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Renal

New set 2023 UWORLD only

QuestionAnswer
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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