Nephro

Question 1

pyuria, hematuria and white cell casts. What type of AKI?

Answer 1

acute interstitial nephritis

Question 2

dysmorphic red blood cells and red blood cell casts with hematuria. What dx?

Answer 2

acute glomerulonephritis

Question 3

What are the 3 criteria needed to dx AKI?

Answer 3

one of the three following criteria must be met:

1. an increase in serum creatinine (by ≥ 0.3 mg/dL) within 48 hours
2. an increase in serum creatinine to ≥ 1.5 times baseline within 1 week
3. a decreased urine volume (< 0.5 mL/kg/hour) for at least 6 hours

Question 4

What are the 3 associated findings commonly seen with poststreptococcal glomerulonephritis?

Answer 4

hematuria
HTN
periorbital edema

Question 5

What are 3 associated findings with minimal change disease?

Answer 5

proteinuria
edema
hypoalbuminemia

Question 6

medications that are nephrotoxic, such as aminoglycosides, amphotericin B, vancomycin, and contrast are likely to cause what type of AKI? What are some trademark findings?

Answer 6

Acute tubular necrosis (ATN)

ATN:
-muddy brown granular casts
-the fractional excretion of sodium (FENa) is generally elevated > 2%

Question 7

What can the fractional excretion of sodium (FENa) tell you?

Answer 7

This represents how much filtered sodium is excreted in the urine. In prerenal AKI, this number is often low because the tubule is functioning and reabsorbing as much sodium as possible in the face of hypovolemia.

In ATN, the tubule is damaged and thus unable to reabsorb as much sodium and FENa is generally elevated > 2%

Question 8

hyaline casts are commonly seen with ______ injury, which is often caused by _______

Answer 8

prerenal kidney injury

hypovolemia

Question 9

Evaluation of ______ is the most important initial step in evaluating a patient with abnormal kidney function

Answer 9

serum creatinine

Question 10

fever, rash and peripheral eosinophilia. What type of AKI?

Answer 10

interstitial nephritis

Question 11

What is the most serious complication of Autosomal dominant polycystic kidney disease (ADPKD)?

Answer 11

cerebral aneurysm

Question 12

Autosomal dominant polycystic kidney disease (ADPKD) can also have cyst forming of what 2 other organs?

Answer 12

liver and pancreas

Question 13

What is another name for arginine vasopressin resistance?

Answer 13

nephrogenic DI

Question 14

What is a known complication of chronic lithium toxicity?

Answer 14

arginine vasopressin resistance

aka nephrogenic DI

Question 15

What is the formula to calculate anion gap? What is considered elevated?

Answer 15

sodium - (bicarb + chloride)

> 11 mEq/L

Question 16

What very not good side effect happens when you correct hypernatremia too fast?

Answer 16

cerebral edema

Question 17

What very not good side effect happens when you correct hyponatremia too fast?

Answer 17

osmotic demyelination syndrome

Question 18

What is Alport syndrome?

Answer 18

genetic condition that leads to hearing loss, poor visual acuity and hematuria

usually presents in kiddos

Question 19

______ is a direct complication of nephrotic syndrome

Answer 19

DVT secondary to hypercoagulable state

Question 20

ASA overdose. What acid-base disturbance is most likely?

Answer 20

mixed respiratory alkalosis with metabolic acidosis

Question 21

What is a common cause of hypomagnesemia?

Answer 21

malnutrition

Question 22

Pt’s who miss dialysis, what is the bodies response mechanism to correct acid base disorder?

Answer 22

body with increase respiratory rate to decrease carbon dioxide and increase serum pH

pts who miss dialysis are likely to have a metabolic acidosis problem because there kidneys do not function well

Question 23

What can cause a false negative for proteinuria on a urine dip stick?

Answer 23

dilute urine

Question 24

Urine microscopy of a patient reveals elevated creatinine with muddy brown cellular casts. What dx?

Answer 24

acute tubular necrosis

Question 25

What electrolyte abnormality is associated with vasopressin?

Answer 25

hyponatremia

Question 26

What is the most likely patient population with Fibromuscular dysplasia (FMD)?

Answer 26

Fibromuscular dysplasia (FMD) should be suspected in women < 35 years with unexplained hypertension. FMD is most commonly seen in women. The mean age of diagnosis is 52 years. The renal arteries and extracranial cerebrovascular arteries are most commonly affected, and most patients have involvement of multiple arteries. FMD is a noninflammatory, nonatherosclerotic disease that results in arterial occlusion, stenosis, and dissection

Question 27

What is a complications that is associated with the use of furosemide, especially if given rapidly via IV push?

Answer 27

acute hearing loss

Question 28

Best imaging to dx renal artery stenosis?

Answer 28

gadolinium-enhanced MRA