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Renal
New set 2023 UWORLD only
| Question | Answer |
|---|---|
| What type of medication should be avoided in pts with bilateral RAS? | ACE Inhibitor |
| Why are ACE inhibitors closely monitored in pts with bilateral RAS? | Bilateral RAS pts depend on AT-II induced efferent vasoconstriction to maintain GFR, which is disrupted by ACE-inhibitors |
| What are the associated conditions due to insulin that led to hypokalemia? | Tx of DKA and Refeeding syndrome |
| What are two sympathomimetics known to cause hypokalemia? | Albuterol and Dobutamine |
| What are the causes of GI loss that lead to hypokalemia? | Diarrhea, vomiting and Hyperaldosteronism |
| Where is Potassium mostly stored? | Intracellularly through the action of Na+/K+-pumps |
| What is the simplistic definition of Rhabdomyolysis? | Release of intracellular muscle contents due to myocyte injury |
| What are muscle contents released in Rhabdomyolysis? | Myoglobin and electrolytes |
| Heme pigment is: | Form of myoglobin after it is degraded by the kidney |
| What nephrotic disease is due to the release of Heme pigment? | ATN |
| How is myoglobinuria diagnosed? | (+) blood or urine dipstick in the absence of blood cells on microscopic UA |
| What is Cardiorenal syndrome? | Complication of decompensated HF cycle, in which the back pressure for the heart --> ↑ renal venous pressure -----> ↓↓ GFR |
| What are the common lab findings of prerenal azotemia? | BUN:Cr > 20:1 Low urine Na+ (<20 mEq/L) Low FeNa+ (<1%) High urine osmolarity and specific gravity |
| Are thiazides associated with development of metabolic acidosis or metabolic alkalosis? | Metabolic alkalosis |
| Which type of diuretics are most prone to cause hyponatremia, loops or thiazides? | Thiazides |
| Are loops or TZDs more common to cause hypokalemia? | Loop diuretics |
| What fails to fuse in congenital Horseshoe kidney? | Metanephros |
| Which vessel prevents the caudal migration of the horseshoe kidney? | IMA |
| What are the EM findings in Membranous nephropathy? | Irregular, subepithelial, electron-dense immune deposits on the GBM with moderate podocyte foot effacement. |
| What are the IF findings in Membranous nephropathy? | Diffuse granular pattern of IgG along the capillary loops |
| Is Membranous nephropathy EM deposits, subepithelial or subendothelial? | Subepithelial |
| What is an example of a weak diuretic that blocks reabsorption of Na+ and HCO3- in the PCT? | Acetazolamide |
| What are the effects of Acetazolamide? | ↑↑ urine pH mild Metabolic ACIDOSIS with compensatory respiratory alkalosis hypokalemia hypocalcemia |
| What are the overall results of the compensatory mechanisms to hypovolemia? | ↑ renal Na+, Cl-, water, and urea reabsorption + ↑↑ K+ excretion. |
| The ↑ RAAS, leads to ↑aldosterone and _____________ release. | Endothelin |
| What is the MC type of RCC? | Clear cell carcinoma |
| What is the origin of Clear Cell carcinoma? | Epithelial cells of the PCT |
| What is the gross histopathologic description of Clear cell carcinoma? | Sphere-like mass composed of golden-yellow cells (high lipid) w/ areas of necrosis and hemorrhage |
| What are the causes of stress incontinence? | 1. ↓ urethral sphincter tone 2. Urethral hypermobility |
| What are the associated symptoms of stress incontinence? | Leakage with coughing, sneeze, and lifting |
| What is the cause of Urge incontinence? | Detrusor overactivity |
| How is Urge incontinence described by pts? | Sudden, overwhelming urge to urinate |
| What are the 2 causes of Overflow incontinence? | 1. Impaired detrusor contractility 2. Bladder obstruction |
| How are the symptoms in Overflow incontinence? | Incomplete emptying and persistent involuntary dribbling |
| What forms the bladder trigone? | 2 slit-like uretic orifices and the internal ureteral opening |
| What is suggested in a patient with blood in the Uretic orifice? | Upper urinary tract bleeding in the kidney |
| What is a common cause for an upper urinary tract bleed? | Renal Papillary necrosis |
| How do the kidneys compensate metabolic acidosis due to DKA? | Completely reabsorbing filtered HCO3- and excreting excess H+ in the urine |
Created by:
rakomi
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