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Clin Med Renal > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

most common measure of renal function

A

glomerular filtration rate GFR

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2
Q

normal GFR

A

90-120 ml/min.. yte over 60 usually considered normal

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3
Q

when does GFR naturally decline?

A

after age 30-35 years

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4
Q

2 ways to calculate GFR

A

Cockcroft gault and MDRD

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5
Q

what can make sCR inaccurate?

A

muscle mass, diet, medications

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6
Q

creatinine should be in blood?

A

no should be cleared, a byproduct of breakdown of creatine phosphate in muscle

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7
Q

what is best test for early sign of kidney dz like DM?

A

spot urine

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8
Q

what test may overestimate GFR?

A

24 hour urine test

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9
Q

spot urine finds what?

A

marker of urinary excretion of albumin (PRO)

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10
Q

what is normal 24 urine test albumin finding?

A

less than 30 mg of albumin in 24 hr sample

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11
Q

what is normal spot urine result?

A

albumin : creatinine is less than 30 mcg/min on a spot urine

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12
Q

microalbuminuria is a good screening for ____

A

early kidney dz like DM that would not necessarily be caught on a UA

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13
Q

what are 6 indications for hemodialysis

A
  1. sx uremia: mental status change, pruritis
  2. refractory hyperkalemia
  3. refractory volume overload (esp if compromise cardiac or respiratory function)
  4. refractory acidosis
  5. crCl or eGFR less than 10-15
  6. bleeding diathesis
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14
Q

what is big problem with factor 10 inhibitor meds?

A

there is no reversal.. if person on this and quickly needs emergency surg.. can dialysis meds out

prob: have to put cath in person already bleeding

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15
Q

what is initial renal imaging option

A

ultrasound

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16
Q

when is an ultrasound indicated?

A

to look at size, thickness of cortex, medulla and pyramids, urinary collection system

17
Q

what is normal size of kidney on us?

A

9-12 cm

18
Q

what are some conditions us can find?

A

hydronephrosis, polycystic disease, masses/lesions, obstructive uropathy

19
Q

what is the one con to renal us?

A

poor visualization due to body habitus (type)

20
Q

what is first line test for renal stones in pt with acute flank pain?

A

non contrasted CT scan

21
Q

what are 4 reasons to use a renal CT?

A
  1. if US finds something ..next line image - get a CT
  2. solid or cystic lesions
  3. non contrast for - renal stones
  4. contrast for parenchymal tissue
22
Q

what parenchymal tissue problems can a contrasted CT find?

A

cysts, neoplasms, vessel visualization, ureters

23
Q

when would you not use a contrast CT to look at kidneys?

A

not needed for stones or looking for bleeding

24
Q

when looking for mets from lung cancer always scan down to level of the ____

A

adrenals

25
Q

pt comes in with flank pain, hematuria and walks like dog.. scan for?

A

CT scan without contrast for kidney stone

26
Q

what does MRI/MRA differentiate in kidney anatomy?

what conditions is this helpful for? (3)

A

renal cortex and medulla well.

Helpful for: glomerulonephritis, hydronephrosis, vascular occlusion

27
Q

Cystic lesions show best on a ___

A

MRI

28
Q

solid lesions show best on a ___

A

CT

29
Q

what test do you use when contrast is CI based on patient?

A

MRI

30
Q

what is one example (besides DM) that would make contrast contraindicated?

A

when sCR is elevated

31
Q

what test is 100% sensitive and 97% specific for diagnosing renal artery stenosis?

A

MRA –> this is the gold standard for renal artery stenosis

32
Q

5 indications for renal biopsy

A
  1. unexplained AKI or CKD (or refractory)
  2. acute nephritic syndrome
  3. unexplained proteinuria or hematuria
  4. systemic dz associated with renal dysfunction (SLE, Goodpastures)
  5. transplant management
33
Q

where can renal biopsy bleed a lot?

A

into retroperitoneal space - be OFF blood thinners

34
Q

what is most common renal biopsy complication

A

local hematoma

Clin Med Renal (3 decks)

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