Term
| Structures developed from metanephric mesoderm |
|
Definition
| glomerulus, Bowman's capsule, PCT, LOH, DCT and distal tubule |
|
|
Term
| Structures derived from ureteric bud |
|
Definition
| Renal collecting system: collecting ducts, minor calices, major calices, renal pelvis and ureters. |
|
|
Term
|
Definition
volume of plasma from which the substance is completely cleared per unit time (mL/min).
Cx = UxV/Px |
|
|
Term
| Responsible for negative charge barrier of GBM |
|
Definition
|
|
Term
|
Definition
Freely filtered and neither secreted or reabsorbed
used to calculate GFR |
|
|
Term
| Using Creatinine to measure GFR |
|
Definition
| Slightly overestimates GFR b/c it is moderately secreted by renal tubules |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Used to measure RPF b/c it is filtered and actively secreted in the PCT so all PAH entering Kidney is excreted |
|
|
Term
| Diluting Segments of the nephron |
|
Definition
Thick ascending limb of the LOH
Early DCT |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Genetic Cause of Wilms tumor
Absent iris in the eye; may also see partial hypertrophy of a limb (one bigger than the other). Problem on Chrom 11 |
|
|
Term
|
Definition
Proteus Infx of kidney
Due to infx in kidney of urease producing bacteria proteus that breaks down urea into ammonium and precipitation of MgNH4PO4. Urin pH goes up (alkalinization) and it smells like ammonia. |
|
|
Term
|
Definition
Malignant HTN/lupus nephritis
Petichia on renal cortex due to hyperplastic arteriolosclerosis and the vessel rupture |
|
|
Term
|
Definition
Nephrosclerosis
Hyaline Areteriolosclerosis |
|
|
Term
|
Definition
Acute Drug-induced Insterstial Nephritis
eosinophils in the urine |
|
|
Term
|
Definition
Analgesic Nephropathy
Acetaminaphen (free-radical damage) + ASA (vasoconstriction) leading to ischemic damage of the renal medulla causing an empty space on a renal pyelogram where the renal papilla should be. |
|
|
Term
|
Definition
Chronic Pyelonephritis
Constant or recurrent inflamm in the kidney due to an infx causes a scar of the cortex and the lost of the concavity of the renal calyx |
|
|
Term
|
Definition
1. Acute Pyelonephritis (Neutrophils got into the renal tubules and became casts)
2. tubulointerstitial dz
3. glumerular d/os |
|
|
Term
|
Definition
Acute Tubular Necrosis
Tubes becomse ischemic, tubes undergo coagulative necrosis and the cells slough off. |
|
|
Term
| Kimmelsteil-Wilson Nodules |
|
Definition
Nodular Glomerularsclerosis
Type IV collagen build up in the mesagium of a DM pt's glomeruli |
|
|
Term
|
Definition
Lupus Nephritis
Thickening of glomerular capilary BM |
|
|
Term
|
Definition
Goodpatures
Proliferating of parietal epith cells of glom |
|
|
Term
| Hair on end appearance/ epimembranous spikes |
|
Definition
Diffuse Membranous GN
Can see immune complexes on silver stain |
|
|
Term
|
Definition
IF appearance of PSGN, IgA nephropathy, SLE nephropathy and HSP
Subepitheial Deposits |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. Nephritic Syndrome
2. ischemia
3. malignan HTN |
|
|
Term
|
Definition
Lipoid nephrosis/minimal change dz
Liver makes more cholesterol when albumin gets low in nephrotic syndrome and it gets into urine |
|
|
Term
|
Definition
|
|
Term
|
Definition
Linear IF
Goodpasture Syndrome, Wegener's and Microscopic polyarteritis
|
|
|
Term
|
Definition
Acute Poststreptococcal GN
Granular IF |
|
|
Term
|
Definition
PSGN EM
Subepith IC deposits |
|
|
Term
| Glomerular injury in Wegener's Granulomatosis |
|
Definition
|
|
Term
|
Definition
Type II HSR: Ab to alpha-3 chain of collagen IV in GBM
Nephritic Syndrome and RPGN |
|
|
Term
|
Definition
c-ANCA positive (anti proteinase)
Causes nephritic syndrome and RPGN type 3 on LM and Pauci-immune pattern on IF |
|
|
Term
RPGN/Crescentic GN
(Nephritic/Nephrotic, IF, LM) |
|
Definition
Nephritic
IF- linear
LM- fibrin deposition and proliferation of parietal epithelial cells in a crescent formation |
|
|
Term
| Diffuse Proliferative GN (ritic/rotic, LM, IF, EM) |
|
Definition
Nephritic
LM- wire-looping
EM- subendothelial DNA-anti-DNA ICs
IF- Granular |
|
|
Term
| Berger's Dz (ritic/rotic, pathogenesis, IF) |
|
Definition
= IgA glomerulopathy if just in lungs
Nephritic
ICs deposit in the mesangium and activate alternative compliment p'way.
IF- Granular |
|
|
Term
| Alport Syndrome (ritic/rotic, pathogenesis) |
|
Definition
Nephritic
Mutation in Type IV collagen that leads to split GBN |
|
|
Term
| Nephritic syndrome following a URI |
|
Definition
| Berger's dz/IgA glomerulopathy |
|
|
Term
| Nephritic syndrome w/ nerve d/os |
|
Definition
|
|
Term
| Membranous GN/Diffuse membranous glomerulopathy (ritic/rotic, LM, EM, IF) |
|
Definition
Nephrotic
LM- diffuse capillary and GBM thickening
IF- granular
EM- "spike and dome" and sub-epithelial ICs, fusion of podocytes |
|
|
Term
| MCC of adult nephrotic syndrome |
|
Definition
| Membranous GN/Diffuse membranous glomerulopathy |
|
|
Term
| SLE's nephrotic presentation |
|
Definition
| Membranous GN/Diffuse membranous glomerulopathy |
|
|
Term
| Minimal change Dz (ritic/rotic, pathogenesis, LM, EM) |
|
Definition
Nephrotic
preceded by immunization or URI; T-Cells cytokines destroy negative charge barreir to GBM leading to loss of low molecular weight proteins (albumin and transferrin)
LM- normal glomeruli
EM- foot processes effaced and fused |
|
|
Term
| Amyloidosis (ritic/rotic, LM) |
|
Definition
Nephrotic
LM- congo red stain w/ apple-green birefringence |
|
|
Term
| Glomerular injury assoc. w/ multiple myeloma, chronic conditions, TB and RA |
|
Definition
|
|
Term
| Diabetic Glomerulopathy (ritic/rotic, LM, EM) |
|
Definition
nephrotic
GBM thickening, Kimmelstiel-Wilsom nodules
EM- fusion of podocytes |
|
|
Term
| Focal Segmental Glomerulosclerosis (ritic/rotic, LM, EM) |
|
Definition
Nephrotic
LM- segmental sclerosis and hyalinosis
EM- fusion of the podocytes |
|
|
Term
| MCC of chronic renal failure in US |
|
Definition
|
|
Term
| MC glomerular dz in HIV pts |
|
Definition
| focal segmental glomerulosclerosis |
|
|
Term
| MPGN (ritic/rotic, pathogenesis, EM, IF) |
|
Definition
Nephrotic
subendothelial ICs
EM- "Tram-tracking" appearance due to GM splitting caused by mesangial growth
IF- granular |
|
|
Term
| Glomerular injury assoc. w/ HBV and HCV |
|
Definition
|
|
Term
|
Definition
| MPGN- appearance of GBM on EM due splitting. |
|
|
Term
| Sudden onset of flank pain radiating to the ipsilateral groin and hematuria |
|
Definition
|
|
Term
|
Definition
Nephrotic Syndrome
What fatty casts in UA look like under polarized light |
|
|
Term
|
Definition
| Nidus for UTIs Caused by ureas positive bact (proteus bulgaris, Staph spp., Klebsiella) |
|
|
Term
| Cuase of Ammonium magnesium phosphate (struvite)stones |
|
Definition
| infx w/ urease positive bacteria Klepsiella, Staph spp., and proteus vulgaris |
|
|
Term
|
Definition
1. Calcium phosphate/oxalate
2. Ammonium magnesium phosphate (struvite)
3. Uric Acid
4. cysteine |
|
|
Term
| Alkalinization of urine and kidney stones |
|
Definition
| treats cysteine stones, worsens ammonium magnesium phosphate stones and calcium oxalate stone |
|
|
Term
| Radio opacity of kidney stones |
|
Definition
Calcium stones opaque
Ammonium magnesium phosphate stones can be either opaque or lucent
cysteine stones are faintly opaque
uric acid stones are lucent |
|
|
Term
|
Definition
|
|
Term
| yellow or reddish brown crystals |
|
Definition
|
|
Term
| crystals seen in acidic urine |
|
Definition
|
|
Term
| rhomboid or rosette crystals |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| ammonium magnesium phosphate crystals |
|
|
Term
| crystals in alkaline urine |
|
Definition
| Ammonium magnesium phosphate crystals |
|
|
Term
| Urinary tract cancers assoc. w/ smoking |
|
Definition
| RCC or transitional cell carcinoma |
|
|
Term
| Clinical preseation of RCC |
|
Definition
1. hematuria
2. fever
3. flank pain
4. palpable mass
5. 2o polycythemia
6. weight loss |
|
|
Term
| Paraneoplastic syndromes assoc. w/ RCC |
|
Definition
1. ectopic EPO
2. Ectopic ACTH
3. PTHrP
4. Prolactin |
|
|
Term
| Associated genetics of RCC |
|
Definition
1. VHL
2. deletion on chrom 3 |
|
|
Term
|
Definition
| polygonal cells w/ small nuclei and abundant cytoplasm |
|
|
Term
| MC renal malignancy ages 2-4 |
|
Definition
|
|
Term
| Presentation of Wilm's Tumor |
|
Definition
|
|
Term
|
Definition
| deletion of tumor suppressor gene WT1 on Chrom 11 |
|
|
Term
| MC cancer of the urinary tract system |
|
Definition
| Transitional Cell carcinoma |
|
|
Term
| Presentation of Transitional cell carcinoma |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diffuse Cortical necrosis |
|
Definition
caused by vasospasm and DIC
assoc. w/ obstetric catastrophes (abruptio placentae) |
|
|
Term
| sx of drug-induced interstitial nephritis |
|
Definition
1. fever
2. rash
3. eosinophilia
4. hematuria
all 2 wks after administration |
|
|
Term
| Drugs assoc w/ drug-induced interstitial nephritis |
|
Definition
| NSAIDS, PCN derivatives, diuretics |
|
|
Term
| MCC of acute renal failure in hospitals |
|
Definition
|
|
Term
| Pathogenesis of Renal Papillary necrosis |
|
Definition
| sloughing of renal papillae |
|
|
Term
| presentation of renal papillary necrosis |
|
Definition
gross hematuria and proteinuria assoc. w/:
1. DM
2. Acute pyelonephritis
3. Chronic phenacetin use
4. SS anemia |
|
|
Term
| Diuretic that can cause Type I HSE rxn and alternative in same class |
|
Definition
Acetazolamide, Furosemide and HCTZ (both have sulfa groups)
Can use ethacrynic acid as alternative to furosemide |
|
|
Term
| Diuretic that increases calcium excretion |
|
Definition
|
|
Term
| Diuretic that causes Ototoxicity |
|
Definition
|
|
Term
| Diuretic that can cause gout |
|
Definition
| Furosemide (ethacrynic acid may be used however) |
|
|
Term
| diuretic that decreases Calcium excretion |
|
Definition
|
|
Term
| Diuretic that causes metabolic acidosis |
|
Definition
|
|
Term
| Diuretic that can cause hypokalemia |
|
Definition
|
|
Term
| Diuretic assoc. w/ hyperglycemia, hyperlipidemia, hyperuricemia and hypercalcemia |
|
Definition
|
|
Term
| Diuretic assoc. w/ hyponatremia |
|
Definition
|
|
Term
| Diuretic assoc. w/ metabolic alkalosis |
|
Definition
|
|
Term
| Affect of diuretics on Urine NaCl |
|
Definition
|
|
Term
| affect of diuretics on urine K+ |
|
Definition
| increases except K-sparing (spironolactone, amiloride, triamterene, eplerenone) |
|
|
Term
| Affect of diuretics on blood pH |
|
Definition
acidemia: CA inhibitors
alkalemia: loop diuretics and thiazides |
|
|
Term
| diuretics that cause contraction alkalosis |
|
Definition
| Loop diuretics and thiazides |
|
|
Term
| mechanism of acidemia for K-sparing diuretics |
|
Definition
| diuretic induced hyperkalemia causes an intracellular shift of K+ in exchange for H+ |
|
|
Term
| mechanism of alkalemia for thiazides and loop diuretics |
|
Definition
| diuretic-induced hypokalemia causes a extracellular shift of K+ in exchange for H+ |
|
|
Term
|
Definition
low volume status -> ↑ATII → ↑ proximal Na/H exchange → ↑HCO3- reabsorption
|
|
|
Term
|
Definition
| in low K+ state (caused by most diuretics except spironolactone), H is exchanged for Na in the principal cell instead of K causing the urine to be acidified even though these diuretic have simultaneously caused alkalemia |
|
|
Term
| Diuretics that cause hypercalciuria |
|
Definition
| Loop diuretics abolish the lumen positive potential in the thick ascending limb → ↓ paracellular Ca reabsorption → hypocalcemia and ↑ urinary Ca |
|
|
Term
| Diuretics that cause hypocalciuria |
|
Definition
Thiazides
Block of luminal Na/Cl cotransport in DCT → ↑ Na gradient ↑ interstitial Na/Ca → hypercalcemia/hypocalciuria |
|
|
Term
| Affects of ACE inhibitors on Renin |
|
Definition
| Increase because loss of feedback inhibition |
|
|
Term
| side effects of ACE inhibitors |
|
Definition
1. hyperkalemia
2. Cough
3. Angioedema
4. proteinuria
5. Rash |
|
|
Term
| pre-renal cause(s) of kidney damage |
|
Definition
| Low RPF (hypotension, e.g.) |
|
|
Term
| Intrinsic causes of acute renal failure |
|
Definition
|
|
Term
| Post-renal causes of Acute Renal Failure |
|
Definition
Outflow obstruction (stones, BPH, neoplasia)
Usually in bladder or urethra, b/c would need bilateral kidney obstruction for acute injury to occur |
|
|
Term
| BUN/Cr ratio in pre-renal AKI |
|
Definition
| ↑ because kidney senses low blood flow and attempts to increase it's solute reabsorption to compensate. Urea reabsorption goes up as a result. |
|
|
Term
| BUN/Cr ration in intrinsic causes of AKI |
|
Definition
| ↓ because the kideny's ability to reabsorb urea is impaired |
|
|
Term
|
Definition
FeNa= excreted Na/Filtered Na
= (UNa/PNa)/(Ucr/Pcr) x 100
|
|
|
Term
| Fanconi's Syndrome definition |
|
Definition
| ↓ prox. tubule transport of AA, phosphate, glucose, uric acid, protein and e'lytes. |
|
|
Term
| complications of Fanconi's Syndrome |
|
Definition
Rickets (from ↓ PO4 reabsorption)
Metabolic acidosis (from ↓ HCO3 reabsorption)
↓ K+ (from ↓ prox Na reabsorption causing |
|
|
Term
|
Definition
| Berry aneurysms (from HTN), polycystic liver dz, and MVP |
|
|
Term
|
Definition
| Adult w/ flak pain, hematuria, HTN, UTI and progressive renal failure |
|
|
Term
|
Definition
| multiple, large, bilateral cysts that destroy parenchyma. Enlarged kidneys. |
|
|
Term
| Conditions assoc. w/ ARPKD |
|
Definition
| Hepatic cysts and fibrosis |
|
|
Term
| Lysosomal storage dz that results in renal failure |
|
Definition
|
|
Term
| Missing alpha-glactosidase A |
|
Definition
Fabry's dz
Lysosomal storage dz that leads to build up of ceramide trihexose
pts die of renal and heart failure |
|
|
Term
| inability to metabolize ceramide trihexose |
|
Definition
Fabry's dz (deficiency in alpha-galactosidase A)
pts die of renal and heart failure |
|
|
Term
| drug(s) assoc w/ renal toxicity |
|
Definition
| Aminoglycosides, acyclovir (IV high doses), and amphotericin B |
|
|
Term
|
Definition
|
|
Term
| Vasculitis-assoc. causes of MPGN |
|
Definition
1. HSP
2. lupus vasculitis |
|
|
Term
| "Full House" Appearance on IF |
|
Definition
Lupus Nephritis
Caused by depositions of all classes of immunoglobulins and complement: IgG, IgM, IgA, C3, C4, C1q
Granular |
|
|
Term
| Pauci-immune pattern on IF |
|
Definition
Wegener's Granulomatosis
Caused by c-ANCA Ab binding to PMNs in glomeruli leading to glomerular damage
No immune complexes seen hens "pauci" |
|
|
Term
|
Definition
1. Dense-Deposit Dz (MPGN 2)
2. IgA glomerulopath/Berger's Dz
3. PSGN |
|
|
Term
|
Definition
Dense Deposit Dz
Auto-Ab that binds to C3 Convertase and prevents its degredation so it is constantly breaking down C3
Leads to activation of alternative P'way and low C3 |
|
|
Term
| Location of Action of ADH |
|
Definition
| Medullary Collecting Ducts |
|
|
Term
| Location of action of Aldo |
|
Definition
| cortical collecting ducts |
|
|
Term
|
Definition
|
|
Term
| Drug assoc. w/ ototoxicity |
|
Definition
1. Aminoglycosides
2. Vancomycin
3. Cisplatin
4. salicylates
5. Loop diuretics (furosemide) at IV high doses |
|
|
Term
| Net excretion of a substance |
|
Definition
| = (GFR)(PX)- tubular reabsorption of X |
|
|
Term
|
Definition
< 2g/24 hr
Not assoc w/ renal dz
Caused by fever, exercise, CHF |
|
|
Term
|
Definition
Only happens when standing (not supine)
No proteinuria in morning/first void of day
No progression to renal dz |
|
|
Term
|
Definition
MCD
Loss of negative charge barrier of GBM (heparin sulfate)
Loss of low molecular weight proteins like albumin and transferrin |
|
|
Term
| Renal site of action for PTH |
|
Definition
|
|
