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COMLEX 2 > Renal > Flashcards

Renal Flashcards

1
Q

Milk-alkali Syndrome can lead to?

A

Acute Renal Failure

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2
Q

When should you measure PTH levels in Milk Alkali Syndrome?

A

In milk-alkali syndrome, vigorous treatment of hypERcalcemia with saline diuresis and loop diuretics may lead to hypOcalcemia. With the hypocalcemia, PTH will rise and may reach levels above reference range. Therefore:
PTH levels should be determined BEFORE or AT THE INITIATION of tx.

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3
Q

Gitelman Syn (Bartter Syn if

A

AR disorder of Na-Cl cotransporter at distal tubule in early adulthood

HyPOKalemia and AlkaLOsis
Hypercalciuria
Inc. Renin, Aldosterone, and HCO3
Weakness, fatigue, spasm

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4
Q

CHF can lead to ischemia which can then lead to what in the kidneys?

What would you see on microscopic urine analysis?

A

Acute Tubular Necrosis

Muddy brown granular casts

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5
Q

Pts. with ATN will typically have a FeUrea of what?

A

> 50%

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6
Q

Cystinosis inheritance?

A

Auto Rec

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7
Q

Cystinosis:
S&S
How does it cause problems?

A

Defective transport of cystine out of lysosomes that manifests as:
polyuria, polydipsia, dehydration,
non-anion gap met acidosis, rickets, FTT

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8
Q

ADPKD keywords

A 
Hypertension
Hematuria (episodic)
Stroke fam hx
Hepatic cysts on CT, One parent has renal cysts too
Chromosome 16
Berry aneurysms

30 y.o.

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9
Q

What is the leading cause of death in ADPKD?

A

cardiovascular disease

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10
Q

What is the 1st line tx for VUR?

A

Daily Amoxicillin, TMP-SMX, or Nitrofurantoin

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11
Q

Medullary Cystic Disease

A

inc. uric acid –> gout in the young teen

eventual renal failure

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12
Q

What has been shown to prevent Contrast-Induced Nephropathy?

A

Aggressive hydration

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13
Q

Tx. Fibromuscular Dysplasia

A

Angioplasty + Renal A. Stent placement

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14
Q

What diabetic drug can’t you give to someone with renal failure/impairment? Why?

A

Metformin –> Lactic Acidosis

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15
Q

Car crash pt. –> brown urine is likely?

Appropriate dx. to confirm?

A

Rhabdomyolysis

elevated Creatinine Kinase

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16
Q

Bladder pressure is used to dx. what?

A

Abdominal compartment syndrome

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17
Q

Suprapubic abd pain + fever + dysuria + pneumaturia + urine per rectum would be indicative of?

A

Colovesical fistula

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18
Q

What is the most common cause of colovesical fistula?

A

Acute diverticulitis

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19
Q

Primary Hyperaldosteronism

A

adenoma of glomerulosa of adrenal gland

20
Q

Bartter Syndrome

A

Presents prior to 2 y.o.

Low Mg2+
High Urine Ca2+

21
Q

What is Winter’s Formula?

When is it used?

A

Expected pCO2 = [1.5 * HCO3-] + 8 +/- 2

During metabolic acidosis

22
Q

Tx. asymptomatic renal cyst

A

Nothing

23
Q

Triad of Renal Cell Carcinoma

Increased risk with?

To where does it usually metastasize?

A

Hematuria
Flank pain
Possible flank mass

Inc. risk with obesity and smoking

To lungs

24
Q

Drug given in Microalbuminuria

A

Lisinopril

25
Q

Most CKD pts. on dialysis die from?

A

cardiovascular disease

26
Q

Liddle Syndrome

A 
AD mutation of ENaC channel in distal tubule
HTN
HypOkalemia and alkaLOsis
HyPERnatremia
Low Aldosterone
27
Q

What common medication should you remember can cause bladder distension via its anticholinergic side effects?

A

Benadryl

28
Q

Post-Strep Glomerulonephritis

S&S

Dx?

What is a common consequence of PSGN?

A

Type 3 H.S. rxn

periorbital edema, coca-cola urine, HTN

UA
CBC, complement levels (remember IgG, IgM, and C3 deposit on basement membrane), strep Ag assays, antiDnase B Abs
“Lumpy bumpy” on immunofluorescence

HTN

29
Q

Gentamicin is associated with what condition?

A

Renal Tubular Acidosis Type I –> Hypokalemia –> Flat T waves

30
Q

NephrOtic Syndrome keywords

e.g.

A

prOteinuria 3.5 g/d and edema
frothy urine + fatty casts
decreased albumin
increased lipids

e.g. 
Focal Segmental Glomerulosclerosis (FSGS)
Minimal change dz
Membranous nephropathy
Amyloidosis
Diabetic glomerulonephropathy
31
Q

Nephritic Syndrome keywords

e.g.

A 
Inflammation
Azotemia
Hematuria
Oliguria
hypertension
granular casts
e.g.
Post-strep glomerulonephritis (PSGN)
Rapidly progressive glomerulonephritis 
IgA Nephropathy (Berger Disease)
Alport Syndrome
Membranoproliferative Glomerulonephritis
32
Q

ARPKD keywords

A

Chromosome 6

ARPKD in a full sibling

33
Q

Ethylene glycol poisoning

A

calcium oxalate crystals (“envelope”)

34
Q

Rapidly Progressive (Crescentic) Glomerulonephritis keywords

e.g.

Tx

A

crescent moon
hematuria, hemoptysis
poor prognosis

e.g.
Goodpasture (pANCA+)
Granulomatosis w/ polyangiitis (aka Wegener - cANCA+)

Tx: Plasmapheresis

35
Q

Diffuse Proliferative Glomerulonephritis keywords

A

SLE’s most common cause of death

“wire looping” of capillaries

36
Q

IgA Nephropathy keywords

A

mesangial proliferation
immune complex deposits
assoc. w/ Henoch Schonlein Purpura
RBC casts

37
Q

Alport syndrome keywords

A

type IV collagen mutation
X-Recessive
“Basket weave”

38
Q

Membranoproliferative Glomerulonephritis (MPGN) keywords

A

Type I - Tram track Immune complex deposition, Hep B/ HepC

Type II - intramembranous immune complex “dense” deposits

39
Q

Focal Segmental Glomerulosclerosis keywords

A

Foot processes effacement
African Americans, Hispanics
HIV, Heroin, Interferon

40
Q

Minimal Change Disease keywords

A

children
normal glomeruli
Tx. Steroids

41
Q

Membranous Nephropathy keywords

A

GBM thickening
Spike and Dome
Caucasian adults

42
Q

Diabetic Glomerulonephropathy keywords

A 
Kimmelsteil Wilson (eosinophilic nodular glomerulosclerosis)
GBM thickening
43
Q

1st Line Tx. for non-pregnant woman with pyelonephritis requiring hospitalization?

A

Ciprofloxacin

44
Q

1st line Tx. for Acute cystitis?

A

TMP-SMX

45
Q

Staghorn calculi keywords

A

CVA tenderness (S&S nephrolithiasis)
Alkaline urine pH, urease-producing Proteus
Coffin-lid Mg-Ammonium-Phosphate crystals
Radioopaque (seen on xray)

46
Q

What value for BUN:Cr would indicate pre-renal cause for Acute Kidney Injury?

A

BUN:Cr >20

COMLEX 2 (19 decks)

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