Juan Shared "Boards: RENAL" - 114 Picmonics

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Boards: RENAL

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
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Blood Acid-Base Control
Characteristics
In a State of Acidemia
Medullary Chemoreceptors Control Ventilation Rate
Expulsion of CO2 through Lungs Increases pH
Bicarbonate Reabsorption from the Kidney Increases pH
Kidney Excretion of H+ Increases pH
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2 mins
Blood Glucose Lab Value
70-100 mg/dL
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25 secs
Collecting Duct
Characteristics
Na+ Reabsorption via Passive Transport
Vasopressin Causes Water reabsorption
Concentrates Filtrate
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2 mins
Distal Tubule
Characteristics
Hormonally Regulated
Aldosterone Causes Na+ Reabsorption
Na+ Reabsorbed Via Active Transport
Water follows Na+
Parathyroid Hormone Causes Ca2+ Reabsorption
Leads to Collecting Duct
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1 min
Dopamine
Indications
Heart Failure
Shock
Unstable Bradycardia
Mechanism of Action
Alpha 1 Agonist (at high doses)
Beta-1 Agonist
Dopamine 1 and 2 Agonist
Induces Vasoconstriction
Side Effects
Arrhythmias
Nausea and Vomiting
Kidney Damage
Gangrene
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3 mins
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
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2 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
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1 min
Gitelman Syndrome
Pathophysiology
Autosomal Recessive
Defective Sodium-Chloride Cotransporter in Distal Tubule
Mechanism Mimics Thiazide Diuretics
Clinical Presentation
Cramping and Tetany
Severe Fatigue
Polyuria
Diagnosis
Hypokalemia
Metabolic Alkalosis
High Urine Chloride
Treatment
Electrolyte Supplements
Spironolactone
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5 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
Liddle Syndrome
ETIOLOGY
Autosomal Dominant
Occur in children
Pathophysiology
Beta and Gamma subunits in ENaC Channel mutations
SCNN1B and SCNN1G gene mutation on Chromosome 16p
Clinical Manifestations
Hypertension
Diagnosis
Hypokalemia plus Metabolic Alkalosis
Decreased Renin and Decreased Aldosterone
Treatment
Amiloride
Triamterene
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Loop of Henle
Characteristics
Descending Limb
Water Follows Na+
Medullary Hypertonicity
Increased Water Reabsorption
Vasa Recta
Na+ Reabsorbed Via Active Transport
Ascending Limb
Reabsorbs Na+, K+, Cl-
Decreased Concentration of Filtrate
Impermeable to Water
Distal Tubule
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2 mins
Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl)
95 to 105 mEq/L
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2 mins
Parathyroid Gland
Characteristics
Blood Calcium Sensor
Parathyroid Hormone
Bone Resorption
Blood Calcium Increases
Vitamin D Activation
Calcium Absorption From The Small Intestine
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1 min
Proximal Tubule
Characteristics
Na+ Reabsorbed Via Active Transport
Water Follows Na+
Most Of Glucose Reabsorbed
Most Of Amino Acids Reabsorbed
Bicarbonate Exchanged For H+
Drugs and Toxins Excreted
Filtrate Osmolarity Same As Plasma
Leads To Loop Of Henle
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2 mins
Renal Corpuscle
Characteristics
Arterioles
Glomerulus
Capillaries
Fenestrations
Plasma Solutes and Other Small Molecules Become Ultrafiltrate
Bowman's Capsule Encapsulates Glomerulus
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2 mins
Renin-Angiotensin-Aldosterone System
RAAS Activators
Hypotension
Decreased NaCl delivery to Macula Densa
Increased Sympathetic Tone (Beta-1 receptors)
Renin Effects
Juxtaglomerular Cells release Renin
Renin converts Angiotensinogen to Angiotensin I
Angiotensin Converting Enzyme (ACE)
Kidneys and Lungs produce ACE
ACE breaksdown Bradykinin
Angiotensin II
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2 mins
Renin-Angiotensin-Aldosterone System - Effects of Angiotensin II
Effects in CNS
Hypothalamus Increases Thirst
Posterior Pituitary Releases Vasopressin
Effects in adrenal gland
Adrenal gland releases Aldosterone
effects in kidney
Increases Na+/H+ activity in PCT
effections on efferent arteriole
Efferent Arteriole Vasconscriction
effects on blood pressure
Induces Vasoconstriction
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3 mins
Sodium (Na+) Lab Value
135-145 mEq/L
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24 secs
Vitamin D Metabolism/Mechanism
Mechanism Of Action
Ergocalciferol (Vitamin D2)
Plant Sources
Cholecalciferol (Vitamin D3)
Sunlight Conversion in Skin
7-Dehydrocholesterol
Liver Hydroxylation
25-(OH) D (25-hydroxyvitamin D)
Storage Form
Kidney Hydroxylation
1,25-(OH)2 D (1,25-dihydroxyvitamin D)
Active Form Calcitriol
Absorbs Calcium and Phosphorus in Intestine
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4 mins

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