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RENAL

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resexuwe's version from 2017-07-28 19:27

RENAL

Question Answer
Which part of the nephron concentrates urine?Medulla
What is the course of the ureter?The ureter passes under the uterine artery and under the deferens?
What is the 60/40/20 rule?60% total body water, 40% ICF, 20% ECF
What is Goldblatts kidney?Flea bitten kidney (blown capillaries)
What is Uremia?Azotemia + symptoms
What is Azotemia?Increase BUN/Cr
What is Nephritic Kidney disease?Increase Size of fenestration -> Vasculitis
What is Nephrotic Kidney disease?Lost BM charge due to deposition on heparinsulfate -> Massive proteinuria and lipiduria
What is seen in RPGN?Cresents
What is Post- Strep GN?Subepithelial, IgG/ C3/C4 deposition, ASO Ab
What is Interstitial Nephritis?Urine Eosinophils or eosinophilic casts
What is lupus nephritis?Subepithelial
What is Membrano-glomerulonephritis?"Deposition of something"
What is Membrano-proliferative Glomerulonephritis?Tram-Tracks(type II has low C3)
What is Minimal change disease?Kids, Fused foot processes, no renal failure, loss of charge barrier
What is FSGSAA, HIV pts
What are the vasculitis w/ low C3?PMS in Salt lake city -> Post-strep GN, Mpgn Type II, Sbe, Serum Sickness, Lupus, Cryoglobulinemia
What is the most common cause of kidney stones?Dehydration
What are the most common type of kidney stones?Calcium Phosphate
What type of Kidney stones have coffin-lid crystals?Triple Phosphate
What type of Kidney stones have rosette crystals?Uric Acid
What type of kidney stones have hexagonal crystals?Cystine
What type of kidney stones have envelope or dumbbell shaped crystals?Oxalate
What disease has Aniridia?(absence of iris)Wilms tumor
What disease has Iridocyclitis? (inflammation of uvea)Juvenile rheumatoid arthritis
What is Phimosis?Foreskin scarred at penis head (foreskin stuck smooshed up)
What is Paraphimosis?Foreskin scarred at penis base (retraction of foreskin -> Strangulates penis)
What is Urge incontinence?Urgency leads to complete voiding -> ~detrustor spasticity -> small bladder vol)
What is stress incontinence?Weak pelvic floor muscles (estrogen effect)
What is overflow incontinence?Runs down leg but cant complete empty of bladder
What structures have one way valves?Urethra, ejaculatory duct
What structures have fake sphincters?Ureters, LES, Ileocecal valve
What has WBC casts?Nephritis
What has WBC casts only?Pyelonephritis (Sepsis)
What has WBC casts + eosinophils?Interstitial nephritis (allergies)
What has WBC casts 9 RBC casts?Glomerulonephritis
What has fat casts?Nephrotic syndrome
What has waxy casts?Chronic renal failure
What has tubular casts?ATN
What has Muddy brown casts?ATN
What has Hyaline casts?Normal sloughing
What has epithelial casts?Normal sloughing
What has crescents?RPGN
How do you measure afferent renal function?Creatinine (or inulin)
What do you measure, efferent renal function?BUN (or PAH)
What is the afferent arteriole job?Filter
What happens if you constrict the afferent arteriole?RPF & GFR goes down, FF(GFR/RPF) stays the same
What is efferent arterioles job?Secrete
What happens if you constrict the efferent arteriole?RPF goes down, GFR goes, FF(GFR/RPF) goes up
How do you test afferent arteriole function?GFR
What is normal GFR?100 mL /min
How do you test efferent arteriole function?RPF
What happens if you increase plasma protein concentration?RPF stays unchanged, GFR goes down, FF(GFR/RPF) goes down
What happens if you decrease plasma protein concentration?RPF stays unchanged, GFR & FF(GFR/RPF) goes up
What is pre-renal failure?Low flow to kidney (BUN-> Cr >20)
What is renal failure?Damage to glomerulus (BUN -> Cr <20)
What is post-renal failure?Obstruction (havent peed in last 4 days)
What is the job of the proximal tubule?Reabsorb glucose, amino acids, salt, and bicarb
What is the job of the thick ascending limb?Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water
What is the job of the early distal tubule?Concentrate urine by reabsorbing NaCl (hypotonic)
What is the job of the late distal tubule and collecting duct?Final concentration of urine by reabsorbing water, excretion of acid
What does the macula dense do?Measures osmolarity
What does the J-G apparatus do?Measures Volume
What is Fanconis syndrome?Babt w/ defective triple transporter (low Na, Cl, K, w/normal BP)
What is psychogenic polydipsia?No concentrating ability -> cerebral edema
What is hepatorenal syndrome?High urea from liver -> Increase activity of glutaminase -> NH4 -> GABA -> Kidney stops working
What is Type 1 RTA?Distal renal tubular acidosis -> H/K in CD is broken -> High urine pH (UTI, STONES, Li)
What is Type 2 RTA?Proximal RTA -> bad Ca -> Lost all bicarb -> Low urine pH (Multiple Myeloma)
What is Type 3 RTA?RTA I+II -> Normal urine pH (5-6)
What is Type 4 RTA?Infarct J-G -> no renin -> no aldo -> High K (DM, NSAIDS, ACE-I, Heparin)
Chronic PyelonephritisWBC's, Blunted & scarring of calyces Thyoridization of Kidney
UrethritisBurning on urination
CystitisPain, frequency, urgency
PyelonephritisCostovertebral angle tenderness, flank pain, wbc cast
memorize

DERMATOLOGY

 

Question Answer
What are 1st degree burns?Red (Epidermis)
What are 2nd degree burns?Blisters (hypodermis)
What are 3rd degree burns?Painless neuropathy (dermis)
What diseases have “Palm & Sole” rashes?“TRiCKSSS” (1) Toxic Shock Syndrome, (2) Rocky mountain spotted fever, (3) Coxasacki A: Hand-Foot-Mouth disease, (4) Kawasaki – CAD problem, (5) Scarlet fever, (6) Staph Scaled Skin, (7) Syphilis
What is Erythema Multiforme?Target lesions (viral, durgs)
What is Steven Johnson Syndrome?Erythema Multiforme Major (mouth, eyes, vagina)
What is Toxic Epidermal Necrolysis?Steven Johnson w/ Skin sloghing
What is Pemphigus Vulgaris?Ab against Desmosomes → circular immunofluorescence, in Epidermis, oral lesions, (+) positive Nikolsky sign
What is Bullous Pemphigoid?Ab against Hemidesmosomes → linear immunofluresence, subepidermal, “floating” keratinocytes, eosinophils
What is Eczema?Dry flaky dermatitis in flexor creases “itch that rashes”
What is Nummular dermatitis?Circular eczema
What is Spongiotic eczema?Weeping eczema: Scratching causes oozing “like a sponge”
What is Lichenification?Scratching → thick leathery skin
What is Pityriasis Rosea?Herald patch that follows skin lines (Tx: Sunlight) “Christmas-tree pattern”
What is Lichen Planus?Polygonal pruritic purple papules
What is Scabies?Linear excoritation “Burrows” in webs of fingers, toes, belt line (Sarcoptes scabiei)
What does UV-A cause?Aging
What does UV-B cause?Burns & Cancer
What are the ABCD's that indicate worse prognosis of skin cancer?(1) Asymmetric, (2) Irregular Boarders, (3) Color difference, (4) >4mm in Diameter
What does the Clark level tell you?Invasion of melanoma
What does Breslow's classification tell you?Depth of melanoma
Where are Malignant Melanomas usually found?(1) Males → Back, (2) Females → Legs
What is the precursor of a Malignant Melanoma?Hutchinson's freckle
What are the types of Malignant Melanomas?(1) Superficial Spreading → most common, “Flat-Brown”, (2) Nodular → Worst prognosis, black, dome-shape, (3) Lentigo maligna melanoma → elderly pts, fair-skin, (4) Acral lentigous → AIDS pts, dark skin
Where are Squammous Cell Carcinomas usually found?Flat flaky stuff on lower face, KERATIN pearls
What is the precursor of Squamous Cell Carcinoma?Actinic Keratosis (red scaly plaque)
What are the types of Squamous Cell Carcinoma?(1) Bowen's disease → SCC in situ on uncircumcised penis dorsum, (2) Verrucous Carcinoma → Wart on foot
What are Basal Cell Carcinomas usually found?Pearly papules on upper face, palisading nuclei, good prognosis
What are the types of Basal Cell Carcinomas?(1) Nodular → Waxy nodule w/ central necrosis, (2) Superficial → red scaly plaques, like eczema, (3) Pigmented → looks like melanoma, (4) Sclerosing → yellow waxy plaques
What is Acne Rosacea?Blush all the time, worse w/ stress/ alcohol
What is a Brown Recluse Spider Bite?Painful black necrotic lesion
What is Cellulitis?Warm red skin
What is Cutaneous Anthrax?Painless black necrotic lesion
What is a Decubitus Ulcer?Bedsore
What is a DVT?Blood clot in veins, associated w/ hypercoagulable state
What is Erysipelas?Shiny red, raised, does not blanch, usually on face, associated with Strep. Pyogenes
What is Ichtyosis?Gradual lizard skin
What is Miliaria?“Heat rash” → buring, itching papules on trunk
What is Molluscum Contagiosum?Fleshy papules w/ central “dimple”, Pox virus (can be STI)
What is Psoriasis?Silver Scales on extensors, nail pitting, differentiated too fast, worse w/ stress. (1) Auspitz Sign: Remove scale → pinpoint bleeding, (2) Koebner's phenomenon → lesions at sites of skin trauma
What is a Pyogenic Granuloma?Vascular nodule at site of previous injury
What is Seborrheic Dermatitis?Dandruff in eyebrows, nose, behind ears
What is Seborrheic Keratosis?Rubbery warts with aging, (greasy warts look)
What is Thrombophlebitis?Vein inflammation w/ thrombus
What is Vitiligo?White patches, (anti-melanocyte Ab)
What is Xeroderma Pigmentosa?Bad DNA repair
What is Erythema Chronicum?Lyme disease (solitary lesion that spreads)
What is Erythema Infectiosum?Fifth disease “Slapped cheeks” due to “Parvovirus-B19”
What is Erythema Marginatum?Rheumatic Fever (red margins)
What is Erythema Multiforme?Target lesions due to HSV, Phenytoin, Barbs, Sulfas
What is Erythema Multiforme Major?Steven Johnson Syndrome (>1 mucosal surface)
What is Erythema Nodosum?Fat inflammation (painful red nodules on legs), Sarcoidosis
What is Erythema Toxicum?Newborn benign rash (looks like flea bite w/ eosinophils)
memorize

MUSCLE

Question Answer
Where is CK-MB found?Heart
Where is CK-MM found?Muscle
Where is CK-BB found?Brain
Why should you wait 30min after a meal before swimming?All blood in gut and skeletal muscle have ran out of ATP
How does a neurogenic muscle disease present?Distal weakness + fasiculations
How does a myopathic muscle disease present?Proximal weakness + pain
What is a light chain composed of?Actin
What is a heavy chain composed of?Myosin
What band of the sarcomere does not change length?A band
Where are the T-tubules located?(1) Cardiac muscle → Z line, (2) Skeletal muscles → A-I junction
What is DMD?“Dystrophin frameshift”, Gower sign, Calf Pseudohypertrophy
What is Becker's MD?Dystrophin missense, symptoms > 5 y/o
What is Myotonic Dystrophy?(1) Bird's beak face, (2) Can't let go when shake hand
What is Mysthenia Syndrome = Lambert-Eaton?Gets stronger as day goes by, stronger with EMG, not small cell carcinoma associated
What is Myasthenia Gravis?1) Gets weaker as day goes, 2) stronger with Endrophonium, 3) weaker with EMG, 4) rule out “Thymoma”
What is Multiple Sclerosis?Anti-myelin Antibodies, Young women with vision problems, S/E comes and go
What is Metachomatic Leukodystrophy?(1) Arylsulfatase deficiency, (2) kid with MS presentation
What is Ataxia Telangectasia?(1) Spider Veins, (2) IgA deficiency
What is Freidrich's ataxia?(1) Retinitis Pigmentosa, (2) Scoliosis
What is Adrenal Leukodystrophy?(1) Carnitine shuttle problem, (2) adrenal failure
What is Guillane-Barre?Ascending paralysis, 2 week after URI
What is ALS?Middle-age male w/ fasiculations, descending paralysis, no sensory problems
What is Werdnig-Hoffman?Fasciculations in a newborn, no anterior horns
What is Polio?Asymmetric fasiculations in child, 2 weeks after gastroenteritis
What is Choreoathetosis?Dance-like movements, wringing of hands, quivering voice
What is Atonic Cerebral Palsy?No muscle tone, Floppy
memorize