Term
| JG apparatus -- what's it made of, where do the cells come from, what do they do? |
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Definition
JG cells -- modificed SM of afferent arteriole, monitor BP/beta1 innervation, secretes RENIN!!
macula densa -- modified epithelium of distal renal tubule (TAL), monitor Na+ in TAL, stim JG cells |
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Term
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Definition
under gonadal vessels
over common/external iliacs
between gonadal (lateral) and internal iliacs (medial)
under uterine artery/vas deferens |
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Term
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Definition
total body weight
60% total body water
2/3 intracellular, 1/3 extracellular (inulin)
1/4 plasma (RISA), 3/4 interstitial |
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Term
| glomerular filtration barrier |
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Definition
1. fenestrated endothelial cells (size barrier)
2. fused BM with heparan sulfate (charge barrier)
3. podocytes |
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Term
| creatinine GFR vs. true GFR |
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Definition
| creatinine slightly overestimates because some is secreted |
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Term
| PRF from PAH vs. true PRF |
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Definition
| PAH underestimates ~10% b/c doesn't measure flow to areas that don't filter or secrete PAH |
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Term
normal values
blood osmolality
GFR
FF
RBF percent of CO |
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Definition
290
100
FF = 20%
RBF = 25% of CO |
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Term
effect on arterioles
prostaglandins, NO, D1, bradykinin, alpha1, adenosine, ATII, ANP |
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Definition
prostaglandins, NO, D1, bradykinin -- dilate afferents
alpha1, adenosine (macula densa) -- constrict afferents
ATII, ANP -- constrict efferents |
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Term
| FF in same direction as GFR except... |
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Definition
afferent arteriole constriction
decrease GFR, no change in FF (since RPF also decreases) |
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Term
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Definition
| PCT problem --> can't absorb glucose, AAs, phosphorus, bicarb |
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Term
| where is most water reabsorbed? high ADH? low ADH? |
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Definition
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Term
| relative concentrations along PCT |
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Definition
diagonal lines up -- PAH, Cr, inulin
horizontal at 1 -- Na, K
down to zero -- AAs, glucose
others up -- urea, Cl
others down -- HCO3, Pi |
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Term
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Definition
constrict efferent arteriole --> increased GFR AND compensatory increase in reabsorption --> no volume loss
general vasoconstriction AND affects barorecptor function --> limited reflex bradycardia |
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Term
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Definition
constrict efferent arteriole --> increased GFR, but no compensatory increase in reabsorption --> diuresis
general vasodilation |
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Term
| where epo is made? where vit D is activated? |
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Definition
epo -- tubular interstitial cells (peritubular capillary lining cells of cortex)
vit D -- proximal tubule cells |
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Term
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Definition
#1 low blood volume!!!
#2 osmolarity |
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Term
effects on K
insulin, beta agonists, acidosis, hyperosmolarity, dig |
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Definition
insulin -- into cells
beta agonist -- into cells
acidosis -- out of cells
hyperosmolarity -- out of cells (with water)
dig -- out of cells |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| neuromuscular irritablity, arrhythmias |
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Definition
|
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Term
|
Definition
| pCO2 = 1.5 * HCO3 + 8 +/- 2 |
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Term
|
Definition
resp acidosis -- 1, 3.5
resp alkalosis -- 2, 5
for each 10 change in pCO2 |
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Term
|
Definition
|
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Term
|
Definition
MUDPILES
Methanol
Uremia
DKA
Paraldehyde, Phenformin
Iron/INH
Lactic acidosis
Ethylene glycol (oxalate crystals)
Salicylates |
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Term
|
Definition
type 1 -- "distal", CDs can't excrete H+ (also impaired citrate excretion --> kidney stones); urine pH always > 5.5
type 2 -- "proximal", PCT can't reabsorb HCO3 (also impaired PO4 absorption --> hypophosphatemic rickets); urine pH can go < 5.5
type 4 -- hyperkalemic (hypoaldo or lack response to aldo) |
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Term
|
Definition
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Term
|
Definition
rapidly progressive GN
made of cells + FIBRIN!! |
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Term
|
Definition
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Term
|
Definition
diffuse proliferative GN
membranoproliferative GN, type I |
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Term
|
Definition
post-strep GN
membranous GN |
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Term
|
Definition
| membranoproliferative GN, type II |
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Term
|
Definition
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Term
|
Definition
| membranoproliferative GN, type I |
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Term
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Definition
| post-strep GN (nml C4), SLE (low C4), membranoprolif GN type II (nml C4) |
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Term
| causes of diffuse proliferative GN (3) |
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Definition
SLE (worst kind for SLE)
MPGN
bacterial endocarditis |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| immune complex mediated kidney disease |
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Definition
post-strep GN
diffuse proliferative GN
Berger's disease
membranous GN
membranoproliferative GN |
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Term
| complications of nephrotic syndrome (3) |
|
Definition
thromboembolism
hyperlipidemia
infection
DIC?!?! |
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Term
|
Definition
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Term
| causes of membranous GN (5) |
|
Definition
drugs -- gold salts, penicillamine
infections -- Hep B, syphilis, malaria
SLE
solid tumors
idiopathic -- antibodies to PLA2R on podocytes!! |
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Term
| causes of membranoproliferative GN, type I |
|
Definition
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|
Term
| causes of membranoproliferative GN, type II |
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Definition
| C3 nephritic factor (IgG that stabilizes C3 convertase --> low C3, normal C4) |
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Term
| "Kimmelstiel-Wilson lesion |
|
Definition
| diabetic glomerulonephropathy |
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Term
| swollen, enlarged, hypercellular, bloodless glomeruli |
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Definition
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Term
| pH that stones precipitate in |
|
Definition
| all low pH EXCEPT ammonium magnesium phosphate (and calcium phosphate) |
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|
Term
kidney stone shapes
calcium oxalate, ammonium magnesium phosphate, uric acid, cystine |
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Definition
calcium oxalate -- back of envelope
ammonium magnesium phosphate = struvite = infection = triple-phosphate -- coffin lid, staghorn calculi
uric acid -- football
cystine -- hexagonal |
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Term
| Crohn's and kidney stones |
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Definition
| terminal ileus involvement --> decreased bile acid absorp --> bile acids bind Ca2+ --> more free oxalate --> more oxalate absorbed --> more calcium oxalate stones |
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Term
| sodium cyanide-nitroprusside test |
|
Definition
cystine stones
treat with acetazolamide to alkalinize the urine!! |
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Term
| polygonal clear cells (what is it, derived from what cell, associated with what syndrome) |
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Definition
RCC
proximal tubules!!
von Hippel-Lindau |
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Term
|
Definition
Beckwith-Wiedemann (WT2)
WAGR (WT1)
Denys-Drash (WT1) |
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Term
| associated with transitional cell cancer |
|
Definition
Pee SAC
Phenacetin
Smoking
Aniline dyes
Cyclophosphamide
rubber, plastics, textiles, leather factories!! |
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Term
|
Definition
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|
Term
| diffuse cortical necrosis (what is it, what conditions cause it) |
|
Definition
cortical infarction of both kidneys
vasospasm + DIC
placental abruption, pre-eclampsia, septic shock |
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Term
| ATN -- phases and what to watch for, which part of tubules |
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Definition
1. inciting event
2. maintenance -- hyperkalemia!!
3. recovery -- hypokalemia!!
PCT and TAL |
|
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Term
| causes of papillary necrosis (4) |
|
Definition
1. DM
2. acute pyelo
3. sickle cell
4. phenacetin use + ASA/other analgesics |
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Term
| findings in renal failure (Na/H2O, K, HCO3, lipids) |
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Definition
Na/H2O retention
hyperkalemia
metabolic acidosis (first non-gap, then gap)
high lipids, esp. TGs |
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Term
|
Definition
nausea, anorexia, metallic taste
fibrinous pericarditis
asterixis
encephalopathy
platelet dysfunction (nml count, PT, PTT) |
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Term
| associations with ADPKD (3) |
|
Definition
polycycstic liver disease
berry aneurysms
MVP |
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Term
| associations with ARPKD (1) |
|
Definition
| congenital hepatic fibrosis --> portal HTN |
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Term
|
Definition
|
|
Term
| medullary cystic disease associated with |
|
Definition
kidney stones!!
infection |
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|
Term
| renal failure after renal transplant (~3 wks) |
|
Definition
1) acute rejection -- lymphocytic infiltrate
2) drug toxicity (tacrolimus, cyclosporin) --> ATN-like |
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Term
| prognosis of post-strep GN |
|
Definition
good!
better if younger AGE!! |
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Term
| minimal change disease triggers |
|
Definition
| recent infection, immunization, allergic reaction/immune stimulus |
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|
Term
| hypovolemia -- RPF, GFR, FF |
|
Definition
| RPF down down; GFR down; FF up |
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|
Term
| acute interstitial nephritis |
|
Definition
F, rash, oliguria 1-2 wks after starting med (diuretics, NSAIDs, penicillins, sulfonamids, rifampin)
eosinophils |
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