Nephro

Question 1

4 cardinal sx of Nephrotic Syndrome

Answer 1

1. Proteinuria
2. Edema
3. Hyperlipidemia
4. Hypoalbuminemia

*Oval fat bodies that are maltese cross shaped-lipoproteints in urine

Question 2

HTN, hematuria, proteinuria, and azotemia

Answer 2

Acute Glomerulonephritis

Question 3

Berry anuerysms, hepatic cysts, mitral valve prolapse, colonic diverticular

Answer 3

Polycystic kidney diseases

Question 4

Broad waxy casts

Answer 4

CKD

Question 5

Management of progression

Answer 5

1. HTN- <140/90
2. Proteinuria- Ace/ARB
3. DM- less than 6.5

Question 6

Renal osteodystrophy

Answer 6

Calcicum and phosphate dysruglation causing bone and proximal muscle pain

Question 7

Low vitamin D and calcium with elevated phosphate and PTH–> Secondary hyperparathyroidism

Answer 7

Renal osteodystrophy

Question 8

Decreased serum osmolality and increased urine osm

Answer 8

SIADH

Question 9

Dehydration, hypernatremia, polyuria, polydipsia

Answer 9

DI

Question 10

Pt presents with polyuria, polydipsia, and nocturia after having head trauma 2 weeks prior. Administration of ADH leads to increased urine osm. Dx?TX?

Answer 10

Central DI- give Desmopressin

Question 11

Administration of ADH leads to persistent inability to concentrate urine osmolality. Dx and tx?

Answer 11

HCTZ, low solute diet

Question 12

Impaired kideny free water excretion and increased aDH can lead to what sx?

Answer 12

CNS dysfunction due to hyponatremia from cerebral edema

1. muscle cramps
2. seizures
3. decreased DTR

Question 13

Serum osmallility of greater than 145 inidcates…

Answer 13

Hypernatremia brought on by GI losses

Question 14

Pt with hx of CKD presents for weakness, fatigue, and palitations. EKG shows peaked T waves. What do you administer?

Answer 14

IV caclium gluconate

Question 15

Pt with hx of HTN presents for poluria, muscle weakness, decreased DTR. EKG shows U wave. What do you expect to find on labs?

Answer 15

Hypokalemia from possible use of diuretics

-Give KCL oral

Question 16

MC type of acute kidney disease

Answer 16

Prerenal-hyovomemia

Question 17

Reasons for muddy brown casts

Answer 17

Aminoglycosides, MM, rhabdo

Question 18

Pt presents increased creatinine and BUN. Labs show metabolic acidosis.PE shows maculopapular rash and fever. UA shows WBC casts and IgE. What do you suspect is etiology?

Answer 18

Acute tublointerstitial nephritis induced by NSAIDs or PCN.

Question 19

Pt comes in AmS

Labs show decreased serum osmolality and increased urine osm, hyponatremia. What do you suspect and tx

Answer 19

SIADH caused by SAH
Use IF hyertonic saline with furosemide

Caution as you can induce central pontine myelinolysis

Question 20

What lab values can give you a false hyponatremia reading

Answer 20

1. . hypertriglyceridemia

2. Hyperproteinemia

Question 21

Pt comes in with diarrhea. Hx-drinks and takes PPI daily. Pt has increased DTR and is showing signs tetany. EKG showing torsades. What do you suspect is electrolyte deficiency?

Answer 21

1. Hypomagnesemia
2. Hypocalcemia

Tx: Oral Mg for mild
and IVMg Sulfate for torsades

Question 22

Tx for hypermagnesemia?

Answer 22

Calcium gluconate for severe

Question 23

Pt with hx of CKD presents c/o vomiting and diarrhea. Currently takes diuretic. Labs show metabolic alkalosis. C.o crmaping and muscle weakness. Prominents U wave. Dx?

Answer 23

Hypokalemia and give KCL for mild and can give K+ sparring diuretics