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KUB - Coggle Diagram

- - - - Most Absorb & Secrete
        
        Reabsorb
        
        Glucose
        
        Amino acid
        
        HCO3-
        
        Na+,Cl-,PO3-,K+
        
        Secret
        
        NH3
        
        NH4+
        
        H+
        by Na+/H+ ex; ATII stimulate
        
        H2PO4- (Titrable acid)
      - Fanconi syndrome
        
        Cause by Wilson disease, Cisplatin, Tenofovir, Lead poisoning
        
        Unreabsorb HCO3-
        
        Metabolic acidosis (proximal renal tubular acidosis)
    - - Passive Water osmosis by concentration gradient
    - - NKCC2
        
        Na+, K+, 2Cl-
      - Mg2+, Ca2+ by Inducing K+ from NKCC2
      - NKCC2 blocker
        (furosemide )
        
        ADR
        
        HypoK+, Metabolic alkalosis
        
        HypoMg2+
        
        Ototoxicity
    - - NCC
        
        Na+, Cl
      - NCC blocker
        (Thiazide)
        
        Ca2+ and Urate sparing diuretic
        
        ADR: Sulfa drug
    - - Principle cell
        (stimulate by Aldosterone)
        
        Na+ K+ ATPase with ENaC
        
        ENaC blocker
        (Amiloride)
        
        Spironolactone (Aldosterone antagonist)
        
        K sparing diuretic
        
        ADR: HyperK+, Metabolic acidosis
        
        ADR: Gynecomastia, Anti-Androgen
      - Alpha intercalated cell
        (stimulate by Aldosterone)
        
        Na+ K+ ATPase with H-ATPase
      - ADH stimulate AQP2 insert
        
        Nephrogenic Diabetes insipidus
        
        Cause : Lithium, Cidofovir, recovery ATN, Severe HypoK+/HyperCa2+
        
        Vasopressin agonist
        
        Desmopressin for Central DI, Inducing vWF
    - - ATN
        
        Granular cast “Muddy brown”
        
        Phase progression
        
        Recovery(Polyuria, risk of HypoK+)
        
        Maintenance phase(Oliguria, risk of HyperK+, Metabolic acidosis)
        
        P§:sloughed cell & tubular backleak
        
        Ischemia
        
        Prolong hypoperfusion
        
        NSAID
        
        ACEI, ARB
        
        Shock
        
        Toxic
        
        Myoglobin
        
        Hb
        
        Cisplatin
        
        Aminoglycoside
        
        Lead
      - AIN
        
        P§: Tubular inflammation
        
        NSAID
        
        Beta lactam
        
        Rifampin
        
        Pyuria *eosinophils, Azotemia
      - ADPKD
        
        Destroy kidney parenchyma
        
        SS: Flank pain, Hematuria, HT
        
        Consequence
        
        UTI
        
        Renal failure
        
        Complication
        
        Berry aneurysm, Benign hepatic cyst
      - ARPKD
        
        P§: CD dilation
        
        Complication
        
        Hepatic fibrosis
        
        Present at young
  - - - Afferent arteriole
        
        Dilate by PGE2, PGI2
        
        RAAS
        
        Stimuli
        
        BP at VSMC of Afferent arteriole
        
        Beta1 adrenergic receptor
        
        Na+ gradient at Macula densa of DCT (Tubuloglomerular feedback)
        
        JG cell release Renin
        
        Renin convert Angiotensinogen (by liver) to Ang I
        
        ACE convert Ang I to AngII
        
        Ang II effect
        
        Constrict Efferent arteriole -> (+)FF
        
        Vasoconstrict -> (+)BP
        
        Stmuilate Glomerulosa at adrenal cortex -> Aldosterone
        
        Stimulate neurohypophyseal -> (+)ADH
      - Efferent arteriole
        
        Constrict by Ang.II, Endothelin, NE
      - Glomerulonephritis
        
        Nephritis syndrome
        
        GMB and Endothelium injury
        
        Hematuria
        
        RBC cast
        
        Dysmorphic RBCs
        
        Hypertension
        
        Azotemia
        
        Disease
        
        Acute Post-streptococcus GN
        
        P§: Type III hypersense (onset 2 wks) to skin or pharynx GAS
        
        Enlarged glomeruli & Hypercellularity(PMN,Lymphocyte)
        
        IgG,IgM,C3 deposit
        
        2 more items...
        
        SS: Dark urine, HT, Periorbital edema
        
        Lab: anti-DNase B titer
        
        IgA nephropathy
        
        P§: Flares with URI or Gastroenteritis
        
        Mesangial proliferate
        
        IgA-based IC deposit in mesangium
        
        SS: Episodic Hematuria with RBC cast +/- Henoch-Schölein Purpura
        
        Rapidly progressive GN
        
        Crescentic/moon shape of glomerular parietal proliferate
        
        Cause
        
        Type I
        
        1 more item...
        
        Type II
        
        1 more item...
        
        Type III
        
        1 more item...
        
        Alport syndrome
        
        P§: Type IV collagen mut.
        
        Thining & irregular GMB
        
        1 more item...
        
        Rentinopathy
        
        Lens dislocation
        
        Diffuse proliferative glomerulonephritis
        
        Cause
        
        Lupus nephritis Type IV (ANA, Anti ds-DNA, Anti Smith)
        
        MPGN
        
        Wire looping
        
        Intra membranous IgG-based IC
        
        Nephrotic syndrome
        
        Podocyte injury
        
        Hyperlipidemia
        
        Fatty cast
        
        Loss AT
        
        Hypercoagulability
        
        Loss Ig
        
        Risk of SHiN infection
        
        Hypoalbuminemia
        
        Disease
        
        Minimal change disease
        
        Normal glomeruli appearance
        
        EM: Foot process effacement
        
        Trigger by infection, immunization
        
        Membranous nephropathy
        
        IC deposit at subepithelium
        
        Spike and dome
        
        Granular Appearance
        
        Cause
        
        Anti-PLA2
        
        NSAID, HBV, SLE
        
        Diabetic glomerulonephropathy
        
        Non-enzymatic glycosylation
        
        Mesangial expansion
        
        GBM thickening
        
        KW lesion
        
        1 more item...
    - - Glomerular filtration barrier
        
        Fenestrated capillary
        
        GBM (neg charge heparan sulfate)
        
        Podocyte foot process
        
        GFR (normal 100)
        
        Hydrostatic pressure, Oncotic pressure
        at Glomerular capillary vs Bowman space
  - - - Cause by Atherosclerosis
        
        Activate RAAS by (+)Renin
    - - Cause by Fibromuscular dysplasia
  - - - PTH
      - EPO
      - ACTH
      - Renin
  - - - Metabolic acidosis, HyperK+, Uremia(encephalopathy), HT, Anemia, 2° HyperPTH
  - - - SS: CVA tender, N/V, Fever, Chill
      - Lab: WBC in urine +/- WBC cast
      - Associated obstruction, vesicourteral reflux, pregnancy, DM
    - - Thyroidization, corticomedullary scar, blunted calyx
- - - - Ureter to CD
    - - Glomerular to DCT
    - - Risk of Uteropelvic junction obstruction, Infection
      - Associated Turner syndrome and Trisomy
- - - - Celiac trunk organs
  - - - Kidney & Ureter
- - - - Tumor
      - Stone
- - - - Ca, Phosphate in basic
      - Ca, Oxalate in acidic
      - Envelope & Radiopaque
      - Associated Crohn disease, HyperPTH
      - Tx: Thizide & Citrate
    - - Struvite stone/Triple phosphate
      - Coffin lid & Radiopaque Staghorn Calculi
      - Urease by Proteus, GBS, Klebsiella
    - - Rhomboid/Radiolucent
      - Cause by gout & Leukemia
- - - - Median umbilical lig.