Nephrology

Question 0

What is the effect of prerenal acute renal failure on Na excretion?

Answer 0

decreased (<1%)

Question 1

What is the classic triad of acute interstitial nephritis (other than renal failure)?

Answer 1

fever, rash, arthralgias

Question 2

What is the effect of acute tubular necrosis on Na excretion?

Answer 2

increased

Question 3

When does IgA glomerulonephritis begin in relation to pharyngitis?

Answer 3

at the same time

Question 4

How does PSGN affect complement levels?

Answer 4

low C3

Question 5

How does SLE affect complement levels?

Answer 5

Low C3 and C4

Question 6

What diagnosis should be suspected in a pt. w/ renal failure, hypercalcemia, severe anemia, and a low anion gap? There is also a discrepancy between protein values on dipstick and 24-hr urine collection.

Answer 6

myeloma

Question 7

What 3 findings, similar to those found in allergic rxns, are found in pts w/ acute interstitial nephritis?

Answer 7

rash, sterile pyuria, and peripheral eosinophilia

Question 8

In a pt. w/ a toxic ingestion, the presence of a mixed anion gap metabolic acidosis and respiratory alkalosis suggests _______ toxicity.

Answer 8

salicylate

Question 9

What is Winter’s formula for expected Pco2?

Answer 9

1.5 × [HCO3-] + 8 ± 2

Question 10

What is an increased osmolar gap indicative of?

Answer 10

unmeasured osmole, esp. ethanol, ethylene glycol or methanol

Question 11

What is the normal osmolar gap?

Answer 11

10 mosm/kg

Question 12

How do you calculate the serum osmolality?

Answer 12

2[Na+] + glucose + urea

Question 13

What is the normal anion gap?

Answer 13

8-16 meq/L

Question 14

Why would a person w/ closed angle glaucoma have a non-anion gap metabolic acidosis? (Make sure to give the mech.)

Answer 14

acetazolamide inhibits bicarb reabsorption in the proximal tubule

Question 15

What is the mechanism of respiratory alkalosis in pts w/ end-stage cirrhosis?

Answer 15

increased circulating progestins increase ventilatory drive

Question 16

If a pt. develops hyperkalemia when using an AC-I or ARB, what can be used in its place?

Answer 16

hydralazine + nitrates

Question 17

In what 2 cases is psuedohyponatremia most commonly seen?

Answer 17

(1) elevation of plasma lipids/proteins or (2) hyperglycemia

Question 18

Is pseudohypernatremia seen on the measured or calculated plasma osmolarity?

Answer 18

crackulated

Question 19

_______ is defined as hypotonic hyponatremia w/ urine osmolality >100 mosm/kg in the absence of volume depletion, adrenal insufficiency, CHF, hypothyroidism, cirrhosis, and/or renal impairment.

Answer 19

SIADH

Question 20

Severe hypocalcemia and hyperphosphatemia in an alcoholic should raise suspicion for _______.

Answer 20

hypomagnesemia