T4 - Renal

Question 1

Most common type of stone

Answer 1

CaOxalate (75-85%)

Question 2

Kidney stones more common in ____

Answer 2

Men - 2:1. Ratio

Question 3

Which stones are radiopaque?

Answer 3

Ca Oxalate citrate.

Question 4

If you have a kidney stone with a low urine pH, what shoud you do?

Answer 4

Send for C+S - could be infection!
Check GFR to make sure there is no postrenal AKI

Question 5

For patients who cannot get a CT scan ( Pregnant or kids) what is another option to check for kidney stones?

Answer 5

KUB
US

Question 6

Kidney stones >10mm have a _____ spontaneous pass rate
<1mm have a ____ spontaneous pass rate.

Answer 6

25%
87%

Question 7

Tx for Ca stones?

Answer 7

Thiazide diuretics, potassium citrate daily, allopurinol.

Question 8

Tx for uric acid stones?

Answer 8

K citrate, allopurinol and febuxostat in pts with gout.

Question 9

Reduce risk of kidney stone recurrence?

Answer 9

Hydration (1L/day), diet low in Na, protein, Phos and Ca.

Question 10

What classifies as an AKI?

Answer 10

Increase sCr of 0.3 over 48hrs
OR
1.5x baseline over prior 7 days
OR
UOP <0.5ml/kg/h over 6hrs

Question 11

What classifies as CKD?

Answer 11

Decrease in renal fxn >3mo AND GFR < 60ml/min.

Question 12

CKD occurs in _______ of T1DM
And ______ of those with HTN.

Answer 12

30-40%
24%

Question 13

Most common marker of CKD?

Answer 13

Persistent proteinuria.

Question 14

CKD stage 1+2 are usually incidentally diagnosed through routine labs. No s/s.

Question 15

CKD stage 3 may present with :

Answer 15

HTN, decreased calcium absorption, decreased Ph secretion, altered lipoprotein metabolism, anemia, Na and H2O retention.

Question 16

Preferred HTN medication in CKD stage 1-3?

Answer 16

ACEi/ARB, statins.

Question 17

What stage of CKD is usually referred to the nephrologist?

Answer 17

Late stage 3

Question 18

Diet for CKD:

Answer 18

Na, Ca, Ph, K and Protein restriction
Loop diuretics
HepB, flu and PNA vax.