Nephro Flashcards
(32 cards)
Hematuria
Glomerular origin is suggested by
Dysmorphic erythrocytes
Anion gap is calculated as
AG= Na - ( CL + Hco3)
Delta-Delta ratio
= ( AG - 12 ) / ( 25 - HCO3)
Delta- delta ratio interpretation
< 1 ; + NAGMA
1-2 ; pure HAGMA
> 2 ; + metabolic alkalosis
Osmolar gap formula
= measured osmolality - calculated osmolality
Plasma osmolality is calculated by
( 2x Na ) + Glucose + urea
causes of Metabolic alkalosis
VALH
1. Vomiting
- Antacid use
- Loop diuretics
- Hyperaldosteronism
NAGMA causes
HARD ASS
1. hyperalimentation ( TPN)
- Addison disease
- RTA
- Diarrhea
- Acetazolamide
- Spironolactone
- Saline infusion
HAGMA causes
Renal: uremic acidosis when GFR < 15-20
Extrarenal :
Lactic acidosis
DKA
Starvation ketoacidosis
Alcoholic keto acidosis
Poisoning
Treatment of chronic HTN in pregnancy if BP
SBP >= 160 or DBP > =110
Treatment of Lithium induced DI
Amiloride
Ttt of RTA type 1
Potassium citrate
Ttt of RTA type 2
Bicarbonate + - thiazide
Ttt of RTA type 4
Correct the underlying cause
Thiazide or loop
Causes of Urine Cl< 15
Vomiting
Nasogastric suction
Diuretics
Urine cl > 15 + HTN + Hypo K
Cushing
1ry hyperaldosteronism
Urine cl > 15 + Hypo K without HTN
Bartter’s syndrome
Gitelman’s syndrome
Correction rate of hyper Na
=< 0.5 mmol/hr with goal correction of 10 -12 mmol / day
Ttt acute symptomatic isovolemic hypotonic hypo Na
100 ml bolus 3% saline to increase S.Na by 2-3 mmol/l
Correction Target of chronic symptomatic isovolemic hypotonic hypo Na
4-6 mmol /l over 24 hrs
Ttt osmotic demyelination syndrome
Desmontes sin & iv D5%w
Tolvaptan indicated in
S.Na < 120
Persistent SIADH that failed to water restriction
Tolvaptan contraindicated in
Hypovolemic or
Acute symptomatic hypo Na
Ttt of struvite stone
Treatment of the infection
Urological intervention