thyazide like diuretics
(metalic laser gun→)metolazone
(Indian→)indapamide
(colorful salad→)chlorthalidone
(water baloon→)hypertension&edematous states
(sippy cup→)nephrogenic diabetes insipidus
(milk bottle→)kidney stone
(bone→)osteoporosis
(candy bar→)hyperglycemia
(butter→)hyperlipidemia
(red rash→)sulfa allergy
hyperuricemia,hypercalcemia,hypokalemic metabolic alkalosis pharmacologyrenal May 31, 2019, 5:01 AM HirotoShishido
indications for acute dialysis in DICAIUEO
Acidosis refractory to bicarbonate
Intoxcation with some drugs
Uremic symptoms(eg. cardiac friction rub,altered mental status)
Electrolyte abnormality(especially potassium)
volume Overload refractory to diuretics renal May 31, 2019, 7:12 AM HirotoShishido
nephrotic syndrome+thrombmembolic eventsdue to renal losses of antithrombin Ⅲ,protein C,protein S renal May 28, 2019, 10:44 PM HirotoShishido
pathogenesis of Goodpasture synd
+risk factorstype Ⅱ hypersensitivity reaction targetting α3chain in collagenⅣ forming glomerular and alveolar basement membrane
genetic:HLA-DR15
environmental:infection,smoking,oxidative stress,hydrocarbon-based solvents(as in dry cleaning industry)→damage α4,α5 chains in collagen Ⅳ and expose α3 renal May 25, 2019, 6:46 AM HirotoShishido
HIV infection, heroin abuse,sickle cell disease renal May 27, 2019, 7:28 AM HirotoShishido
angiotensin Ⅱ and prostagrandins effects to renal arteriolesPDA and ACE
Prostagrandins Dilate Afferent arteriole
Angiotensin Ⅱ Constricts Efferent arteriole renal May 27, 2019, 7:02 AM HirotoShishido
the most common cause of nephrotic synd in children
cause, diagnosisminimal change disease
often 1° (idiopathic)
2° to lymphoma(cytokine mediated damage)
LM→normal glomeruli
IF→−
EM→effacement of podocyte foot process renal May 26, 2019, 1:37 AM HirotoShishido
the cause of diabetic glomerulo-nephropathy
diagnosishyperglycemia→nonenzymatic glycation of tissue proteins→hyaline arteriosclerosis→obstruction of blood flow(in efferent arteriole)→arteriole dialation(afferent arteriole)→hyperfiltration→albumiuria→decreased filtration→renal failure
LM→mesangial expansion, GBM thickning,eosinophilic
nodular glomerulosclerosis(Kimmelstiel-Wilson lesions) renal May 26, 2019, 1:56 AM HirotoShishido
thyroidization of kidneychronic pyelonephritis may show tubules containg eosinophilic casts resembling thyroid tissue renal May 11, 2019, 7:19 AM HirotoShishido
