in the collecting duct - gain of function mutation - only one thats AD - you get increased activity of Na channel (more absorption of Na) - metabolic alkalosis, hypoK, hypertension, low aldosterone - it looks like primary hypoaldosteronism, but the aldosterone is undetectable

Renal Flashcards by Amelia Kellar

What is POTTER sequence?

Can’t pee in utero- oligohydramnios

pulmonary hypoplasia
oligohydramnios
twisted face
twisted skin
extremity defects
renal failure
low set ears and retrognathia, flattened nose

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What affects the metanephric mesenchymal differentiation?

interaction with the ureteric bud
-if you get this you can get multicystic dysplastic kidney, usually unilateral and nonfunctional, but if bilateral then you get POTTER sequence

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what is a duplex collecting system?

the ureteric bud bifuricates befor it interacts with the metanephric blastema
-higher risk UTIs and reflux

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what does the ureter go over and under anatomically?

goes under the gonadal arteriesm over the common iliac artery then under the uterine artery
-gyne procedures can damage the ureter

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how do you calculate the clearance of a substance?

Cx=UxV/Px, if CxGFR, then net secretion and if they are equal then theres no reabsorption or secretion

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what is the normal GFR?

100ml/min, can calculate with Uinulin because not absorption or secreted

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effective renal plasma flow calculation?

is estimated by PAH, because 100% should be excreted

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how do you estimate the filtration fraction?

GFR/RPF, normal FF 20%

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what do prostaglandins and angiotensin 2 due to the afferent and efferent arterioles?

prostaglandins dilate afferent arteriole

angiotensin 2 constricts the efferent arteriole

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fractional excretion of sodium?

UNa x V (flow)/GFR xPNa

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What is Fanconi syndrome?

PCT reabsorption issue, so excretion HCO3, glucose, PO4, can get osteopenia, metabolic acidosis, hypophosphatemia

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What is Bartter syndrome?

affects thick ascending loop of henle,- Na/K/2Cl pump- looks like chronic use of loop diuretics so you can get metabolic alkalosis, hyperca, hypoK

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Gitelman syndrome?

DCT, looks like chronic thiazide diuretic use- get metabolic alkalosis, hypoCa, hypoMg, hypoK

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Liddle syndrome?

in the collecting duct

gain of function mutation
only one thats AD
you get increased activity of Na channel (more absorption of Na)
metabolic alkalosis, hypoK, hypertension, low aldosterone
it looks like primary hypoaldosteronism, but the aldosterone is undetectable

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Syndrome of apparent mineralocorticoid excess

hereditary deficiency in 11B-hydroxysteroid dehydrogenase

too much cortisol , increased mineralocorticoid activity
metabolic alkalosis, hypoK, hypertension
actually have low aldosterone because cortisol is trying to be aldosterone
tx with K sparing diuretic and steroids, exogenous steroids will dec endogenous secretion

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What are ANP and BNP?

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ANP-atria
BNP-ventricles
-secreted when high volume, relax vascular smooth muscle so inc GFR and decrease renin, dilate afferent and constrict efferent

where is 25OH vit d converted to 1,25 OH vit d?

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PCT by 1-alpha hydroxylase (PTH increases 1 alpha hydroxylase)

What is winters formula?

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predicted respiratory compensation

PCo2=1.5 (HCO3) + 8 +/-2

What are causes of non-anion gap metabolic acidosis?

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HARDASS-hyperailmentation, addisons disease, renal tubular acidosis, diarrhea, acetozolamide, spironolactone and saline infusion

Whats the difference between type 1 and type 4 distal renal tubular acidosis?

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type 1- alpha intercalated cell dysfunction, pH>5.5, because can’t secrete H, hypokalemia
type 4- hypoaldosteronism-ph urine <5.5 b/c secreting H to compensate, hyperkalemia

What is the maltese cross sign?

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oval fatty casts- nephrotic syndrome

what causes nephrotic syndrome?

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