Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Foundations II- Nephrology > Hydronephrosis, ARF, CKD, ESRD > Flashcards

Hydronephrosis, ARF, CKD, ESRD Flashcards

(77 cards)

Start Studying
1
Q

US is usually first choice when imaging kidneys, when should you use CT?

A

when looking for masses or stones

also higher sensitivity for PKD

avoid IV contrast- nephrotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of imaging study is preferred in children?

A

radionuclide studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In moderate to advanced KD, gadolinium can lead….

A

severe syndrome of nephrogenic systemic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the gold standard for RVT?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why isn’t renal arteriography and venography really used?

A

more invasive than CT/MMRI

can see arterial and venous occlusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is IVP used for?

A

High sensitivity and specify for stones

but not really used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for renal biopsy?

A

Nephrotic syndrome: SLE

Acute nephritic syndrome

Unexplained ARF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is renal biopsy NOT indicated?

A

In patient with: Isolated glomerular hematuria,

Low grade proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a page kidney?

A

bleeding under the capsule of the kidney after biopsy , causing compression of the collecting system leading to damage to the kidney, requires removal of the capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is hydronephrosis?

A

Unilateral or bilateral edema of the collecting system

-usually asxs
-poss. pain if obstructive involved
+/- change in UOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some obstructive etiologies for hydronephrosis?

A

Bladder outlet obstruction consider GI and GYN masses, stones, BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Imaging for hydronephrosis?

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some non-obstructive etiologies for hydronephrosis?

A

Large diuresis can distend intrarenal collecting system (ie. Diabetes insipidus).

CT if US not indicative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for hydronephrosis?

A

stenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is AKI (ARF)?

A

Abrupt (within 48hrs) decline in renal filtration function

Usually reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Labs consistent with ARF?

A

decreased in GFR and UOP (UOP less than 0.5ml for >6hrs)

increased Urea

Increased Creatinine (Azotemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is considered pre-renal?

A

Anything that happens above the kidney. Ex. Renal Hypoperfusion, hypovolvemia, poor fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is considered intrinsic AKI?

A

Damage within the kidneys themselves, ex. Damage to glomeruli, tubular or interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is considered post-renal AKI?

A

Damage after the kidney. Urology problem. Ex. Obstructive nephropathy, prostatic hyperplasia, bladder tumors, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most AKI are due to?

A

Pre-renal causes. Hypoperfusion leading to decrease in renal perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In AKI due to pre-renal causes will show…on labs

A

Increased BUN/Cr ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx for pre-renal AKI?

A

Maintain euvolemia, give fluids. Avoid nephrotoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

64 y/o M with chronic systolic HF. BUN 41mg/dL. Cr 1.4 mg/dL. What is likely cause of elevated BUN/Cr ratio?

  • Acute tubular necrosis
  • Bilateral ureteral obstruction
  • Renal hypoperfusion
  • Fe deficiency anemia
A

Renal Hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What would the BUN/Cr ratio be in ATN?

A

normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Bilateral ureteral obstruction is a….
Post renal problem
26
Rhambdomylysis is a...process
ATN myoglobin clogs up the tubule
27
What are some causes of AKI due to intrinsic causes?
ATN, Intersisital. Glomerular, vascular
28
causes for post renal AKI?
Obstructive: BPH, urolithiasis, bladder dysfunction (anticholinergic drugs), bladder CA
29
Sxs of post renal AKI? Dx?
lower abd pain bladder US labs: elevated BUN: Cr ration
30
Tx for postrenal AKI?
catheter, stent, surg depending on etiology remove what ever is causing the back up
31
How do you correct prerenal AKI? intrarenal? Postrenal?
IVF- normal hemodynamics Avoid nephrotoxic agents removal of obstruction for all: consider short term dialysis
32
What will you see on UA in ATN?
Muddy brown casts. ATN makes up 85% of intrinsic AKI
33
Is AKI reversible?
YES can do dialysis
34
HD can be done via
fistula > graft (due to risk of infx) tunneled line
35
When should you dialyze?
Weight Physical exam/fluid overload electrolytes imbalance? UOP/uremic complications Unresponsive acidosis pH<7.1
36
What is ATN?
Tubular damage due to ischemia or nephrotoxins
37
What are some nephrotoxins?
Aminoglycosides, Amp B, Vanco, contrast, CNI
38
Tx for ATN?
o Avoid volume overload, avoid hyperK, protein restrict, +/- diuretics
39
What can you use to renally protect from IV contrast?
Give N-acetylcystine/IVF with bicarb
40
What is AIN?
Inflammatory response leading to edema and possible tubular cell damage. Usually caused by nephrotoxic drugs but can also be infectious or autoimmune
41
What will you see on UA in AIN?
Eosinophiluria
42
Tx for AIN?
Steroids +/- dialysis
43
What causes intrinsic GN?
IgA nephropathy, post infectious strep GN, MPGN, Goodpastures
44
What will you see on UA in intrinsic GN?
RBC casts
45
Tx for intrinsic GN?
steroids and plasma exchange
46
Renal function in ESRD?
<15 or dialysis
47
What is GFR?
Glomerular filtration rate: - Degree of impairment - Varies by age, gender, and body size - Measurement via MDRD
48
What is creatinine?
Waste product of creatinine phosphate from muscle which passes in the blood and through kidneys Dependent on muscle mass
49
What is Azotemia?
Nitrogen in the blood Occurs when renal function can no longer efficiently clear metabolites Results from renal parenchymal damage
50
How do you determine Azotemia?
by measures of BUN and Cr leads to uremia
51
How do you monitor for uremia?
with blood urea nitrogen (BUN), urea produced by liver, excreted by urine
52
At what stages of CKD will you see uremia?
3-5
53
Sxs of uremia?
Malaise, N/V, dyspnea, impaired mentation, RLS, pruritus, weakness, insomnia, muscle cramping. Can lead to spontaneous bleeding, cardiac arrest, coma, seizure weight loss/muscle wasting, HTN, ecchymosis, asterixis, kussmaul respirations
54
Work up for CKD?
GFR* Labs: BUN and Cr elevated, proteinuria present, +/-microalbuminuria Abn H &H, lytes, UA consider bx
55
Tx for CKD?
ACE/ARBs- slows progression Tx underlying condition: Epo, Fe, antiplatelets low protein diet, fluid restriction Ca/ Vit D supplements consider dialysis/transplant
56
What causes hypervolemia?
Hyponatremia with hypervolemia usually CHF, nephrotic syndrome, ESRD or ESLD
57
Labs in CKD during hypervolemia?
Hgb and Hct decreased
58
Tx for hypervolemia?
Fluid restrict +/- diuretics +/- dialysis
59
What causes hypovolemia?
lost from EC compartment, GI tract, kidneys, "third spacing" skin/injured tissues
60
Labs for CKD pt with hypovolemia?
H&H increased urine Na decreased Urea increase
61
Tx for hypovolemia?
give isotonic IVFs
62
What are some causes of ESRD/CKD?
PKD,DM, glomerulonephritis. HTN, SLE, nephrolithiasis
63
Describe PKD
multiple bi cysts reduction of renal mass reduces kidney func. mostly genetic (75%) Autosomal Dominant
64
Sxs of PKD?
hematuria, infx, pain from rupture, nephrolithiasis, nocturia also assoc. with hepatic and pancreatic cysts
65
How do we eval for PKD?
US
66
Tx for PKD?
pain management ACE/ARB aggressive abx is sxs Transplantation
67
Half of ESRD causes are due to...
DM these patient also have increased risk of CV and stroke due to large vessel atherosclerosis
68
When should Metformin should be avoided?
in pts with Cr greater than 1.4 in women and 1.5 in men who need CT imaging should hold Metformin day of scan and 2 days after this is to avoid lactic acidosis
69
95% of renal artery stenosis is due to..
atherosclerosis
70
How do we dx renal artery stenosis?
Gold standard: renal angiogram Start with: Dopple US
71
Tx of renal artery stenosis?
angioplasty +/- stenting
72
Epidemiology of SLE?
9x more in females African americans > caucasians nephritis with proteinuria
73
What is the most common type of renal stone? What does it look like on imaging?
calcium (75-85%) radiopaque
74
Major causes of death for dialysis pts?
CV disease, infx, withdrawal from dialysis
75
What is KDRI?
kidney donor risk index, summarizes risk of graft failure high percentage = higher chance of graft failure
76
What makes someone more likely to have a rxn to transplant?
previous transplant pregnancy blood transfusions
77
possible post transplant s/s?
``` Hyper/hypoglycemia HTN/hypotension N/V/D Wound complications Anemia Watch for hyper/hypovolemia ``` new meds and drug-drug interaction

Foundations II- Nephrology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions