Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Nephro > MTB 3 > Flashcards

MTB 3 Flashcards

(56 cards)

Start Studying
1
Q

Causes of Hyponatremia

A

HYPERvolemia
HYPOvolemia
Addison Dz
Euvolemia

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

Pathophys of Hypervolemia Hyponatremia

Examples

A

Intravascular volume depletion leads to increased ADH. Pressure receptors in atria and carotids sense decrease in volume, stimulate ADH

  • CHF
  • Cirrhosis
  • Nephrotic Sydnrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophys of Hypovolemia Hyponatremia

Examples

A

Sweating, burns, fever, pneumonia, diarrhea, diuretics

- When chronic replacement with water

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

Pathophys of Euvolemia Hyponatremia

Examples

A 
Pseudohyponatremia
Psychogenic Polydipsia
Hypothyroidism
SIADH
Hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hyperglycemia pathophys in Hyponatremia

A

Very high glucose levels lead to decrease in sodium levels.
Every 100mg/dL of glucose above normal, there is 1.6 mEq/L decrease in sodium

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

Psychogenic Polydipsia Pathophys

A

Massive water ingestion above 12 to 24 liters/day

Hx of Bipolar

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

SIADH pathophys

Examples

A

Lung or Brain Dz

Drugs: SSRIs, sulfonylureas, vincristine, cyclophosphamide, TCAs

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

Presentation of Hyponatremia

A 
Confusion
Lethargy
Disorientation 
Seizures
Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Urine osmolality in SIADH

A

High - inappropriately concentrated urine
Uric Acid - Low
BUN - Low

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

Most accurate test in SIADH

A

High ADH level

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

TX for SIADH

A

Severe, symptomatic
- ADH Antagonists: Tolvapatan, Conivaptan
Chronic
- Demeclocycline blocks ADH at collecting duct

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

Correction of low sodium too rapidly?

A

Central Pontine Myelinolysis

Osmotic demyelinization

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

How fast do we correct low sodium

A

0.5-1 mEq per hour OR

12 to 24 mEq per day

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

Causes of pseudohyperkalemia

A

Hemolysis
Repeated fist clenching
Thrombocytosis or leukocytosis

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

Drugs that cause hyperkalemia

A 
Non-selective beta blockers
ACE, ARBs
Spironolactone
Digitalis
Cyclosporine
Heparin
NSAIDs
Succinylcholine
Trimethoprim (esp HIV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperkalemia - causes of decreased excretion

A 
Renal Failure
Aldosterone decreases
- ACE/ARBs
- Type IV renal tubular acidosis 
- Spironolactone/Eplerenone
- Triameterene and amiloride
- Addison Dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperkalemia from increased release by tissues

A

Tissue destruction
-Rhabdomyolysis
- Tumor lysis syndrome
Decreased insulin
Acidosis - cells pick up hydrogen and release potassium in exchange
Beta blockers/Digoxin - inhibit Na/K ATPase
Heparin

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

Role of insulin and potassium

A

Inusulin drives potassium INTO cells

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

K+ is intra or extracellular

A

95% Intracellular

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

Presentation of hyperkalemia

A 
Muscle contraction and cardiac conduction
Weakness
Paralysis
Ileus
Cardiac rhythm disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most urgent test in severe hyperkalemia

A

EKG

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

EKG findings in hyperkalemia

A

Peaked T waves
Wide QRS
PR interval prolongation

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

TX for Hyperkalemia w abnormal EKG

Study These Flashcards
A
  1. Calcium chloride or calcium gluconate
  2. Insulin and glucose drive K+ back into cells
  3. Bicarbonate - drives K+ into cells
    - used most when acidosis causes hyperkalemia
24
Q

TX for removing K+ from the body

Study These Flashcards
A
  1. Kayexalate - sodium polystyrene sulfonate - removes thru bowel over several hours by binding K+ in gut
25
How to lower K+ Levels
1. Insulin and Bicarb redistribute into cells 2. Inhaled beta agonist - albuterol 3. Dialysis
26
When is calcium used in hyperkalemia
Only when EKG is abnormal to protect the heart
27
Causes of hypokalemia
Shifting into cells Decreasing intake Renal loss GI Loss
28
Renal loss of K+ hypokalemia Causes
``` Loops Increased aldosterone Primary hyperaldosteronism = Conn's Cushing syndrome Bartter syndrome = Salt loss at LOH Licorice Volume depletion Hypomagnesemia RTA = types I and II ```
29
Presentation of hypokalemia
Muscular contraction and cardiac conduction Weakness Paralysis Loss of reflexes
30
EKG of Hypokalemia
U waves | PVCs (ventricular ectopy), flattened T waves, ST depression
31
TX for Hypokalemia
Oral K+ replacement
32
AE of IV K+ replacement
Fatal arrhythmia if done too fast
33
How long do bicarb and insulin take to work in hypokalemia
15 - 20 mins
34
RTA = what kind of acidosis
Metabolic Acidosis with normal AG
35
How to calculate Anion Gap | Normal range
Na - (Cl + HCO3) | 6-12
36
Two most important causes of Metabolic Acidosis with normal AG Why normal AG
1. RTA 2. Diarrhea BC both are hyperchloremic = Cl rises
37
Type I RTA Pathophys Causes
Distal tubule damage where HCO3 cannot be generated, so acid cannot be excreted into tubule which raises pH of urine Nephrocalcinosis = Calcifies renal parenchyma Drugs - Ampho B AI - SLE, Sjogren
38
What is role of Distal tubule
Generates new bicarb under Aldosterone influence
39
What kind of urine (acidic/alkaline) do we see increased formation of kidney stones
Alkaline - from calcium oxalate
40
Best initial test for RTA type I
UA - abnormally high pH > 5.5
41
Most accurate test for RTA type I
Infuse acid into blood w ammonium chloride
42
TX for RTA type I
Replace bicarbonate that will be absorbed at proximal tubule
43
RTA Type II Location Causes
Proximal -90% of filtered HCO3 reabsorbed at proximal tubule Damage causes decreased ability to reabsorb HCO3, and is lost in urine
44
What damages proximal tubule
Damage by - Amyloidosis - Myeloma - Fanconi syndrome - Acetozolamide - Heavy metals
45
What effect does chronic metabolic acidosis have on calcium
Leaches calcium out of bones - softens them | Osteomalacia
46
Most accurate test for Type II RTA
Evaluate HCO3 malabsorption in kidney - give HCO3 and test urine pH - urine pH rises b/c kidney can't absorb
47
K+ in Type I RTA
Hypokalemic
48
K+ in Type II RTA
Hypokalemic
49
TX for Type II RTA
Volume depletion enhances HCO3 reabsorption | - Thiazides
50
Type IV RTA pathophys MC in which population
``` Hyporeninemia, Hypoaldosteronism Decreased amt or effect of aldosterone at kidney tubule - Na Loss - K+ and H+ retention MC in Diabetes ```
51
Testing for Type IV RTA
Persistently high urine Na despite Na-depleted diet | Hyperkalemia
52
Which RTA do we see nephrolithiasis
Type I - Distal
53
RTA with Variable urine pH
Type II - Proximal
54
RTA with high urine pH
Type I - Distal
55
TX for Type IV RTA
Fludrocortisone | - highest aldosteronelike effect
56
RTA with Hyperkalemia
Type IV

Nephro (6 decks)

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