Extras Flashcards

1
Q

Aldosterone acts WHERE

A

cortical collecting duct

principal cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most sodium resorbed where

A

65% PCT
25% LOH
10% DCT and CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PLA2 actually expressed where

A

podocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

reduced podocyte levels in diabetes correlates with

A

risk prog diabetic nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Klotho expression in CKD

A

reduced- less responsive to FGF23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

factors in membranous nephropathy that predict progression CKD

A
renal function off at baseline
male 
over age 50
increase degree and duration proteinuria
hypertension
biopsy showing tubuloint fibrosis, stage 3 or 4, 
non asian
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

podocyte foot effacement seen in

A

minimal change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ANP acts on which bit of nephron

A

medullary collecting duct to inhibit sodium reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

BK nephropathy RF

A

female donor
use ATG
older recipient
DR mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment BK nephropathy
(urine and blood PCR positive, biopsy show tubulitis, interstitial infiltrate lymphocytes, intranuclear inclusion bodies)

A

reduce overall immunosupression
leflunomide (antiviral as well as pyrimidine synth inhibitor)
IV cedofovir maybe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when would you consider bicarb for contrast induced neph prevention

A

when urgent CT and do not have the 12 hours pre-scan, bicarb is probably non inferior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

heart failure AND proteinuria, think

A

AL amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common presentation of dialysis related amylodiosis

A

carpal tunnel
shoulder pain
Thy cystic lesions at the end of long bones contain amyloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why do you hold metformin before and after contrast?

A

If there is deterioration in renal function, then will be at higher risk of lactic acidosis, NOT because there is increased risk lactic acidosis

on the other hand,
ACEi and ARB, diuretics, NSAIDS DO increase risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what type of transplant is most likely to give you PTLD?

A

bowel
heart lung

10-20% each

liver next
then lung
kidney only 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PTLD treatment

A

reduce immunosupresssion
next line ritux
no antivirals work

17
Q

Uveitis and interstitial nephritis, think

A

acute tubuloint nephritis with uveitis syndrome

HLADQA1 DQB1 and DRB1

18
Q

FSGS after renal transplant- what does it look like?

A

hours to days- massive proteinuria
or
late- insidiously years to months

give high dose ARB, ACE, statins
immunosupression increase
most commonly try plasmapheresis or immunoadsorption with protein A
can try ritux if no response to plasmapheresis

19
Q

COX2 inhib use assoc with which GN

A

minimal change

20
Q

MPGN on

  • light
  • immuno
  • EM
A

Light: diffuse thickening capillary walls, mesangial hypercellularity
IF: coarse granular pattern along capillaries
EM: large discreet electron dense supendothelial deposits

21
Q

For every 100 patients given tac instead of CycA…

A

2 fewer graft loss
12fewer rejectons
5 extra cases DM

22
Q

Benefits of mTOR over CNI

A
not nephrotoxic alone
malignancy- def reduced skin cancers
reduced CMV - definite
early on there is more rejection- only swap after a few months
increased graft survival 
better renal function 
but MORE proteinuria 

When conversion from a CNI to an mTOR inhibitor is performed late, the patient has GFR

23
Q

When picking a kidney, is matching or Ab level most important?

A

levels ab

24
Q

Tac does what to your hair

A

alopecia

25
Q

What cells in urine suggest BK nephropathy?

A

Decoy cells

also look for EM- bug
and IHC- SV70 antigen

26
Q

Which GN cause does not really reccur

A

post strep GN

27
Q

which is highest risk of recurrence
which is highest risk failure

GN

A

recurrence MPGN

failure IgA

28
Q

Which transplant med does NOT increase risk DM

A

MMF