Nephrology Flashcards
A patient with stage 5 CKD presents to the ED with signs of uremia. You learn that the patient missed three dialysis appointments last week. ABG shows an uncompensated acid/base derangement. You expect that the pH will be ______ (high/low/normal) and the HCO3 will be ______ (high/low/normal).
low, low
A patient presents with a partially compensated metabolic acidosis. You expect that the patient’s minute ventilation will be ______ (increased/decreased).
Increased
A diabetic patient presents with a decreased GFR and proteinuria. In addition to treatments for diabetes, which class of medication is most appropriate for this patient?
ACE-I/ARB
You are treating a patient with AKI. Upon reviewing the patient’s labs, you find that the BUN:creatinine ratio is increased and the FENa is 0.9%. This patient’s AKI is most likely due to a ______ (prerenal/renal/postrenal) cause.
Prerenal
You are treating a patient in the ICU for septic shock. The patient develops prerenal AKI. This progression is ______ (common/uncommon). What treatment is likely to be of greatest benefit for this patient?
Common, IV fluids
A 38 year-old patient with a history of HTN refractory to aggressive medical therapy presents with bilateral flank pain. On exam, the kidneys are easily palpable. Labs show a decreased GFR. What is the most appropriate study to evaluate this patient?
Renal ultrasound
Among patients with CKD of all stages, the greatest cause of mortality is ______ ______.
Cardiovascular disease
A patient is given a saline infusion that causes a dramatic shift of fluid into the intravascular space. The concentration of the saline was probably ______ (0.45%, 0.9%, 3%). This fluid is best described as ______ (hypotonic/isotonic/hypertonic).
3%, hypertonic
An 8 year-old patient presents with hypertension, edema, and hematuria. UA is positive for protein, and the patient is hypoalbuminemic. Kidney biopsy is unremarkable. What is the most likely diagnosis?
Minimal change disease
An 8 year-old patient presents with hypertension, edema, and hematuria. UA is positive for protein, and the patient is hypoalbuminemic. Kidney biopsy is unremarkable. Which medication is most likely to be of benefit for this patient?
Prednisone
An 8 year-old patient presents with hypertension, edema, and hematuria. UA is positive for protein, and the patient is hypoalbuminemic. Kidney biopsy is unremarkable. You ______ (warn/reassure) the patient’s parents since most children ______ (do/do not) recover completely from this disorder.
Reassure, do
A patient presents with hemoptysis and acute renal failure. There is mild proteinuria and the UA is positive for dysmorphic RBCs, WBCs, and granular casts. Renal biopsy shows a linear deposition of anti-GBM antibodies. What is the most likely diagnosis?
Goodpasture’s syndrome
A patient presents with hemoptysis and acute renal failure. There is mild proteinuria and the UA is positive for dysmorphic RBCs, WBCs, and granular casts. Renal biopsy shows a linear deposition of anti-GBM antibodies. What are the three components of treatment for this patient?
Plasmapheresis
Prednisone
Cyclophosphamide
Which of the following IV fluids is least appropriate for intravascular volume replacement in a dehydrated patient? A. D5W B. Normal saline C. Lactated ringers D. 5% Albumin
A. D5W
A patient with a history of chronic renal failure on dialysis presents with lethargy and confusion. You review the patient’s EKG and notice tall, peaked t-waves. Which disorder do you suspect?
Hyperkalemia
