Type I MPGN

ingrowth of mesangium

348
Q

Are angiomyolipomas monoclonal or polyclonal?

A

polyclonal

349
Q

What is the most adverse effect of streptokinase therapy?

A

cerebral hemorrhage

350
Q

Why could a patient taking acetozolamide present with encephalopathy?

A

alkaline urine promotes neutral charge of ammonia and consequent reabsorption

351
Q

What drug can abolish the hypertonicity of the medulla?

A

acetozolamide

352
Q

Would hyperkalemia cause acidosis or alkalosis? Why?

A

acidosis

electrolyte exchange

353
Q

What is the equation for RBF?

A

RBF = RPF/(1-Hct)

354
Q

What type of epithelium is found in the thin descending LoH?

A

squamous

355
Q

Aldosterone upregulates which two ion transporters? Where are they located?

A

K+ channels = principal cells

H+ ATPase = intercalated cells

356
Q

Why do β-blockers cause hyperkalemia?

A

antagonize Na+/K+ ATPase

357
Q

Metastatic calcifications are primarily contributed to by what electrolyte disturbance ?

A

Hyperphosphatemia

358
Q

Why would metabolic acidosis cause a low pCO2?

A

increased respiration rate

359
Q

Why would metabolic alkalosis cause a high pCO2?

A

decreased respiratory rate

360
Q

During respiratory acidosis would pCO2 and bicarb be high or low?

A

high pCO2

high HCO3

361
Q

During respiratory alkalosis would pCO2 and bicarb be high or low?

A

low pCO2

low HCO3

362
Q

What drug is used to treat Serotonin Syndrome? What receptor does this drug antagonize?

A

Cyproheptadine

5HT2 antagonist

363
Q

What are the two drugs for Hairy Cell Leukemia?

A

cladribine

pentostatin

364
Q

Peyroinne Disease features fibrosis within what structure?

A

tunica albuginea

365
Q

What does radiolabeled inulin measure?

A

extracellular volume

366
Q

Of the ECF, how much is plasma? How much is interstitial fluid?

A

plasma = 1/4

interstitial = 3/4

367
Q

What is used to estimate ERPF?

A

clearance of PAH

368
Q

What causes a duplex collecting system?

A

duplication or ureteric bud

369
Q

Does hypermagnesia cause hypo or hyper calcium?

A

hypo

370
Q

Can malignant HTN cause RBC casts?

A

yes bitch

371
Q

Does CD55 block C3 or C9?

A

C3

372
Q

Does CD59 block C3 or C9?

A

C9

373
Q

Does Buergers Disease present in 2/3 days or 2/3 weeks?

A

2/3 days

374
Q

Does PSGN present in 2/3 days or 2/3 weeks?

A

2/3 weeks

375
Q

Would Type Two MPGN have high or low C3 levels?

A

low

376
Q

Does a Neuroblastoma or Wilms tumor cross the midline?

A

Neurolastoma

377
Q

Can bacterial toxins from pyelonephritis cause preterm labor?

A

yes