Janani Shared "Z Renal" - 43 Picmonics
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Z Renal
Oligohydramnios
- Decreased Amniotic Fluid
- Etiologies
- Renal Agenesis (Fetal Urinary Tract Abnormalities)
- Uteroplacental Insufficiency
- Premature Rupture of Membranes (PROM)
- Diagnosis
- Ultrasound
- Amniotic Fluid Index (AFI) < 5 cm
- Complications
- Spontaneous Abortion
- Pulmonary Hypoplasia
- Musculoskeletal Abnormalities
- Intrauterine Growth Restriction (IUGR)
- Treatment
- Treat Underlying Cause
- Delivery (When Viable)
2 mins
Polyhydramnios
- Pathophysiology
- Increased Amniotic Fluid
- Causes
- Duodenal Atresia (or Gastrointestinal Atresias)
- Maternal Diabetes
- Multiple Gestations
- Anencephaly
- Hydrops Fetalis
- Diagnosis
- Ultrasound
- Amniotic Fluid Index (AFI) > 25 cm
- Treatment
- Weekly Nonstress Test (NST) and Biophysical Profile (BPP)
- Amnioreduction
- Indomethacin
3 mins
Fanconi Syndrome Characteristics
- Pathophysiology
- Resorption Defect in Proximal Tubule
- Signs and Symptoms
- Hypophosphatemia
- Rickets
- Osteomalacia
- Hypokalemia
- Metabolic Acidosis
- Type 2 Renal Tubular Acidosis
- Treatment
- Treat Underlying Disorder
- Bicarbonate
1 min
Fanconi Syndrome Causes
- Hereditary Causes
- Cystinosis
- Dent's Disease
- Wilson's Disease
- Oculocerebrorenal (Lowe) Syndrome
- Galactosemia
- Hereditary Fructose Intolerance
- Glycogen Storage Diseases
- Tyrosinemia
- Acquired and Medication Causes
- Tenofovir
- Heavy Metals
- Expired Tetracyclines
- Cisplatin
- Gentamycin (Aminoglycosides)
- Valproate Sodium
- Multiple Myeloma
2 mins
Bartter Syndrome
- Autosomal Recessive
- Defective Na+/K+/2Cl- Co-transporter
- Thick Ascending Limb Of Loop Of Henle
- Secondary Hyperaldosteronism
- Symptoms
- Polyuria
- Polydipsia
- Hypokalemia
- Metabolic Alkalosis
- Hypercalciuria
- Treatment
- NSAIDS
- Potassium Sparing Diuretics
Gitelman Syndrome
- Metabolic alkalosis
- Gitelman syndrome causes a hypokalemic metabolic alkalosis
- Hypomagnesemia
- Genetic mutation
- Loss-of-function mutation of the thiazide-sensitive sodium chloride symporter
- Signs & Symptoms
- Hypocalciuria
21 secs
Liddle Syndrome (Pseudoaldosteronism)
- Autosomal Dominant
- Constitutively Active ENaC
- Hypertension
- Hypokalemia
- Metabolic Alkalosis
- Low Aldosterone (vs. Hyperaldosteronism)
- Tx. = Amiloride and Triamterene
Syndrome of Apparent Mineralocorticoid Excess
- Hereditary deficiency of 11Beta-hydroxysteroid dehydrogenase
- Excess cortisol
- Hypertension
- Hypokalemia
- Metabolic Alkalosis
- Low serum aldosterone
- Can acquire disorder from glycyrrhetinic acid
- Corticosteroids
Normal Gap Metabolic Acidosis
- HARD-ASS
- Hyperalimentation
- Addison's Disease
- Renal Tubular Acidosis
- Diarrhea
- Acetazolamide
- Spironolactone
- Saline Infusion
2 mins
Anion Gap Metabolic Acidosis
- Pathophysiology
- Increased Anion Gap
- MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis (DKA)
- Propylene Glycol
- Isoniazid or Iron
- Lactic Acid
- Ethylene Glycol
- Salicylates
1 min
Winter's Formula
- Evaluates Respiratory Compensation
- Used in Metabolic Acidosis
- Equation
- (HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
- Steps
- Bicarbonate (HCO3) x 1.5
- + 8
- ± 2
- = Expected Value for PCO2
2 mins
Renal Tubular Acidosis
- Hyperchloremia
- Type 1 RTA
- Type 1 RTA
- Urine pH >5.5
- Kidney stones
- Defect in hydrogen secretion
- Bicarbonate treatment for Type 1
- Type 2 RTA
- Type 2 RTA (Fanconi Syndrome)
- urine pH <5.5
- Thiazide treatment for Type 2
- Type 4 RTA
- Type 4 RTA
- Urine pH
- Aldosterone resistance
- Hyperkalemia
- Treatment
- Fludricortisone treatment for Type 4 RTA
Congenital Cystic Kidney Pathology
- Multicystic Dysplastic Kidney (MCDK)
- Ureteric Bud failure to induce Metanephros
- Dysplasia: Inc. Collagen, Connective Tissue
- Proximal Ureter Atresia
- If B/L --> Oligohydramnios --> POTTER
- Medullary Sponge Kidney (MSK)
- Cysts: Alpha-intercalated Cells in Collecting Duct
- Recurrent Kidney Stones
- Medullary Cystic Kidney Disease (MCKD)
- MCKD1: MUC1 mutation | MCKD2: UMOD mutation
- Autosomal Dominant
- presents in Adulthood
- Tubulointerstitial Fibrosis + Corticomedullary Cysts --> Glomerular Sclerosis --> ESRD
- Hyperuricemia, Polyuria, Salt Wasting
- Nephronophthisis
- presents in Childhood
- Autosomal Recessive
- NPHP1: Ciliary dysfunction --> Tubular atrophy, Hepatic fibrosis, Situs Inversus
- presents like MCKD
Autosomal Dominant Polycystic Kidney Disease (ADPKD)
- Begins at 20-25
- Tubular epithelium
- Most common symptom is flank pain
- PKD1
- Chromosome 16
- More severe disease
- 80-85% of disease
- Renal Failure at 55
- PKD2
- Chromosome 4
- Renal failure at 75+
- Ca2+ Receptors
Acute Interstitial Nephritis
- penicillin
- TMP-SMX
- cephalosporins
- NSAIDS
- clinical signs
- Maculopapular rash
- fever
- eosinophils/ WBCs in urine
- Diuretics
Renal Papillary Necrosis Causes
- POSTCARDS
- Pyelonephritis
- Obstruction of Urogenital Tract
- Sickle Cell Disease
Hypertension & kidneys
- Hypertensive nephrosclerosis
- Uncontrolled essential HTN (benign)
- cobblestone, shrunken kidneys
- Malignant hypertension
- flea bitten kidney
Nephrotic Syndrome
- Signs and Symptoms
- Massive Proteinuria > 3.5g per Day
- Edema
- Increased risk of infection
- Thromboembolism
- Hyperlipidemia
- Fatty casts
1 min
Minimal Change Disease
- Pathophysiology
- Nephrotic
- Most Common in Children
- May be Triggered by Recent Infection or Immune Stimulus
- Diagnosis
- On Electron Microscopy (EM) See Foot Process (Podocyte) Effacement
- On Light Microscopy (LM) See Normal Glomeruli
- Loss of Negative Charge
- Selective Loss of Albumin
- Treatment
- Responds to Corticosteroids
2 mins
Focal Segmental Glomerulosclerosis
- Most Common Cause of Nephrotic Syndrome in Hispanic People and African Americans
- Associated with Sickle Cell Disease and HIV
- Associated Interferon Therapy and Heroin Abuse
- Histopathology
- LM Segmental Sclerosis and Hyalinosis
- EM Focal Damage of Visceral Epithelial Cells
- IF Negative
- Signs & Symptoms
- Microscopic Hematuria
- Nonselective Proteinuria
- Considerations
- Poor Prognosis
2 mins
