MKSAP - Nephrology Flashcards Preview

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Flashcards in MKSAP - Nephrology Deck (19)
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1
Q

Orthostatic proteinuria?

A

Proteinuria only when upright (children)

2
Q

Persistent hematuria? Interpretation of urine? Tests

A

3+ RBCs in urine on 2 more samples

If casts/dysmorphic RBCs - glomerular origin
If normal RBCs - from lower in the urinary tract

Kidney US and cytoscopy

3
Q

Risk factors for genitourinary malignancy?

A
  1. Male
  2. age>50
  3. tobacco use
  4. cyclophosphamide/benzene/radiation exposure
4
Q

Pt with azotemia - must do this before dialyzing?

A

Fluid resuscitation (and see if pt improves)

5
Q

Drugs to help with hepatorenal syndrome?

A

Octreotide and midodrine

6
Q

Drug to treat malignancy-related hyperuricemia?

A

Rasburicase

7
Q

In acute interstital nephritis - expect to see what UA findings?

A

pyuria, WBC casts, eosinophils on UA

8
Q

On ACE/ARB - acceptable increase in Cr?

A

30%

9
Q

Gap-metabolic acidosis - next steps?

A

1) Winters

2) Delta-Delta (AG - 12 + bicarb)

10
Q

Ammonium excretion in types of metabolic acidosis?

A

extra-renal - high acid secretion and high urine ammonium

renal acidosis - low acid secretion and low urine ammonium

11
Q

Urine anion gap? Normal range? Interpretation?

A

Urine Na + Urine K - Urine Cl
Normally 30-50
Neg UAG - non-renal (NH4 excreted)
Positive UAG - renal cause

12
Q

HyperK in pt with CKD - how to tell if its due to the CKD or other factor?

A

If GFR>15, due something else

13
Q

Pt with CKD - when is a thiazide not effective?

A

When GFR<30

14
Q

Way to estimate osmolarity?

A

2*Na

15
Q

hyperosmolar Pt without hyperglycemia who presents with polyuria and polydipsia with dilute urine? Test and interpretation?

A

Diabetes Insipidus

Give AVP - if urine concentrates, then central, if not nephrogenic

16
Q

Cinacalet?

A

Binds to parathyroid Ca-sensing receptor decreasing PTH release

17
Q

Pt with hyperCa and sarcoidosis - tx for hyperCa (and mech)?

A

Steroids (Ca from macrophages, steroids deactivate macrophages)

18
Q

Hypophosphatemia seen in what types of pt? Precipitated by? Symptoms?

A

Alcoholics, glucose administration (pushes phosphate into cells)

Confusion, rhabdomyolysis, hemolytic anemia, severe muscle weakness

19
Q

Indications for dialysis?

A

AEIOU

  1. Acidosis
  2. Electrolyte abnormalities-hyperkalemia
  3. Ingestion of substances like barbiturates, salicylates, lithium, methanol, etc
  4. Overload fluid (unresponsive to diuretics)
  5. Uremia symptoms (pericarditis, encephalopathy)

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