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Internal Medicine- Areej > Nephrology > Flashcards

Nephrology Flashcards

1
Q

what cast you will see after strenous exercise?

A

Hyaline

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2
Q

Indication of renal replacement therapy
Hint : mostly refractory

A
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3
Q

Patient with
Dark tea color urine with dipstick +ve for blood but no erythrocyte on UA
And high CK

Ttt?

A

Rhabdomyolysis
IV fluid💦

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4
Q

Increased BUN: creatinine ratio occurs in ?
Renal ? Post rena?

A
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5
Q

Isolated high BUN with normal creatinine occurs in ?

A

Upper GI bleeding 🩸

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6
Q

MCC of renal AKI

A

ATN

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7
Q

Prolonged pre-renal injury leads to?

A

ATN (renal)

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8
Q

Patient eating a lunch composed of 5 NSAID pill + 15 PII
Then came to hospital complaining of
Fever, rash, hematuria and proteinuria, and esonophillouria
Dx?

A
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9
Q

Patient after PCI development
Hematuria + rash + levido reticularis + esonophilluria
Dx?
Hint : it is Ameera fault

A

Ameera moved the cholesterol plaque when she did PCI 😝
Dx: cholesterol emboli

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10
Q

Patient lab
High, K, PO4, uric
Low Ca

Ddx?

A

TLS (+ Hx of cancer ttt)
Rhabdomyolysis ( + high CK )

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11
Q
A

A

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12
Q

MCC of death in ESRD ?
Hint : same as RA and SLE

A

CVS disease

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13
Q
A
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14
Q
A

Always choose
AV fistula

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15
Q

When to screen DM patient for diabetic nephropathy?

Remember we sceen by microalbuminuria level

A
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16
Q
A
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17
Q

Do not be tricked 🤣

A

Answer: A
EXCLUDE IRON FIRST !!!!
Surprise ☠️Nobody in practice order EPO level for dx of CKD anemia

The rule says if not iron it is due to CKD

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18
Q

What is the cutoff point of protien in urine for nephritic and nephrotic syndrome?

A
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19
Q

All nephritic and nephrotic disease are confirmed by 🤔 except 🤔 is confirmed clinically

A
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20
Q

Which of the nephrotic syndrome disease has the best response to steroid?

A

Minimal change disease

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21
Q

Which of the nephrotic syndrome disease has the best response to steroid?

A

Minimal change disease

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22
Q

Patient with protein in urine >3.5gm
And renal vein thrombosis
Dx?😣

A

Membranous nephropathy

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23
Q
A

A

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24
Q
A

A

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25
Q
A

D
all nephrotic give ACEI
except minimal change choose steroid

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26
Q
A

D
all nephrotic give ACEI
except minimal change choose steroid

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27
Q
A

A

in any case of fever there is normally a transient protein leak
So repeat if normal no further workup

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28
Q
A

FIRST 3 days after URTI > IgA (Burger)
After 7 -10 days of URTI > post-streptococcal GN

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29
Q
A

FIRST 3 days after URTI > IgA (Burger)
After 7 -10 days of URTI > post-streptococcal GN

30
Q
A

Low complement in PSCGN
BUT NOTMAL IN IgA

31
Q

GN + low complement
DDX???
very important

A
32
Q

Patient with hematuria + family hx of ESRD ??
Dx

A

Also called hereditary nephritis

33
Q

Patient with hypertension
Developed increase in creatinine >30% of baseline after taking ACEI
US showed asymmetric kidney
DX?

A
34
Q
A

Next step DOPPEL US ( 🙅🏻‍♀️not renal US)
best CTA

35
Q

Which on of the following cause hyperkalemia?
ACEI
BB
NSAID
spironolactone

A

All of them 😂😂😂😂😂😂😂😂

36
Q

NEXT STEP

A

First stabilize the heart ❤️
Ca gluconate

37
Q

Patient with
- hypocalcemia and hypokalemia
Next step in ttt? Think of one thing treat both !
-And you need to check what in case of refractory case?

A

Ca gluconate
Check Mg

38
Q
A

C

39
Q

Dx?

A

Refeeding syndrome
Tha body is starving so it will absord glucose largely and then high insulin spike lead to shif of all electrolyte

To avoid give smaller meals

40
Q

Dx?

A

Refeeding syndrome
Tha body is starving so it will absord glucose largely and then high insulin spike lead to shif of all electrolyte

To avoid give smaller meals

41
Q

Flat T wave
And U wave appear in what condition?

A

Hypokalemia

42
Q

What is the ttt and prophylaxis of tumor lysis syndrome?

A
43
Q
A
44
Q

Hyponatriemia approach?

A
45
Q

😎

A

C
If there is severe hyponatriemia <120 + neuro symptoms ( confused, obtunded, …) = 3% saline

46
Q

Rapid correction of
Hyponatremia
And
Hypernatremia
What will cause
If you did it in real life areej will kill you peacefully 😘😘

A
47
Q

Rapid correction of
Hyponatremia
And
Hypernatremia
What will cause
If you did it in real life areej will kill you peacefully 😘😘

A
48
Q
A

A
Remeber aspirin activate the central resp center so forst is will cause resp alkalosis then the body try to compansate

49
Q

Best to diagnose renal stone
CT with or without contrast? 🤣

A
50
Q
A

B

51
Q

RadiolUcent stone in xray?

A

Uric

52
Q

Family hx of stone + hexagonal stone , and is the pathology of this disease

A

Cystiene stone , amino acid defect

53
Q
A

A

54
Q
A

A best for pyelonephritis

55
Q
A

D
👍🏻

56
Q
A

D
👍🏻

57
Q
A

B

58
Q

66 y/o patient did CT angio. 4 days ago, he came today complaining
of oliguria and abnormal renal function dx?

What cast you will see?

A

Contrast induced nephropathy = ATN

Mudd brown or epithelial or granular cast

59
Q

What cast you will see in cholesteric emobli causing AKI

A

esonophilic

60
Q

old male k/c of HTN came with BP 160/90 , you suspected
some kidney abnormality , what you will find on workup ? •
A-Decrease sclerosis •
B-increase sclerosis
C-Increase hyalinization of arterioles

A

C

61
Q

A 63 y/o Patient diagnosed with major depression complaining of excessive thirst and urination +
she has cancer with lung mets. investigations shows hyponatremia and low urine osmolality .
what’s the dx?
A. DI
B. SIADH
C. Psychogenic polydipsia
D. None

A

C
DI present with hypernatremia
Polydypsia present with hyponatremia and increase urination
SIADH hyponatremia without frequent urination

62
Q

Old patient known case of gastric antral cancer with hepatic metastasis, presented with vomiting
for 10 days. On PE he was found to have jaundice . • Which of the following mostly will be found in urinalysis?
A. High K B. Aciduria C. Alkaline Urine D. High Na

A

B
Early = alkalotic urine
Late = aciduria

63
Q

A48 y/o Patient came with history of pin prick sensation, loss of
vibration sensation with loss of ankle reflex. Found to have K 6 and
high creatinine. Initial step in management?
A. IV bicarbonate
B. insulin and dextrose infusion
C. hemodialysis
D. Vitamin B complex

A

C
Symptoms of uremic polyneuropathy are an indication for kidney
replacement therapy, including either dialysis or transplantation.

64
Q

Old patient had URTI and treated 2w ago, now come with hematuria, hypertension, periorbital and ankle edema
Ttt?

A

Supportive
Frusemide

65
Q

Old patient had URTI and treated 2w ago, now come with hematuria, hypertension, periorbital and ankle edema
Ttt?

A

Supportive
Frusemide

66
Q

Patient came with severe vomiting ECG show flat T wave what u
expect in urine as the cause of presentation?
A. high K.
B. high Na
C. alkaline urine
D. Aciduria

A

A

67
Q

A 24 year old UTI patient came k/c of CKD , which antibiotic is
contraindicated for treatment ?
B. TMP-SMZ
C. Fluro
D. Nitrofurantoin
E. Amoxicillin.

A

D

68
Q

A52 year old female came with suspected UTI , which of the following
fast indication infection rather than other diagnoses ?
A. Nitrate B. Leukocyte C. Specific gravity D. RBC

A

A

69
Q

A 53 year old male patient k/c of CKD, his labs showed low calcium. • What is the treatment of choice in such patient ?

A

Calcitriol
The most active form of vit D✅

70
Q

Refractory hypokalemia not response of KCl what is your
management ?

A

A. IV magnesium sulfate

Internal Medicine- Areej (6 decks)

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