ASN QBank Pearls - Mineral Bone Disease Flashcards Preview

Nephrology Board Review Pearls > ASN QBank Pearls - Mineral Bone Disease > Flashcards

Flashcards in ASN QBank Pearls - Mineral Bone Disease Deck (56)
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1

- bone composition shows LOW bone mass
- NORMAL primary mineralization

osteoporosis

2

- bone composition shows LOW bone mass
- HIGH secondary mineralization

adynamic bone disease

3

- bone composition shows NORMAL or INCREASED bone mass
- DECREASED secondary mineralization
- INCREASED osteoid volume

secondary hyperparathyroidism

4

- wide osteoid seams with significant DECREASE in the rate of mineralization
- absence of cell activity and endosteal fibrosis
- aluminum disease is frequently associated with

osteomalacia

5

the Endocrine Society guidelines recommend vitamin D insufficiency/deficiency for whom?

high-risk populations

6

tumor-induced osteomalacia (TIO) is typically caused by

benign mesenchymal tumors of vascular or skeletal origin

7

- abnormal bone mineralization
- increased alkaline phosphatase
- long term, osteomalacia and associated fractures

is caused by?

chronic hypophosphatemia

8

calcitriol levels in TIO are

LOW, despite hypophosphatemia

9

MOST common renal manifestation of sarcoidosis

hypercalciuria

10

topiramate inhibits which enzyme?

carbonic anhydrase

11

topiramate is a/w

- proximal RTA
- distal RTA
- calcium phosphate stones

12

is a/w urinary crystals and is the MCC of nephrolithiasis

atazanavir

13

triamterene is a/w

urinary crystals

14

orlistat is a/w

enteric hyperoxaluria and urinary calcium oxalate crystals

15

- hypotension
- hyperkalemia
- hypocalcemia
- heart block
- cardiac arrest
- at risk if AKI or CKD

hypermagnesemia

16

hypomagnesemia
- renal magnesium wasting
- HIGH urinary Ca2+

thick ascending limb of LOH

17

hypomagnesemia
- renal magnesium wasting
- LOW urinary Ca2+

early distal tubule

18

hypomagnesemia
- renal magnesium wasting
- normal urinary Ca2+

late distal tubule

19

patients who are at highest risk of hypocalcemia at initiation of cinacalcet

those with already low Ca2+

20

how soon after starting cinacalcet should you measure Ca2+ level?

1 week

21

PTH level in milk-alkali syndrome (aka Ca2+-alkali syndrome)

suppressed (LOW)

22

AD hypocalcemia (ADH) is commonly caused by

activating mutation of CaSR gene

23

majority of AD hypocalcemia (ADH) patients are asymptomatic and therefore are not diagnosed until

adulthood, when hypocalcemia is noted

24

- hypocalcemia
- seizures
- neuromuscular irritability during periods of stress, such as a febrile illness (may be mislabeled as febrile seizures)

symptomatic children with AD hypocalcemia (ADH)

25

- Ca2+ 6-8 mg/dL, but as low as 5 mg/dL
- normal/slightly low PTH
- high/high normal UCa2+ excretion (rather than expected low excretion)
- recurrent nephrolithiasis and nephrocalcinosis (worse during treatment with vitamin D and calcium 
supplementation)
- no previous normal serum Ca2+ values
- low Mg2+ (in some patients)

AD hypocalcemia (ADH)

26

how to confirm diagnosis of AD hypocalcemia (ADH)?

analysis for mutation in CaSR gene

27

systemic medial calcification of the arterioles that leads to ischemia and subcutaneous necrosis

calciphylaxis (calcific uremic arteriolopathy)

28

what factors are implicated in the genesis of calciphylaxis (calcific uremic arteriolopathy)?

- hyperparathyroidism
- active vitamin D administration
- hyperphosphatemia
- elevated Ca2+ x PO4- product

29

what medications have been implicated as significant risk factors for the development of calciphylaxis (calcific uremic arteriolopathy)?

- warfarin
- calcium-based binders
- vitamin D analogs
- systemic glucocorticoids

30

how can calciphylaxis (calcific uremic arteriolopathy) develop in the setting of warfarin use?

inhibition of vitamin K-dependent carboxylation of matrix GLA protein (MGP)