All Kirila Lectures Flashcards
1
Q
Which diuretics cause acidosis?
A
CAI
K+ sparing
2
Q
How does the paCO2 compensate for HCO3 in metabolic alkalosis?
A
PaCO2 INC .7 for every 1 INC in HCO3
3
Q
Drug to treat BPH?
Contraindication?
A
Alpha-1 antagonist (terazocin)
Selective Beta blocker
4
Q
Who does atherosclerosis occur most often in?
Bilateral or not?
Associated risks?
A
Males older than 50
33% bilateral
Tobacco, lipids, DM
5
Q
What are the 3 types of coarctation?
A
Interrupted
Pre ductal
Postductal
6
Q
What is diminished in the early stage of CKD?
A
Reserve function
7
Q
Elevated BUN plus confusion is what?
A
Uremia
8
Q
Rib notching on PA chest and 3-sign on lateral chest with cardiomegaly indicate what?
A
Coarctation of heart
9
Q
What can cause a blockage in the urethra???
A
Stricture
Congenital valve
Phimosis
10
Q
What drug to treat migraines?
A
Beta blocker
CCB
11
Q
Renal vein renin ratio of what indicates a dx of renovascular HTN?
A
1.5 or greater
12
Q
What fibromuscular dysplasia occurs in infants and young adults more frequently?
A
Intimal FD
13
Q
GFR equation COCKcroft male?
Female?
A
GFR = (140-age) X (kg) / (SerumCr X 72)
Male GFR X 0.85
14
Q
Describe RTA type IV
Causes?
A
Hyperkalemic, hyporenin, hypoaldosterone
Decreases NH4 excretion and decreased HCO3 production
Analgesic nephropathy, sickle cell, SLE, DM
15
Q
What drugs can increase serum potassium?
A
PATTS
Pentamidine Amiloride Triamterene Trimethoprim Spironolactone
16
Q
Where are the 3 sites located for a post-renal blockage?
A
Ureteric
Bladder neck
Urethra
17
Q
What does an elevated BUN mean?
A
Azotemia
18
Q
What kind of casts are seen with allergic interstitial nephritis?
A
White cell (from eosinophils)
19
Q
Stage 1 of CKD?
A
kidney damage with normal/increased GFR above 90
20
Q
IV drug users with bacterial infections are due to what?
A
Endocarditis
21
Q
Stage 2 of CKD?
A
GFR = 60-89
22
Q
What type of renal artery stenosis shows increased Intravascular volume?
Renin response?
ACE response?
A
Bilateral and 1 kidney
Varied
Unpredictable
23
Q
What imaging may be best to visualize the kidneys?
A
Ultrasound of the abdomen
24
Q
Drug to treat Pheochromocytoma?
A
Alpha blocker then beta
25
What can cause a bladder neck blockage?
```
Neurogenic bladder
BPH
Calculi
Cancer
Blood clot
```
26
What is the most common type of fibromuscular dysplasia?
Medial
27
Describe K, PO4, and uric acid in FSGS?
Ca, albumen, hemoglobin?
What state is patient in?
All high
All low
Metabolic acidosis
28
What pO2 defines hypoxia?
Less than 60
29
Drug treatment for hypertrophic cardiomyopathy?
Contraindication?
Beta blockers, CCB
Diuretic, ACEI
30
What fibromuscular dysplasia occurs in the mid-distal portion of the renal artery?
Perifibromuscular
31
The combination of HTN and hypokalemia indicate what?
Hyperaldosteronism (Conn's syndrome)
32
How is serum creatinine effected in AKI?
Elevated by above 50% or by .5-1 above baseline
33
A physical exam showing HTN, JVD, pericardial changes, muscle wasting, asterixis, and ecchymoses indicates what?
FSGS
34
What kind of casts are found in tubular necrosis?
Bloody, brown
35
What drug to treat chronic renal insufficiency?
Loop diuretic
| CCB
36
What type of renal artery stenosis shows decreased Intravascular volume?
How is renin mediated in this type?
How is BP affected with ACE-I?
Unilateral
Increased
Falls
37
What has a better response to angioplasty: atherosclerosis or fibromuscular dysplasia?
Which is more progressive?
Fibromuscular dysplasia
Atherosclerosis
38
How do uremic toxins affect transmembrane voltage?
INC intracellular Na
DEC intracellular K
Inhibition of Ca flux
39
A dexamethasone suppression test is used for the diagnosis of what?
Cushing's
40
What are the 2 types of metabolic alkalosis?
Cl responsive, urine Cl less than 10-20 mEq/L
Improves with NaCl and volume
Due to vomiting, NG suction, diuretics
Cl unresponsive, urine Cl greater than 10-20
Unresponsive to saline
Due to endocrine causes
41
What is the increase in serum creatinine +/- decrease in urine output over hours to days?
Acute kidney injury
42
Stage 3b of CKD?
GFR = 30-44
43
What is the type B2 lactic acidosis?
Drugs/toxins like ethanol, methanol, ethylene glycol, ASA
44
What kind of anemia may occur with CKD?
What occurs in uremic Pts?
Normocytic, normochromic
Hemolysins
45
Effective volume depletion in 3rd spacing is what kind of kidney injury?
Pre-renal
46
What does CLEVER PD cause?
metabolic alkalosis
47
What is the type B1 lactic acidosis?
Systemic disorders like DM, liver failure, sepsis, seizures
48
What medication is given to treat metabolic alkalosis for mineralocorticoid excess?
Spironolactone
49
What can cause a ureteric blockage?
```
Calculi
Blood clot
Sloughed papilla
Cancer
External compression
```
50
Stage 5 of CKD?
GFR less than 15, (ESRD)
51
FeNa greater than 1-2% means what?
Tubular function not intact
52
Describe type I RTA
Causes?
Distal, decreased secretion of H+
SLE, Sjogren's, toluene
53
Metabolic acidosis due to decrease in bicarbonate can be caused by what?
Loss of HCO3 - GIT
Increase hydrogen load (DKA)
Decrease hydrogen excretion by kidney (uremic acidosis)
54
What drug preferentially dilates veins more than arterioles and is good for use in MI, LVF, CABG?
Nitroglycerin
55
What drug to treat GI Bleed?
Contraindication?
Non-selective Beta blocker
Beta blocker
56
What is the most common complication of ESRD?
HTN
57
What are the #1 and #2 primary causes of renal failure according to a 2005 Pie graph??
1 - DM
| 2 - HTN
58
GFR is about equal to what?
Creatinine clearance
59
CHAMPS causes what?
Stands for what?
Hyperventilation
```
CNS disease
Hypoxia
Anxiety
Mechanical ventilation
Progesterone
Salicylates/Sepsis/Stress
```
60
What is the captopril test for?
Shows what?
Diagnosis of renovascular HTN
Rise in renin, and large fall in BP after administration
61
Stage 4 of CKD?
GFR = 15-29
62
What causes a peaked T wave and severe cases a widened QRS with loss of a p wave?
Hyperkalemia
63
What is long-standing, irreversible impairment of renal function called?
Chronic kidney disease
64
What drug to treat cocaine use?
Labetalol
| Clonidine
65
CKD causes susceptibility to infections, specifically what structures?
Lymphoid structures, lymphocytopenia
66
What causes flattened T wave and in severe cases ST depression?
Hypokalemia
67
Describe RTA type II
Causes?
Proximal, decreased absorption of HCO3
Multiple myeloma, heavy metal poisoning, Wilson's, amyloid
68
What is the most common type of dialysis used for AKI?
Intermittent hemodialysis
69
What are the relative contraindications for a renal transplant?
```
Older than 70
Psychiatric disease
HeppC
Primary focal sclerosis
Multiple myeloma
Amyloid
Oxalosis
```
70
Coarctation of the aorta causes what?
Narrowing of medial layer of aorta
71
What are the following changes due to?
```
Carpal tunnel
Tensosynovitis
Shoulder arthropathy
Bone cysts
Cervical spondyloarthropathy and pseudo tumors
```
Long term dialysis
72
Who does fibromuscular dysplasia occur most often in?
Bilateral or not?
Women under 40
60% bilateral
73
What does MUDPILES CCAT stand for?
```
Methanol
Uremia
DKA
Paraldehyde
Isoniazid, iron
Lactic acidosis
Ethylene glycol
Salicylates
CO
Cyandide
Alcohol
Toluene
```
74
Stage 3a of CKD?
GFR = 45-59
75
What is the type A lactic acidosis?
Tissue hypoxia due to shock, several anemia, HF or CO poisoning
76
Butterfly wing distribution on chest X-Ray indicates what?
Means what?
Peripheral vascular congestion
Increased permeability of alveolar capillary membranes
77
According to the JNC-8, non-blacks (but includes people with diabetes), initial antiHTN treatment should include what type of medications?
Thiazides
CCB
ACE-I
ARB
78
What drug treatment after MI?
Contraindication?
Beta blocker, ACE-I
Direct vasodilator
79
What classifies as a HTN emergency?
Any high BP and damage to one organ system
80
A 30 y/o male with dysuria and perineal pain with a negative urine culture most likely has what?
Chronic prostatitis
| DANNY
81
When treating metabolic acidosis, what rx of NaHCO3 do you give?
1 amp 8.5%, 50 mEq/50cc
82
What cancer is most responsible for causing ascites?
Ovarian
83
What are the absolute contraindications of a renal transplant?
```
Active GN
Active infection
Active/recent malignancy
HIV
HepB surface Ag
Vascular disease
```
84
What is the type B3 lactic acidosis?
Inborn error of metabolism like G6PD deficiency
85
What kind of dialysis treatment may be seen in extremely unstable ICU patients?
Continuous renal replacement therapy
86
HARDUPS explains what?
Stands for what?
Normal anion gap metabolic acidosis
```
Hyperalimentation
Acid infusion, acetazolamide
RTA
Diarrhea
Ureteral sigmoid or ileal diversion
Pancreatic fistula
Spironolactone
```
87
What drug to treat stroke or TIA?
ACE-I
88
A normal anion gap metabolic acidosis is due to changes in what ions?
Caused by what?
HCO3 falls and Cl rises
HARDUPS
89
What are the effects of uremic toxins on metabolism?
Hypothermia (DEC Na transport)
K+ intracellular deficit
Metabolic acidosis
90
Drug treatment for tacyarrythmias?
Beta blocker, verapamil
91
FeNa below 1% means what?
Tubules intact, pre-renal cause
92
What bone changes are seen with uremia?
Terminal phalanges
Long bones
Distal clavicles
93
What hypoxemia?
Subnormal oxygenation in blood
94
CLEVER PD stands for what?
```
Contraction of volume
Licorice
Endocrine (Conn's, Cushing's, Bartters)
Vomiting
Excess alkali
Refereding alkalosis
```
Post hypercapnia
Diuretics
95
Where does coarctation of aorta commonly occur?
Ligamentum arteriosum
96
According to JNC-8, anyone over 18 y/o with CKD should be given what?
ACE-I or ARB
97
Drug treatment for CHF?
Contraindication?
ACEI, diuretic
Beta blocker, CCB
98
What is the Winter equation?
Expected PCO2 = 1.5 (measured HCO3) + 8 +/- 2
