Calcium, Mag, Phos, Stones

Question 1

Most stones are made of this element

Answer 1

calcium, usually Ca Ox (80%)
Ca Phos (hydroxyapatite) 20%
- consider primary HPT, distal RTA (high Ur pH)

Question 2

More common stone to see in DM

Answer 2

uric acid, 60% in DM, overall 10-15%

Question 3

Type of stone with UTI

Answer 3

struvite, 5-10%

Question 4

More common stone in children

Answer 4

cystine, only 1% in adults

Question 5

Name risk factors for calcium stone formation

Answer 5

Question 6

Associate the following Ur pH with dx/type of stone:
high urine pH 6.5-7
very high pH 8-9
low pH 5-5.5

Answer 6

high: RTA
very high: struvite stones
low: uric acid

Question 7

Name some medications associated with stones

Answer 7

Question 8

Ideal urine volume target in stone prevention?

Answer 8

> /= 2L, supported by RCT
*coffee/beer are protective!

Question 9

Answer 9

Increase dairy intake
800-1200mg Ca/day
PharmTx: thiazides, can even use in normal Ur Ca (chlorthalidone and indapamide
- supplement K-citrate
- other: amiloride/spiro

Question 10

Answer 10

C

A: citrate can lower Ur Ca, no difference is shown between meds though
B: technically true, but isn’t a contributory issue overall
D: doesn’t happen, only with urease-producing organisms

Question 11

Describe distal RTA:
Ur pH
K
type of stone
citrate
Ur Calcium
Treatment?

Answer 11

Question 12

This surgery is associated with hyperoxaluria

Answer 12

Roux-en-Y
not as much in gastric sleeve

Question 13

Name 3 contributors to uric acid stones

Answer 13

Question 14

Treatment of uric acid stones

Answer 14

Question 15

What bugs are associated with struvite stones?

What is struvite made of?

Answer 15

Question 16

Answer 16

Cystinuria
- impaired PCT reabsorption

Question 17

Management of cystinuria

Answer 17

Question 18

Dent disease is associated with this kidney pathology/disease?

Answer 18

Medullary nephrocalcinosis
Dent 1 CLCN5 gene or Dent 2 OCRL1
- high Ur Ca, inc activation of 1,25
- LMWP (B2MG and retinol-binding/FSGS) and/or albuminuria

Question 19

Primary Hyperoxaluria

Answer 19

• dx young but can be missed

Question 20

Answer 20

DHA stone d/t defect in APRT enzyme (adenine metabolism to AMP)
- accumulation of 2,8 DHA via xanthine oxidate

Question 21

Question 22

Question 23

Question 24

Phosphorus transporters

Answer 24

Question 25

Main things to know about PTH

Answer 25

Question 26

Main things to know about Vit D

Answer 26

Question 27

Main things to know about FGF 23
(front and back)

Answer 27

Question 28

FGF 23 excess and deficiency diseases (know this)

Answer 28

Question 29

Usual hormone levels in CKD
(CKD hormone axis on the back)

Answer 29

Question 30

Name the primary lesion/disorder

Answer 30

Question 31

Name the primary lesion/disorder

Answer 31

Question 32

Name the primary lesion/disorder

Answer 32

Question 33

Name the primary lesion/disorder

Answer 33

Mirror image of FHH

Question 34

Name the primary lesion/disorder

Answer 34

Question 35

What is Claudin 14 and how does it affect magnesium?

Answer 35

Question 36

Hows does the NKCC2 transport affect mag?

Answer 36

Question 37

How do loops affect Mag?

Answer 37

Question 38

How does K affect Mag?

Answer 38

Question 39

How does Ca affect Mag?

Answer 39

Question 40

EGF inhibitors does what to Mag? name some of the meds

Answer 40

Question 41

Gitelman’s: know the electrolyte values

Answer 41

Question 42

Know the following genetic mutation defects

Answer 42