Term
| The glomerular filtration barrier includes the fenestrated endothelial cells lining the glomerular capillary, the basement membrane, and podocyte foot processes with slit diaphragm made from what molecules? |
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Definition
| Nephrin, which interacts with CD2AP, and Actinin-4 cytoskeleton |
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Term
| Proteinuria greater than 300mg/day can be transient, othrostatic, or fixed, which is a marker of renal disease? |
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Definition
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Term
| Name this disease heavy proteinuria, death in first two years of life, mutated NPHS1, tx with transplant? |
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Definition
| Congential nephritic syndrome |
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Term
| What is the most common cause of nephrotic syndrome in kids? |
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Definition
| Minimal change nephr syndrome, often responds dramatically to steroids, relapsing, shows fusion of podocytes |
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Term
| What is best size and charge for moleulce to pass kidney? |
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Definition
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Term
| What is the diff btw incidence and prevalence of disease, and which type of study is used for each? |
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Definition
| Incidence is the number of new cases in a time period, cohort; prevalence is the active cases at a single point in time, cross-sectional . |
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Term
| What is the difference between internal and external validity of study? |
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Definition
| Internal relates to patients in study, ext to population at large |
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Term
| What is the diff btw cohort and case control study? |
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Definition
| Both assess over time, but cohort looks how exposure affects outcomes, while case-control is retrospective in looking at outcomes and then regresses to exposures |
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Term
| Systematic error is due to bias, but what are the two types of random error due to (Type 1 or 2)? |
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Definition
| Type 1 is risk of finding through chance, type 2 is risk of not finding through chance |
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Term
| What are the approximate volumes of ICV and ECV? |
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Definition
| ECV=1/3 of which 1/3 is plasma and 2/3 is interstitial volume, ICV=2/3 |
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Term
| In the extrarenal circulation there is predominance of arterial vasodilation, that results in reduction of total systemic vascular resistance and arterial hypotension. |
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Definition
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Term
| In heptaorenal syndrome what is the purpose of the TIPS procedure? |
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Definition
| To stent the portal vein to the hepatic vein causing redistribution of splanchnic blood to central volume |
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Term
| In heptaorenal syndromw what works better renal vasodilators or spplanchnic vasoconstrictors? |
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Definition
| Vasocontrictors like octreotids and midodrine |
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Term
| What is the best indicator for body osmolaltiy? |
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Definition
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Term
| What is pseudohyperkalemia? |
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Definition
| Leuko/thrombocytosis cause excessive release of K during blood clotting or hemolysis |
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Term
| Which of the following are cuases for hypoaldosteronism, which in turn leads to hyperkalemia - hyporenin hypoaldosterone, adrenal insufficiency, NSIADS, ARBS, ACEI, heparin, B-blockers, spironolactone, eplenerone, aldactone? |
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Definition
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Term
| What are the following EKG findings seen in - peaking T waves, flattened P waves, prolongation of PR interval, widening QRS, v. fib or cardiac arrest? |
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Definition
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Term
| Name two drugs that can drive extracellular K+ into cells? |
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Definition
| Insulin and B-agoinsts that activate Na/K pump; digoxin, b-blockers, and low insulin block that movement |
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Term
| When is pseudohypokalemia seen? |
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Definition
| In cellular upatake of K+ in vitro, profound leukocytosis |
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Term
| Both the ___________ or __________ are contiguous with glomerular arterioles. |
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Definition
| Mesangium or basement membrane |
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Term
| Do mseangial cells contract, secrete biologic markers, and have phago capability? |
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Definition
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Term
| In glomerular nephropathy what is hyalinosis? |
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Definition
| Entrapped plas,ma proteins in areas of scarring |
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Term
| On histo exam, cellular proliferation in bowmans space of macros, PMNS, epithelial cells are called _______. |
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Definition
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Term
| How can glomerular cell loss cause interstitial fibrosis? |
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Definition
| Efferent arterioles carry blood to tubules so loss of cells causes tubular ischemia, causing interstitial inflammation, and proteinuria causes damage to tubular epithelial cells. |
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Term
| Membranous glomerularnephritis/nepropathy is the most common cause adult NephrOtic syndrome induced by drugs, malign, infection, SLE. What is NephrOtic? |
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Definition
| Massive proteinuria (>3,5g/day), hyperlipidemia, edema, hypoalbuminemia. |
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Term
| Name some common causes of nephrotic syndrome. |
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Definition
| Membranous nephropathy, diabetic glomerulopathy, amyloidosis, minimal change disease, FSGS, membranoproliferative glomerulonephritis. |
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Term
| What is seen on Light microscopy silver stain, IF, and EM in membranous nepropathy? |
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Definition
| Silver stain shows GBM thickening, IF shows subepithelial granular deposits of IgG, EM shows subepithelial spikes and domes |
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Term
| Name this cause of nephrotic syndrome - most common in children, post-infectious, LM is normal glomers, lipoproteins in proximal epithelial cells, EM shows foot process loss, responsive to steroids. |
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Definition
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Term
| Name this cause of neprhotic syndrome - more common in HIV, blacks, obese, hematuira and HTN, injury to visceral epithelial cells except IF and EM negative for immune complex, high recurrence rate even with transplant, segemental sclerosis and hyalinosis. |
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Definition
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Term
| What are the signs of NephrItic syndrome? |
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Definition
| Inflammatory process involving glomers leading to hematuria, oliguria, azotemia, HTN, proetinuria <3.5, RBC casts |
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Term
| What is oliguria and azotemia? |
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Definition
| Reduced urine output and high blood nitrogen compounds like urea and creatinine |
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Term
| Name this cause of nephritic syndrome - increased IgA, immune complexes deposit in mesangium with proliferation, most common glomer disease, seen in asian and Hispanics, seen in young post upper respiratory infection, hematuria, can be part of henoch schonlein purpura syndrome or neprotic synd. |
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Definition
| Bergers disease aka IgA nephropathy |
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Term
| Name this cause of nephritic syndrome - mutation in type 4 collagen causes nerve, renal, ocular, and oto disorders, variable inheritance, EM shows split basement membrane basket weave pattern. |
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Definition
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Term
| Name this cause of nephritic syndrome - LM and IF shows >50% CRESCNETS ( ruptured basement mem with fibrin in bowmans space); 3 types - Anti-GBM showing type 2 hypersens linear IgG IF seen in Goodpatures disease (lung involvement), immune complex mediated where plasma pharesis doesnt help, and Pauci-immune that is ANCA positive seen with Wegeners or polyateritis |
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Definition
| Rapidly progressive glomerulernephrtitis that has poor prognosis |
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Term
| Name this cause of neprhtic syndrome - post infectious, mostly children, resolves spontaneously, LM shows hypercellular glomers with neutrophils, supeipthelial lumpy bumpy appearance on EM, IgG granular on IF. |
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Definition
| Acute post b-hemolytic strep proliferative GN |
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Term
| Most acute kidney injury is pre-renal (2/3) what are some common causes? |
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Definition
| Volume loss, cardiogenic shock, CHF, liver disease, nephritic synd, renovscaulr thrombosis |
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Term
| When considering the fraction of excreted sodium and creatinin in AKI what indicated pre-renal and renal causes for them? |
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Definition
| <1% prerenal, >2%renal for Na, and <35%prerenal, >35%renal for Cr |
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Term
| Name this cause of acute kidney injury - loss of tubular cell polarity, epithelial cell detachment, granular muddy casts, reversible if treated with dialysis, associated with ischemia, crush injury, toxins (aminoglycosides, amphotericin B, myoglobin), stages include inciting event then oliguria then recovery. |
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Definition
| ATN; ATN and pre-renal azotemia is 80% of AKI |
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Term
| What is acute tubulointerstitial nephritis? |
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Definition
| Acute inflammatory injury at least 5 days after crystal drug admin(antiviral, ethylene glycol, tumor lysis), causes fever, rash, eosinos, hematuria, and WBC casts. |
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Term
| Which of the following indicate CKD - small kidneys, anemia, renal osteodystrophy, tolerance of azotemia? |
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Definition
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Term
| If you check the skin and find livedo reticularis patterns what does that indicate? |
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Definition
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