Title: Big Ol' Bonewizardry Deck / Hex Clues / Renal
Tags: hex-clues hex-clues::renal

Q: What has Crescents?
A: RPGN 🌙
crescents = fibrin + parietal cells 🫘
rapidly progressive ⏰

Q: What is Azotemia?
A: ↑BUN/Cr, no symptoms 🫘📈
pre/intra/post-renal 🔍

Q: What has Tubular casts?
A: ATN 🫘
muddy brown granular 🟤
dead tubular cells 💀

Q: What has WBC casts?
A: AIN / pyelo 🫘
WBC casts ⚪
interstitial inflammation 🔥

Q: What is normal GFR?
A: 100-120 mL/min 💧📏
CKD if 📉

Q: What has Muddy brown casts?
A: ATN 🟤
sloughed tubule cells 🫘
intrinsic AKI 💩

Q: What is Uremia?
A: azotemia + symptoms 🫘💀
encephalopathy, pericarditis, platelet dysfunc 🧠

Q: What is Lupus Nephritis?
A: wire-loop deposits 🦋🫘
diffuse proliferative 🐺

Q: What has Fat casts?
A: Nephrotic syndrome 🫘
Maltese cross 🧈
lipiduria ✚

Q: What disease has Aniridia?
A: Wilms tumor (WAGR) 👁️
WT1 deletion 👶
Wilms + Aniridia + GU + Retardation 🧬

Q: What has Hyaline casts?
A: Tamm-Horsfall protein 🫘💧
normal w/ dehydration 🏃

Q: What has Waxy casts?
A: Chronic renal failure 🫘
wide refractile 🕯️
end-stage advanced 💀

Q: What has Epithelial casts?
A: normal sloughing or early ATN 🫘🪨
benign or bad 🤷

Q: What does the J-G apparatus do?
A: senses BP/volume 🫘🎚️
releases renin 💉

Q: What has WBC casts only?
A: Pyelonephritis 🫘
upper UTI 🔥
urosepsis risk 🚨

Q: How do you test afferent arteriole function?
A: GFR 💧
creatinine clearance ➡️
filtration tested 🧪

Q: How do you test efferent arteriole function?
A: RPF 💧
PAH clearance ⬅️
exit flow tested 🚪

Q: What is the job of the afferent arteriole?
A: Afferent = filter 💧
blood into glomerulus ➡️
entrance gate 🚪

Q: What is the job of the efferent arteriole?
A: Efferent = secrete 💧
blood to peritubular caps ⬅️
exit door 🚪

Q: What has WBC casts + RBC casts?
A: Glomerulonephritis 🫘
nephritic syndrome 🔴
inflamed filter 🌋

Q: What does the macula densa do?
A: senses distal NaCl 🫘🎚️
tubuloglomerular feedback 🔄

Q: Which part of the nephron concentrates urine?
A: Medullary collecting duct 💧
ADH-driven 🌵
loop sets gradient 🪜

Q: What is renal failure?
A: Intrinsic renal failure 🫘
BUN:Cr 💀
damaged glom/tubule 🚫

Q: What is Type 3 RTA?
A: mixed I + II 🫘🧂
rare hybrid 🦄

Q: How do you measure efferent renal function?
A: BUN / PAH 🫘
exit-side metrics 📏
RPF surrogates 📊

Q: What is pre-renal failure?
A: ↓ Pre-renal AKI 🚰
BUN:Cr >20
hypovolemia, CHF, sepsis 💔

Q: What type of kidney stones have hexagonal crystals?
A: Cystine stones 💎
hexagonal crystals ⬡
AR dibasic AA transport defect 🧬

Q: What is the most common cause of kidney stones?
A: Dehydration 💎
low urine volume 🚰
concentrates everything 🏜️

Q: What type of kidney stones have rosette crystals?
A: Uric acid 💎
radiolucent rosette 🌹
gout, tumor lysis 🍷

Q: What disease has Iridocyclitis?
A: JRA pauciarticular 👁️
ANA+ 🧒
eye + joint inflammation 👀

Q: What structures have one-way valves?
A: Urethra + ejaculatory duct 🚪
one-way only ➡️
no reflux 🛑

Q: What is the 60/40/20 rule?
A: 60/40/20 fluid 💧
TBW/ICF/ECF 📊
plasma 1/3, interstitial 2/3 of ECF 📐

Q: What are the most common type of kidney stones?
A: Calcium oxalate 💎
most common, radiopaque 🦴
envelope crystals ✉️

Q: How do you measure afferent renal function?
A: Creatinine clearance 💧
inulin = gold standard 📏
filtration metric 🧪

Q: What is Post-Strep GN?
A: PSGN 🦠
subepithelial humps 🫘
+ASO + anti-DNase B 🍯

Q: What is Goldblatt's kidney?
A: Renovascular HTN 🫘
unilateral RAS 🚰
↑renin from ischemic kidney ⚡

Q: What structures have fake sphincters?
A: UVJ, LES, ileocecal 🚪🎭
functional, not anatomic 🔓

Q: What has WBC casts + eosinophils?
A: Acute interstitial nephritis 🫘
drug allergy 💊
NSAIDs/PCNs/PPIs 🩹

Q: What is post-renal failure?
A: Post-renal AKI 🚰
obstruction below kidney 🚧
BPH, stones, tumor 🪨

Q: What type of kidney stones have coffin- lid crystals?
A: Struvite stones 💎
coffin-lid crystals ⚰️
urease+ Proteus → staghorn 🦌

Q: What is Nephritic kidney disease?
A: hematuria + RBC casts + HTN 🫘🌋
big fenestrations 🕳️

Q: What is Interstitial Nephritis?
A: fever + rash + eosinophiluria 🫘💊
drug allergy 🤧

Q: What is seen in RPGN (Rapidly Progressive Glomerulonephritis)?
A: crescents 🌙⚡
Goodpasture, ANCA, post-strep ⏰

Q: What is Stress incontinence?
A: leak with cough/sneeze 💧😅
weak pelvic floor 🤱

Q: What is Phimosis?
A: foreskin won’t retract 🍆🔒
UTI + balanitis risk 🚿

Q: What type of kidney stones have envelope or dumbbell-shaped crystals?
A: Calcium oxalate 💎
envelope/dumbbell crystals ✉️
ethylene glycol, Crohn’s, vit C 🥬

Q: What is Central Pontine Myelinolysis?
A: CPM / ODS 🧠
correct Na+ >0.5/hr 🧊
locked-in syndrome 🔒

Q: What happens if you constrict the efferent arteriole?
A: ↓RPF, ↑GFR, ↑FF 🫘⬅️
AT-II effect 💊

Q: What is the job of the thin descending limb of the Loop of Henle?
A: passive H2O reabsorption 🪜💧
impermeable to solute 🚫

Q: What happens if you constrict the afferent arteriole?
A: ↓RPF, ↓GFR, FF same 🫘➡️
NSAIDs 💊

Q: What is the job of the proximal tubule?
A: reabsorbs 65% filtrate 🫘♻️
glucose + AAs + Na + HCO3 + H2O 💪

Q: What is MPGN (Membranoproliferative Glomerulonephritis)?
A: tram-track GBM 🫘🚆
Type II = C3 nephritic factor ⬇️

Q: What is Fanconi's syndrome?
A: proximal tubule failure 🫘🚰
lose glucose, AAs, PO4, HCO3 🕳️

Q: What is Type 4 RTA?
A: hypoaldo → hyperkalemia 🫘🧂
DM, NSAIDs, ACE-I 💊

Q: What is Type 2 RTA?
A: proximal HCO3 wasting 🫘🧂
hypokalemia, MM, Fanconi 🕳️

Q: What is Bartter's syndrome?
A: loop-like NKCC2 defect 🫘🪜
hypokalemic met alkalosis, normal BP ✅

Q: What is the job of the early distal tubule?
A: NaCl reabsorption, no H2O 🫘🧂
PTH → Ca reabsorption 🦴

Q: What happens if you increase plasma protein concentration?
A: ↓GFR, ↓FF 💧📈
oncotic pressure opposes filter 🚫

Q: What happens if you decrease plasma protein concentration?
A: ↑GFR, ↑FF 💧📉
less oncotic resistance ✅

Q: What is Paraphimosis?
A: foreskin trapped retracted 🍆🚨
strangulation emergency ⏰

Q: What is the course of the ureter?
A: Water under bridge 🚰
ureter under uterine A 🌉
under vas deferens in male 🌊

Q: What is Type 1 RTA?
A: distal H+ failure 🫘🧂
high urine pH + stones + hypoK 💎

Q: What is Urge incontinence?
A: detrusor overactivity 💧😱
sudden gotta-go 🏃

Q: What is MCD (Minimal Change Disease)?
A: #1 nephrotic kids 🫘
effaced foot processes 👣
steroids 🧒

Q: What is Hepatorenal syndrome?
A: splanchnic vasodilation 🍺🫘
cirrhosis → renal hypoperfusion 💔

Q: What is Nephrotic kidney disease?
A: >3.5g/day proteinuria 🫘🫗
edema + hyperlipidemia + lipiduria 🧈

Q: What is the job of the thick ascending limb?
A: NKCC2 cotransporter 🪜⬆️
loop diuretic target 💊

Q: What is Overflow incontinence?
A: continuous dribble 💧🌊
BPH or weak detrusor 🚰

Q: What are the vasculitis w/ low C3?
A: ↓ Low C3 GN 🫘
PMS in Salt Lake City
PSGN, MPGN II, SBE, serum sickness, lupus, cryo 🧂

Q: What is the job of the late distal tubule and collecting duct?
A: principal = ADH/aldo 🫘💧
intercalated = acid/base 🧂