Nephrology Notes for USMLE

NEPHROLOGY EMBRYOLOGY Pronephros: week 4, degenerates Mesonephros: 1st trimester, then becmes ma!e genita!ia Metanephros: a""ears in # th week and becmes kidne$s

Ureteric bud %mesne"hric bud %mesne"hric ca&da! d&ct'  &reter, "e!(is, ca!$ces, c!!ecting d&cts Metaphric mesenchyme: mesenchyme: ind&ced t )rm g!mer&!&s  *+ b$ -B interactin  .berrant interactin interactin ca&ses cngenita! cngenita! ma!)rmatin ma!)rmatin e/g/: m&!tic$stic d$s"!astic kidne$: &ni!atera! nn)&cntina! nn)&cntina! kidne$ cnsisting ) c$sts and cnnecti(e tiss&e, with h$"ertr"h$ ) ther kidne$/ 



-reter"e!(ic -reter"e!(ic 0&nctin is !ast t cana!ise and is a cmmn site ) bstr&ctin Ptter e2&ence Rena! )ai!&re  O!igh$dramnis !eading t 1/ cm" cm"re ress ssi in n ) ) )et )et&s &s 3/ "&!m "&!mn nar ar$ $ h$" h$""! "!as asia ia / )acia! )acia! abnrma abnrma!iti !ities es %!w set ears ears and retrg retrgnath nathia' ia' 4/ !imb !imb de) de)r rmi miti ties es Psterir &rethra! (a!(e, .RP5*, bi!atera! rena! agenesis 

Hrseshe kidne$ 6&sin ) in)erir "!es ) ) kidne$s and )ai!&re t ascend )rm "e!(is "e!(is %st&ck &nder in)erir mesenteric mesenteric arter$' 7 &ret &reter er" "e! e!(i (ic c 0&nc 0&ncti tin n bst bstr& r&ct cti in n 7 h$drne"hrsis 7 rena! stnes 7 8i!m9s t& t&m&r   -RNER9 YN*ROME

 .N.OMY  .N. OMY

-REER  .t risk in "e!(ic s&rger$ s&rger$ 7 riginat riginate e at "e!(is "e!(is and and tra(e tra(e!! in retr"eri retr"eritne tne&m &m n n t" t" ) "sas "sas 7 crss crss &nder &nder the the gna gnada! da! r r &terin &terine e (esse! (esse!s s and (as (as de)e de)eren rens s 7 crs crss s (er (er ete etern rna! a! i!ia i!iacs cs 7 !ie media! media! t t gnad gnada! a! (esse! (esse!s s and and !atera! !atera! t intern interna! a! i!iac i!iac (esse!s (esse!s

PHY;OLOGY G!mer&!ar )i!tratin barrier   )i!ters n charge %he"arin s&!"hate basement basement membrane' and si
Electrolyte disturbance Na+ K+

Ca+

High

Low

Na&sea, ma!aise, st&"r, cma - wa(es n E+G 6!attened  wa(es  .rrh$thmia M&sc!e weakness etan$, sei<&res = "r!ngatin "r!ngatin

;rritabit!it$, st&"r, cma

Mg+

etan$ rsade de Pintes

PO

Bne Bne !ss !ss,, st ste ema ma!a !aci cia a

8ide =R Peaked  wa(es  .rrh$thmias M&sc!e weakness tnes Bne "ain  .bdmina! "ain "ain  .!tered menta! stat&s Red&ced *Rs Letharg$ Brad$cardia, h$"tensin, cardiac arrest H$"ca!caemia Rena Rena!! st sten ens, s, meta metast stat atic ic ca!c ca!ci) i)ic icat ati in, n, h$"ca!caemia