ASN QBank Pearls - Potassium, Acid Base, Tubulointerstitial Disorders, and Nephrolithiasis Flashcards Preview

Nephrology Board Review Pearls > ASN QBank Pearls - Potassium, Acid Base, Tubulointerstitial Disorders, and Nephrolithiasis > Flashcards

Flashcards in ASN QBank Pearls - Potassium, Acid Base, Tubulointerstitial Disorders, and Nephrolithiasis Deck (139)
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1

- low PRA (plasma renin activity)
- high PAC (plasma aldosterone concentration)
- aldosterone synthesis independent of renin levels

primary aldosteronism

2

- low PRA
- high PAC
- high urine free cortisol/cortisone ratio
- high ACTH
- AD
- cortisol-producing zona fasciculata defect d/t promoter fusion causing ACTH dependent activation of aldosterone synthase on cortisol precursors

glucocorticoid-remediable aldosteronism

3

- low PRA
- high PAC
- mass > 5 cm

adrenal Ca

4

- high PRA
- high PAC
- atherosclerosis
- hypoxia-induced

renovascular HTN

5

- high PRA
- high PAC
- unregulated synthesis

renin-secreting tumor

6

- low/normal PRA
- low/normal PAC
- high cortisol
- high urine free cortisol/cortisone ratio
- excess cortisol production

Cushing disease

7

- low/normal PRA
- low/normal PAC
- high cortisol
- high urine free cortisol/cortisone ratio
- mutation of 11-BHSD2

syndrome of apparent mineralocorticoid excess (SAME)

8

syndrome of apparent mineralocorticoid excess (SAME) causes

- can be inherited 

- can be acquired;
- black European licorice (glycyrrhizic acid)
- itraconazole
- ectopic ACTH
- grapefruit

9

- low/normal PRA
- low/normal PAC
- low/normal cortisol
- low/normal urine free cortisol/cortisone ratio
- hypokalemia
- AD
- ENaC gain of function mutation

Liddle syndrome

10

- low/normal PRA
- low/normal PAC
- low/normal cortisol
- low/normal urine free cortisol/cortisone ratio
- worse w/ pregnancy and spironolactone

mineralocorticoid receptor gain of function mutation (Geller’s syndrome)

11

- young female with HTN and hypokalemia
- family h/o early onset HTN and hemorrhagic stroke
- urinary K+ wasting
- increased urinary excretion of aldosterone and 18-OH cortisol during salt loading

glucocorticoid remediable aldosteronism

12

treatment of glucocorticoid remediable aldosteronism

spironolactone and dexamethasone

13

- severe HTN with metabolic alkalosis and hypokalemia
- young women during the second and third trimester of pregnancy

mineralocorticoid corticoid receptor mutation (Geller’s syndrome)

14

MR 810 mutation is activated by what medication, thereby worsening hypertension and hypokalemia

spironolactone

15

treatment of mineralocorticoid corticoid receptor mutation (Geller’s syndrome)

- often requires delivery
- subsequent management includes avoidance of spironolactone

16

hyperemic optic disks and putamen swelling are suggestive of

methanol intoxication

17

changes in mentation as a result of methanol are present w/i the first 6-24 hours but can be the only abnormality for as long as 72-96 hours if patients have also ingested, what?

ethanol (competes for ADH)

18

methanol metabolite

formic acid

19

- changes in mentation
- HAGMA
- large osmolal gap
- less likely to have cerebral edema

ethylene glycol toxicity

20

- ketoacidosis (typically after patient stops drinking)
- usually small osmolal gap

ethanol toxicity

21

solvent used for lorazepam, diazepam, and phenobarbital

propylene glycol

22

- large osmolal gap
- HAGMA
- AKI
- can progress to multisystem organ failure, if severe
- usually a/w dosages above the recommended range of 0.1 mg/kg/hr and/or renal impairment

propylene glycol toxicity

23

- HTN at young age
- CVA at young age
- low aldosterone level
- hypokalemia
- metabolic alkalosis

Liddle's syndrome

24

- hypokalemia
- normo- or hypotension

Bartter's or Gitelman's syndromes

25

- hyperkalemia
- HTN
- metabolic acidosis

Gordon's syndrome (pseudohypoaldosteronism type 2)

26

- if metabolic acidosis, compensation should be what?- - calculation

- respiratory alkalosis
- ∆CO2 = ∆HCO3 x 1.2

27

- if metabolic alkalosis, compensation should be what?
- calculation

- respiratory acidosis
- ∆CO2 = ∆HCO3 x 0.6

28

- ACUTE respiratory acidosis, compensation should be what?
- calculation

- metabolic alkalosis
- ∆HCO3 = ∆CO2 x 0.1

29

- CHRONIC respiratory acidosis, compensation should be what?
- calculation

- metabolic alkalosis
- ∆HCO3 = ∆CO2 x 0.3

30

- ACUTE respiratory alkalosis, compensation should be what?
- calculation

- metabolic acidosis
- ∆HCO3 = ∆CO2 x 0.2