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Step 2 > Renal > Flashcards

Renal Flashcards

1
Q

Chronic NSAID use increases risk for?

A

tubulointerstitial nephritis and papillary necrosis

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2
Q

Fluid management for hypovolemic hypernatremia w/ syx

A

NS until euvolemic

Then add 5% dextrose

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3
Q

Tx for urge incontinence

A

1st line - pelvic floor exercises

Non responders - add po oxybutynin

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4
Q

Why is it difficult to correct hypokalemia in some alcoholics?

A

If they also have hypomagnesemia - removes inhibition of renal K+ excretion

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5
Q

Why does nephritic syndrome cause pulmonary edema?

A

Decreased GFR -> retention of Na+ and water by the kidneys

Get crazy high HTN

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6
Q

Gross hematuria with blood and protein in the sediment, no specific syx, comes from?

A

Glomerular damage

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7
Q

What is amiloride?

A

K+ sparing diuretic

Consider switching in pts with hyperkalemia

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8
Q

why do diuretics cause AKI?

A

Reduced CO -> prerenal ARI

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9
Q

DM pt has nocturia and 3+ protein in dipstic. Wy?

A

Diabetic micrangiopathy

Moderate proteinuria and CKD with elevated Cr

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10
Q

Dietary recommendation to prevent calcium oxalate renal stones

A
  1. Increased fluid intake
  2. Decreased sodium intake
  3. Normal dietary calcium intake
  4. Thiazide diuretics
  5. Low protein diet
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11
Q

While on nitroprusside drip pt develops HA, confusion, arrhythmia, flushing, respiratory depression. why?

A

Cyanide toxicity

Risk is increased when pt has CKD

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12
Q

How do you tx nephrogenic DI d/t Lithium?

A

Salt restriction

d/c lithium

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13
Q

Girl has anorexic patterns but presents with orthostatic hypotension, hyponatremia, hypokalemia. But, her urinary Na and K are elevated. Why?

A

Diuretic abuse

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14
Q

When would you do urgent dialysis?

A

AEIOU
Acidosis (pH<7.1)
Electrolyte abn - EKG changes or K+> 6.5
Ingestion - methanol, salicylate, lithium
Overload - volume overload refractory to diuretics
Uremia - if syx (encephalopathy, pericarditis, bleeding)

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15
Q

Best initial tx for renal a. stenosis

A

ACEI or ARB

Consider stenting or revascularization if resistant to medical mangment

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16
Q

Initial management of hypercalcemia

A

IVF hydration and calcitonin

Bisphosphonates if it remains high despite adequate fluid resuscitation

17
Q

Hypertension
Palpable b/l abdominal masses
Microhematuria

A

AD Polycystic kidney dz

Strong association with berry aneurysm

18
Q

Correcting hyponatremia too quickly puts pt at risk for?

A

osmotic demyelination

19
Q

Correcting hypernatremia too quickly puts pt at risk for?

A

Cerebral edema

20
Q 
Bladder pain that is relieved by voiding
UTI syx (frequency, urgency) w/ benign UA and dyspareunia also common
A

Interstitial cystitis

Tx - PT, behavior modification

21
Q

Nephrolithiasis with hexagonal crystals, + urinary cyanide nitroprusside test. Dx?

A

Cystinuria
Abnormality in amino acid transport
inherited

22
Q

AG acidodic pt has rectangular envelope shaped crystals. Suspect?

A

Ethylene glycol poisoning

Also causes renal failure

23
Q

Renal bx - intimal thickening and luminal narrowing of renal arterioles w/ evidence of sclerosis. Dx?

A

HTN

24
Q

Renal bx - increased extracellular matrix, basement membrane thickening, mesangial expansion, and fibrosis

A

Diabetic nephropathy

25
Q

Seizure pt gets a UA:

Large amount of blood, but only scant RBCs on microscopy. Suspect?

A

Rhabdomyolysis

causes myoglobinuria, electrolyte abn (high K+)

26
Q

T2dm pt has syx similar to BPH (weak stream, dribbling) but NL sized prostate. Decreased LE sensation, absent achiles reflex

A

Neurogenic bladder dysfunction d/t DM nephropathy

Causes urinary retention and bladder distention

27
Q

Tx for severe hyponatremia (<120)

A

3% saline

28
Q

HIV, nephrotic urine

A

Focal and segmental glomerulosclerosis

“HIV related nephropathy”

29
Q

Young male
asyx hypercalcemia
NL to elevated PTH
low urine calcium

A

Familial hypocalciuric hypercalcemia

HPTH would have elevated Ca2+, other causes of hypercalcemia would have low PTH

Step 2 (14 decks)

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