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Flashcards in Nephrology Deck (765)
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1

what is a normal 24-hour urine protein?

less than 150 mg

2

how much protein w/i 24 hours indicates significant GLOMERULAR pathology?

more than 2 g/day (or 40-50 mg/kg/d)

3

how much protein w/i 24 hours indicates significant INTERSTITIAL pathology?

less than 1 g/day

4

the only exceptions in which there can be pathology and a NORMAL URINE SEDIMENT with MINIMAL proteinuria (2)

1. medullary cystic disease
2. obstructive uropathy

5

will urinary light chains in myeloma be picked up on a urine dipstick?

NO

6

causes of false-positive urine albumin on urine dipstick: (6)

1. very alkaline urine with a pH > 8
2. fever
3. heart failure (HF)
4. urinary tract infection (UTI)
5. hematuria
6. very concentrated urine

7

common in people during a febrile illness, after strenuous exercise, and in pts w/ HF and COPD

transient proteinuria

8

first step in a pt w/ transient proteinuria

recheck UA (if negative; benign)

9

proteinuria reverts to near-normal when pt is SUPINE

BENIGN ORTHOSTATIC PROTEINURIA

10

what equates to 24-hour urinary protein?

spot protein:creatinine ratio

11

proteinuria ranges using spot ratio:

- normal
- microalbuminuria
- overt proteinuria, usually d/t interstitial disease
- nephrotic range

- less than 0.15 (150 mg)
- 0.03 - 0.3 (30 - 300 mg)
- 0.3 - 1 (300 mg - 1 g)
- 3 - 3.5 (3 - 3.5 g)

12

EARLIEST indicator of diabetic and hypertensive nephropathy

microalbuminuria

13

indicate probable glomerulonephritis/nephritic syndrome

RBC casts, or "dysmorphic" RBCs

14

FEW RBCs on microscopic analysis, BUT urine dipstick is POSITIVE for blood

HEMOglobinuria or MYOglobinuria (rhabdomyolysis)

15

hematuria associated w/ proteinuria, especially if dysmorphic cells and/or RBC casts are present in the urine, is ALWAYS d/t

glomerular bleeding

16

MCC of ISOLATED GLOMERULAR HEMATURIA (normal renal function, NO proteinuria)

- IgA nephropathy
- thin basement membrane disease
- early Alport syndrome

17

can cause transient hematuria

strenuous exercise

18

pts w/ sickle cell TRAIT may also have

hematuria

19

isolated microscopic or gross hematuria is more likely what in origin?

urologic

20

in older pts, complete GU imaging must be done to exclude what?

renal cell or GU tract carcinomas

21

what GU imaging must be done to r/o renal cell or GU tract carcinomas?

US, MRI, or CT

22

w/ EOSINOPHILURIA, think of

drug-induced interstitial nephritis

23

w/ COARSE GRANULAR casts, or "MUDDY BROWN" casts, think

acute tubular injury

24

w/ OVAL FAT BODIES ("maltese crosses" under polarized light) may be seen in

nephrotic syndrome

25

what suggests rhabdomyolysis-induced renal failure?

unusually rapid rise in serum creatinine (more than 1.5 mg/dL over 24H)

26

in the elderly, what will be normal despite reduced renal function?

creatinine

27

serum creatinine (sCr) is artificially INCREASED by these medications (4)

1. cimetidine
2. probenecid
3. tenofovir
4. trimethoprim

28

interfere w/ the test for creatinine and may falsely elevate results

- acetone
- cefoxitin

29

indicates either PRERENAL AZOTEMIA (low flow and increased absorption), or increased protein breakdown

elevated (> 20:1) BUN:Cr ratio

30

is a nonglycosylated protein that better reflects GFR than sCr

cystatin C