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IM Board Review > Nephrology > Flashcards

Nephrology Flashcards

1
Q

In a young muscular man, can measure ____ instead of Cr to get accurate kidney function

A

Cystatin C

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2
Q

ART, H2 blockers, Bactrim can increase Cr by default, so simply repeat later in time

A
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3
Q

Urine reddening drugs_____

A

Phenytoin, Pyrazinamide (Pyridium), Rifampin

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4
Q

Rhomboid crystals with low urine pH______

A

Uric acid, gout

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5
Q

Coffin crystals with high urine pH

A

struvite, proteus

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6
Q

Hexagonal crystals______

A

Homocysteinuria

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7
Q

Envelope shaped crystals______

A

Calcium oxalate, ethylene glycol, high calcium/oxalate in serum

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8
Q

If there is a proteinuria but dipstick with trace protein indication of____

A

bend jones light chain from MM, unmeasured from the urinalysis assay

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9
Q

Nephrolithiasis best seen with _____

A

NON contrast CT Scan, might do US renal first

CT Urography used for malignancy

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10
Q

Hypernatremia: If the losses are nonrenal, urine osmolality will be _____

A

elevated to >600 mOsm/kg H2O

Body is trying to retain as much water as possible, ADH activity

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11
Q

Hypokalemia urine studies : A value ____ mEq/g identifies hypokalemia secondary to lack of intake, transcellular shifts, or gastrointestinal losses.

A

<13 (Potassium/Cr ratio)

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12
Q

_____, increased sodium reabsorption in the distal nephron causes hypertension, metabolic alkalosis, and potassium wasting

A

In Liddle syndrome

HypoK syndromes: Liddle, Gittleman, Barter

*Mag potentiates Ca2+ and K+

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13
Q

EKG changes with hypokalemia_____

A

U wave, ST depression, low T amplitude

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14
Q

____ is a medication that can cause hypokalemia through hypoaldosteronism

A

Heparin

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15
Q

EKG changes with hyperkalemia______

A

Peaked T wave, short QT, Wide QRS and PR, almost invisible P wave

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16
Q

Symptoms of ____ ion deficiency: nclude tremors, fasciculations, muscle weakness, carpopedal spasm, Chvostek and Trousseau signs, seizures, and cardiac arrhythmogenicity.

A

Mg2+ and Ca2+

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17
Q

Acetaminophen in strict vegetarians can causes metabolic acidosis (T/F)

A

True

18
Q

Ethylene glycol has gap acidosis and _____

A

Osmolar gap

19
Q

_______ RTA is associated with falcon syndrome, which has glucose/phosphate/amino acids in the urine

A

Type II, hypokalemia

*Type 1 associated with Sjogrens, drugs (amphoterecin), hallmark of type 1 is normal urine pH because urine can’t be acidified (H+ failure)

20
Q

_____ drug associated with RTA, and formation of calcium phosphate stones, low urine citrate

A

Topiramate

21
Q

The most common causes of ______ are associated with chloride depletion: vomiting, nasogastric suction, and diuretic use.

A

metabolic alkalosis

*Low urine chloride<15, implies chloride wasting and supplement with NaCl

22
Q

____ poisoning associated with respiratory alkalosis, metabolic acidosis

A

ASA (salicyclate)

23
Q

Baseline electrocardiography is appropriate for all patients with newly diagnosed hypertension.

A
24
Q

Special populations: African American

A

In general, ACE inhibitors are less efficacious in lowering BP in Black patients than are CCBs. Additionally, a landmark trial (ALLHAT) revealed that in Black patients, a thiazide diuretic was more effective in improving cardiovascular outcomes compared with an ACE inhibitor,

25
Q

Common medications causing interstitial nephritis

A

Lithium, NSAIDS, H2 blocker/PPI, HIV meds, Abx, anti-cancer medications

26
Q

Kidney involvement in______ is common and can manifest as nephrocalcinosis from hypercalcemia and hypercalciuria, obstructive uropathy, and TIN due to granulomatous interstitial nephritis.

A

sarcoid

27
Q

Heavy metal causing nephrotic syndrome_________

A

Lead

28
Q

In immunosuppressed patients with transplanted organs, _______ can cause interstitial nephritis. Diagnosis of BK virus nephropathy can be difficult to distinguish from acute cellular rejection. The most important treatment intervention is to decrease immunosuppressive therapy.

A

BK virus

29
Q

Fanconi syndrome characterized by____

A

Phosphate amino acids glucose in the urine, acidosis, associated with cisplatin use, Wilsons disease

30
Q

____ causes multiple types of renal injury: nephrogenic DI, TIN, Type 1 RTA

A

Lithium

31
Q

definition of nephrotic range proteinuria ______

A

3500mg over 24 hrs

32
Q

___________is a leading cause of the nephrotic syndrome in White adults.

A

Membranous glomerulopathy (membranous nephropathy)

Can be associated with PLA2R

Patients with newly diagnosed primary forms of membranous glomerulopathy are usually observed for 6 to 12 months on conservative therapy (renin-angiotensin system blockade, cholesterol-lowering medication, and edema management) before initiating a course of immunosuppression for patients with persistent nephrotic-range proteinuria: Tacro/Pred

33
Q

The biopsy finding of nodular mesangial sclerosis with glomerular and tubular basement thickening, in the absence of immune deposits, is the classic description of ______

A

diabetic nephropathy

34
Q

most common etiologies seen in RPGN cases are ANCA-associated glomerulonephritis, lupus nephritis, and anti–glomerular basement membrane glomerulonephritis.

A

RPGN is a G.nephritis

35
Q

Anti GBM disease is a type of RPGN, linear staining of type 4 collagen antibody

A

Types of G Nephritis: Lupus, post strepp, IgA, MPGN, cryoglobinemia

Treatment for anti-GBM disease consists of plasmapheresis, pulse glucocorticoids (high doses of intravenous glucocorticoids over a short period of time) followed by oral prednisone, and cyclophosphamide.

More than half of patients with anti–glomerular basement membrane antibody disease have lung involvement manifesting as hemoptysis, shortness of breath, or cough.

36
Q

____________ is typically characterized by a vasculitic prodrome of malaise, arthralgia, myalgia, and skin findings; hematuria, proteinuria, and acute kidney injury are present, and kidney biopsy will confirm diagnosis

A

ANCA-associated glomerulonephritis

Typical induction therapy consists of glucocorticoids combined with either cyclophosphamide or rituximab. Plasmapheresis is reserved for patients with evidence of alveolar hemorrhage or severe kidney failure. Other induction options include cyclophosphamide or rituximab-based therapies.

37
Q

Hint to immune complex mediated G.nephritis__________

A

Low C3/C4

38
Q

IgA nephropathy is actually a G.nephritis, associated among asian patients,

A
39
Q

Preferred treatment of lupus nephritis_______

A

Mycophenylate

Treatment of classes I and II lupus nephritis (LN) includes conservative therapy with an ACE inhibitor or angiotensin receptor blocker; classes III, IV, and V LN may require aggressive immunosuppressive therapy; and class VI LN may be treated with conservative therapy.

40
Q

Common viral cause of MPGN______

A

Hepatitis C, MPGN is a type of G.nephritis

41
Q

≥60 years old if blood pressure is >150/90 mm Hg, with a goal of reducing systolic blood pressure to <150 mm Hg

A

Varies by organization

IM Board Review (13 decks)

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