nephro

Question 1

what is the overall MC type of AKI?

Answer 1

pre-renal –> renal hypoperfusion

Question 2

ddx for pre-renal AKIs

Answer 2

think things that cause decreased renal perfusion

• decreased intravascular volume - hemorrhage, GU losses, dehydration, burns, trauma, excessive diuresis
• change in vascular resistance - sepsis, anaphylaxis, anesthesia, vasodilators
• low cardiac output - cardiogenic shock, CHF, PE, tamponade
• systemic vasodilation - sepsis, hepatorenal syndrome

Question 3

What labs to we expect to see with pre-renal AKI

Answer 3

elevated BUN/Cr ratio, >20:1
*dt incr. urea reabsorption

fractional excretion of sodium

Question 4

tx for pre-renal AKI

Question 5

what are some causes of acute tubular necrosis?

Answer 5

ischemic injury -
nephrotoxic drugs
sepsis
inflammatory

Question 6

what lab findings would you expect to see in acute tubular necrosis?

Answer 6

labs:
- BUN/Cr ratio < 20:1
- FeNa > 1%
- hyperkalemia, hyperphosphatemia

urine: muddy brown casts or granual casts

Question 7

muddy brown/granular casts on UA likely indicates

Answer 7

ATN

Question 8

management of acute tubular necrosis

Question 9

what are common causes od acute interstitial nephritis?

Question 10

how does a pt with acute interstitial nephritis present? what lab findings would you expect to see? Tx?

Question 11

glomerular nephritis - how would a pt present, lab and urine findings, tx?

Question 12

compare/contrast lab findings in pre-renal vs intrinsic AKI

Question 13

ddx for post-renal AKI

Answer 13

**due to obstruction of urinary flow
**
- BPH
- bladder, prostate, cervical cancer
- retroperitoneal fibrosis
- neurogenic bladder
- anticholinergic drugs –> urinary retention
- blood clots, stones
- upper tract obstruction (would have to be bilateral or unilateral w/ no contralateral fxn to cause AKI)

Question 14

lab findings, w/u for post-renal AKI

Question 15

rhabdomyolysis - who gets it, how do they present, labs, tx

Question 16

compare/contrast nephritic vs nephrotic syndrome

Answer 16

nephritic
* hematuria, dysmorphic RBC’s, RBC casts
* mi

Question 17

how do you differentiated between post-infectious GN vs IgA nephropathy (Berger’s)

Question 18

nephrotic syndrome - what is the most common primary and secondary cause?

Question 19

what is the MCC of CKD?

Answer 19

secondary systemic processes - Diabetes (MC), HTN

Question 20

how may pts with CKD present? what lab findings may be seen?

Question 21

general CKD tx

Question 22

what is end stage kidney disease (ESRD)?

Question 23

what are some down-stream complications of CKD/ESRD?

Question 24

ESRD - what are some signs/sx of uremia?

Question 25

renal artery stenosis - who gets it, how do the present, how do we dx and tx?

Question 26

in pts with concern for BILATERAL renal artery stenosis, why would you avoid ACE-i/ARB?

Question 27

Polycystic Kidney Disease - who gets it, how do they present, dx, tx?

Question 28

what are some associated complications with polycystic kidnay dz?

Question 29

what congenital abnormalities are assoc. with horeshoe kidney? what are they at risk for?

Question 30

renal cell carcinoma - what are some risk factors, presentation, dx, tx

Question 31

what is the MC renal malignancy in children? how does it present?

Question 32

s/sx of hyponatremia

Answer 32

most asymptomatic more severe levels: - gain instability - lethargy - weakness - confusion - seizures

Question 33

in severe chronic hyponatremia, what is the complication you are worried about if sodium is corrected too quickly?

Answer 33

osmotic demylination syndrome

Question 34

ddx for hypernatremia

Question 35

S/sx of hypernatremia

Question 36

ddx for hypokalemia

Question 37

s/sx of hypokalemia what EKG changes can be seen?

Question 38

in hypokalemia, what concurrent electrolyte deficiency can make k+ correction more difficult?

Answer 38

low magnesium

Question 39

hyperkalemia ddx | what acid/base disturbance is this usally seen with?

Answer 39

| seen with acidosis

Question 40

s/sx of hyperkalemia what EKG changes can be seen?

Question 41

tx of hyperkalemia? what is an important initial consideration?

Question 42

what are some examples of agents that help with K+ elimination

Question 43

ddx of hypocalcemia

Question 44

s/sx of hypocalcemia

Question 45

hypocalcemia - labs, EKG findings, and tx

Question 46

what lab needs to be checked to r/o pseudohypocalcemia?

Question 47

hypercalcemia ddx

Question 48

s/sx of hypercalcemia

Question 49

hypercalcemia tx

Question 50

ddx hypomagnesemia

Question 51

s/sx of hypomagnesemia

Question 52

what electrolyte derangement typically accompanies hypoMg?

Question 53

acid/base stuff