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Undeleted > Exam 3 Important stuff I need to remember > Flashcards

Exam 3 Important stuff I need to remember Flashcards

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1
Q

Dx of acute kidney injury

A

increased of 0.3 serum creatinine (days to wks)

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2
Q

Causes of decreased serum creatinine

A

pregnancy

cirrhosis

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3
Q

Cause of falsely low creatinine assay

A

jaundice

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4
Q

Cause of falsely high creatinine assay

A

DKA

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5
Q

2 Drugs causing increased serum creatinine

A

trimethoprim

cimetidine

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6
Q

Med contraindicated in AKI

A

NSAIDs, they decrease PGE which cause afferent vasodilation

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7
Q

FENA value and meanings

A

2% for ATN/diuresis

if FENA decreased with diuretic=ineffective diuresis

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8
Q

FEurea value and meanings

A

50% for ATN/CKD

used with diuretics because they do no impact FEurea

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9
Q

Suggestion of isothenuria

A

ATN with no response to ADH

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10
Q

Urine lab values for Pre-renal azotemia (Na/Osm/gravity/FENA/BUN:Cr)

A

Na500
specific gravity>1.015
FENA 20:1

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11
Q

Urine lab values for ATN (Na/Osm/gravity/FENA/BUN:Cr)

A 
Na>40
Osm=280
specific gravity=1.010
FENA>2%
BUN/Cr =15:1
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12
Q

Casts with ATN

A

granular casts with muddy brown (RBC)

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13
Q

Casts with CKD

A

waxy casts

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14
Q

Hyperkalemia cardio sx

A

peaked T waves

widened QRS

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15
Q

Med tx for hyperkalemia

A

Ca (increases threshold)
insulin/beta2 stimulants (K into cells)
kayexalate (K/Na exchange in colon)

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16
Q

UTI prophylaxis for recurrent infections

A

TMP-SMX

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17
Q

Viral cystitis cause

A

adenovirus 11, 21

seen seasonally

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18
Q

Neonate UTI

A

from hematogenous spread

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19
Q

Infatn UTI

A

from ascending route

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20
Q

Med choice for ped HTN

A

HCT for no end organ damage

ACEI/ARB for CKD or DM with HTN

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21
Q

Cause of urge incontinence

A

detrusor overactivity

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22
Q

Cause of stress incontinence

A

increased intra-abd pressure, with no bladder contraction

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23
Q

Exacerbation of stress incontinence

A

estrogen

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24
Q

Risks for UT maligancy

A

smoking hx
analgesic abuse
pelvic irradation

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25
Use of intravesical therapy
stages Ta, T1, Cis bladder cancer | noninvasive cancers
26
When do you do a radical cystectomy
non-met, muscle invasive bladder cancer
27
Meds causing kidney stone formation
``` Vit C/D triamterene protease inhibitors lasix acetazolamide ```
28
Stones soluble in alkaline urine
uric acid | cystine
29
Drug for uric acid stones
allopurinol
30
Drug for struvite stones
lithostat
31
Drugs for cystine stones
thiola | D-penicillamine
32
Urosepsis pathogen factors
LPS and Lipid A | type 1 and P-fimbriae
33
Early goal tx for urosepsis
hemodynamic stability
34
Crashing uroseptic tx
nephrostomy
35
Testicular detorsion tx timeframe and ultrasound finding
6 hrs | no flow on echo (heterogenous)
36
Testicular rupture tx timeframe
72 hrs for surgery
37
Epididymitis ultrasound finding
increased flow to epididymis
38
Penile fracture rupture
albuginea and tumescent corpora cavernosa
39
Fournier's gangrene
pain in penis/scrotum out of proportion to exam increased with DM/EtOH/immunosuppressed E coli causes commonly
40
Arterial vs ischemic priapism
arterial has no pain, from cavernous a. damage | ischemic has blood stasis
41
Causes of priapism
Sickle-cell leukemia infiltration trazodone/phenothiazines/cocaine
42
Tx for priapism
for Sickel Cell, transfuse Hb aspiration/irrigation of corpora phenylephrine injection shunt if not tx w/in 1 hour
43
Kidney decline with age
increased decline over the age of 40 (from 0.1 to 0.8cc/min/yr)
44
CKD consequences of adapations
intraglomerular HTN/glomerular hypertrophy cause glomerulus scarring increased ammoniagensis causes scarring of intersitium
45
CKD adaptations
``` increased renal afferent vasodilation increased renal efferent vasoconstriction hypertrophy of tubule above cause increased GFR increased ammonia for H+ removal ```
46
BP control with CKD pts
ACEI/ARBS- slow progression of damage | CCB's for transplant pts
47
Side effect of ACEI/ARBs with CKD
increased creatinine levels | stabilize after a time
48
Cause of anemia with CKD
erythropoietin deficiency seen at Stage 4 of CKD normocytic normochromic anemia
49
Tx of CKD anemia
with EPO | get Hb over 10mg/dL
50
Serum level changes in CKD
increased PTH and FGF-23 | decreased Ca2+ and 1,25 Vit D
51
Primary vs secondary hyperparathyroidism
primary-adenoma causes increased Ca/decreased phosphate | secondary-from hyperplasia responding to decreased Ca/increased phosphate
52
Types of renal osteodystrophy with CKD
osteitis fibrosa cystica (increased PTH) osteomalacia (decreased bone vol) mineralization (decreased 1,25 Vit D)
53
Bone disease prevention with CKD goal
keep phosphate below 5.5mg/dL
54
Major cause of death from CKD
medial calcification (arteriosclerosis)
55
Tx for excess volume in CKD
thiazides up to stage 3 loop diuretics at stage 4 and 5 due to thiazide dependence on GFR
56
Pain mgt meds for kidney stones
``` morphine sulfate (narcotic) ketorolac (NSAID) ```
57
Meds for kidney stone passing
nifedipine (CCB)-decreased ureteral contraction | tamsulosin/teraosin (alpha1-anatagonists)-decreased peristalsis
58
Ca2+ stone prevention
fluids (over 2 L/day) thiazides + amiloride NOT triamterene (causes stones)
59
Tx for primary hyperoxaluria
pyridoxine
60
Tx for secondary hyperoxaluria
cholestryamine (binds oxalate)
61
Meds for cystine stones
tipronin/d-penicillamine | break disulfide bonds b/t cysteines
62
Struvite stone tx without surgery
urease inhibitor | acetohydroxamic acid
63
Tx for nephrogenic diabetes insipidus
thiazides or indomethacin | goal to decrease urine flow
64
Tx for Li+ induced diabetes insipidus
amiloride-decreases Li+ absorption

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