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Internal Medicine Review > Nephrology > Flashcards

Nephrology Flashcards

(67 cards)

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1
Q

Part of the nephron responsible for concentrating the urine

A

Loop of Henle

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2
Q

70% of all solutes are reabsorbed in this tubule

A

PCT (proximal convoluted tubule)

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3
Q

powerhouse of the nephron

A

TAL of Henle

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4
Q

creates a hypertonic environment of the medulla

A

TAL of Henle

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5
Q

aldosterone sensitive Na/K exchangers (2)

A

DCT
Collecting Tubule

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6
Q

Mainly adjust Na reabsorption using thiazide sensitive NA Cl symporter

A

DCT

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7
Q

Where vasopressin acts on aquaporin to allow passage reabsorption of intraluminal water

A

collecting duct

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8
Q

Hormone that has an effect in the efferent arteriole causing increase GFR but with compensatory Na reabsorption

A

angiotensin

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9
Q

facilitate dilation of the afferent arteriole causing increase GFR but no sodium reabsorption

A

ANP (prostaglandin)

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10
Q

Hormone responsible between the play of calcium and phosphate

A

parathyroid hormone

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11
Q

causes sodium reabsorption and K, H secretion at the distal nephrone

A

aldosterone

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12
Q

normal values of potassium

A

3.5-5mg/dL

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13
Q

most frequent cause of hyperkalemia

A

decrease secretion of potassium via renal/kidneys

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14
Q

Classic ECG changes in hyperkalemia

A

Tall peak T waves
Widened QRS
Loss of P waves

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15
Q

Drug to give when there is hyperkalemia

A

calcium gluconate

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16
Q

What is the mechanism of action for calcium gluconate?

A

Raises AP (action potention) threshold to usual 15 mV difference between resting and threshold potential

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17
Q

Treatment for Hyperkalemia classified as membrane stabilizers

A

calcium gluconate
Hypertonic normal saline (3%)

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18
Q

Treatment for hyperkalemia classified as shifters

A

Insulin
Albuterol

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19
Q

Treatment for hyperkalemia classified as excreters

A

furosemide
sodium bicarbonate
sodium polystyrene sulfonate

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20
Q

How does hypomagnesemia cause hypokalemia?

A

ROMK is a channel that secretes K to the renal tubule. Magnesium acts as an inhibitor for this channel.

Decrease magnesium -> increase potassium excretion -> decrease potassium in body

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21
Q

Patient profile:
male, hypokalemia and leg weakness.

This patient likely has?

A

Grave’s disease

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22
Q

ECG changes in hypokalemia

A

U waves

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23
Q

Tapping the front of the ear stimulates facial nerve depolarizations

A

Chvostek’s sign

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24
Q

Tetany in hand especially after decrease perfusion to hand. This sign is elicited via blood pressure cuff due to spontaneous action potentials from the median nerve

A

Trosseau’s sign

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25
First tetanic sign to develop with hypocalcemia
Trousseau's sign
26
ECG changes in hypocalcemia
QT prolongation
27
Normal values of sodium in blood
135-145mg/dL
28
Levels of calcium to define it as hypocalcemia or hypercalcemia
Hypercalcemia: serum Ca > 2.5mmol/L Hypocalcemia: serum Ca < 2.5mmol/L
29
Treatment for hypocalcemia
Calcium gluconate
30
Chronic hyponatremia should be corrected slowly to avoid this condition
ODS (osmotic demyelination syndrome)
31
4 principle causes of high anion gap acidosis
lactic acidosis ketoacidosis toxins renal failure
32
2 causes of hyperchloremic or anion gap acidosis
bicarbonate loss form GI tract renal tubular acidosis
33
METABOLIC ACIDOSIS: Specific causes of High Anion Gap Metabolic Acidosis
"MUPILES" methanol urea DKA paraldehyde propylene glycol iron, isoniazid, idiopathic acidosis lactic acidosis (sepsis, shock) ethylene glycol, ethanol salicylic acid
34
METABOLIC ACIDOSIS: Specific causes of Normal Anion Gap Metabolic Acidosis
"HARD UP" hyperalimentation acetazolamide RTA diarrhea uteroenteric fistula pancreticoduodenal fistula
35
Definition of AKI
urine output <0.5ml/kg/hours for 6 hours serum creatinine increase by 0.3mg/dL within next 48 hours 0.5 times increase in baseline serum creatinine within the next 7 days
36
Most common electrolyte abnormality in a patient with AKI
hyperuricemia hyperphosphatemia hyperkalemia hypocalcemia
37
Which classification of AKI is the most common?
Pre-renal
38
Most common cause of intrinsic AKI are ___. (3)
sepsis nephrotoxin ischemia
39
Complete anuria is uncommon in AKI except in the following conditions (4)
complete urinary tract obstruction renal artery occlusion overhwhelming shock severe proliferative GN
40
Features of amphotericin B nephropathy (4)
Hypomagnesemia Hypocalcemia NAGMA Polyuria
41
Features of aminoglycoside nephropathy
Hypomagnesemia Non oliguric AKI
42
Remarkable in electrolyte abnormality in Platin based therapy
Hypomagnesemia and hypokalemia
43
Cause of Chinese herb nephropathy Balkan nephropathy
Aristolochic acid
44
Contaminant in foodstuffs leading to nephrolithiasis, AKI
Melamine
45
Features of artheroembolic disease
Eosinophiluria Peripheral eosinophilia Livedo reticularis
46
Definition of CKD
eGFR of <60 mL/min/1.73 m2 for at least 3 months
47
Cast found in CKD
Broad waxy casts Isosthenuria
48
Casts found in AKI
Muddy brown cast (for ATN)
49
Definition of oliguria
< 400 mL/day
50
Definition of anuria
< 100 mL/day
51
Definition of polyuria
> 3000 mL/day
52
Definition of hematuria
2-5 RBCs/hpf
53
Features virtually diagnostic of GN
Hematuria with dysmorphic RBC RBC cast CHON excretion > 500mg/day
54
Features of pyelonephritis
WBC casts Bacteriuria
55
Characterized by solute diuresis with an appropriate free eater excretion
post obstructive diuresis
56
Identify: > 500 mOsm/kg
Suggestive of prerenal disease and hypovolemia
57
Identify: < 250 mOsm/kg
True solute diuresis post AKI / post obstructive
58
Identify: > 1000 mOsm/kg
Too concentrated urine found in profound hypovolemic states
59
Identify: < 30 mOsm/kg
Characteristic of total absence of ADH
60
Absolute indications for dialysis:
"AEIOU" Acidosis Electrolytes Intoxication Overload Uremia
61
Bilaterally small kidneys support the diagnosis of CKD except: (4)
Diabetic nephropathy Amyloidosis HIV nephropathy Polycystic Kidney Disease
62
Leading cause of morbidity, mortality in CKD
Cardiovascular disease
63
Stages in CKDA that are asymptomatic
Stage 1 and 2
64
CKD Staging: Clinicwl and laboratory complications are prominent
Stage 3 and 4
65
CKD Staging Normocytic normochromic anemia observed as early as
Stage 3
66
CKD Staging Peripheral neuropathy becomes clinically evident at:
Stage 4
67
CKD Staging: Gadolinium should be minimized at? Gadolinium should be avoided at?
1. Stage 3 2. Stage 4 and 5

Internal Medicine Review (4 decks)

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