Nephrology

Question 1

What EKG findings are associated with hypocalcemia?

Answer 1

a prolonged QT interval is associated with hypocalcemia

Question 2

What EKG findings are associated with hyperkalemia?

Answer 2

A prolonged PR interval, widening of the QRS complex, and peaked T waves are associated with hyperkalemia

Question 3

hypocalcemia is often seen with what other electrolyte imbalance?

Answer 3

hypocalcemia and hypomagnemesia go hand in hand.

Question 4

What is the most common electrolyte imbalance found in DKA?

Answer 4

hyperosmolar hyponatremia is often found in patients in DKA

The hyponatremia is a function of the increased glucose in the serum. Correction of the condition should be directed at controlling the blood sugar

Question 5

What bleeding disorder is associated with azotemia?

Answer 5

Platelets are unable to adhere to the endothelium in uremic states.

Lab reports will show a normal PT, PTT, and normal platelets, but the actual bleeding time will be increased

Question 6

What is the hallmark electrolyte derrangement associated with TPN?

Answer 6

hypophosphatemia is associated with TPN feeding

Question 7

What diuretic causes ototoxicity?

Answer 7

Loop diuretics ( think loop earrings)

Furosemide

FYI: other meds that cause ototoxicity include:

aminoglycosides, aspirin (tinnitis occurs with overdose) and

platinum-based anti-neoplastic agents

Question 8

What is the MoA for loop diruetics?

Answer 8

Loop diuretics inhibit the Na-K-2CL transporter in the thick ascending loop of henle.

Question 9

What is the preferred imaging study for a kidney stone?

Answer 9

confirm the diagnosis of a kidney stone with a non-contrast CT

Question 10

What is the preferred empiric treatment for mild pyelonephritis?

Answer 10

the preferred emperic treatment for pyelonephritis is

CIPROFLOXACIN

Question 11

What is the preferred treatment for cystitis?

Answer 11

Treat cystitis with nitrofurantoin

nitrofurantoin concentrates in the urine. It is not good for treating pyelo because it has poor absorption in the tissues and would never be strong enough to do anything in the kidney.

Question 12

what would cause a young, asymptomatic female with abdominal bruits to have an elevated blood pressure?

Answer 12

fibromuscular dysplasia.

Question 13

Causes of microscopic hematuria

Answer 13

TIGHTS

Trauma (ruptured urethera)

Infection (#1 cause)

Glomerulonephritis

Hypertension

Tumor (bladder cancer)

Kidney Stones

Question 14

What is the normal creatanine excretion in 24 hours?

Answer 14

Normal creatanine secretion in 24 hours is 20mg/kg

Question 15

Differential diagnosis for euvolemic hypotonic hyponatremia

Answer 15

euvolemic hypotonic hyponatremia

RATS

1. Renal Tubular Acidosis
2. Addison’s Disease
3. Thyroid disease
4. SIADH

Question 16

What type of kidney stone is formed in patients with Crohn Disease?

Answer 16

Crohn’s disease, and other conditions that lead to malabsorption of fat in the intestines can cause oxylate stones to form.

*the excess fat in the gut binds to calcium leads to absorption of unbound oxylate in the GI. hyperoxalyurea leads to calcium oxylate stones.

Question 18

What are the characteristics of a benign cyst on the kidney?

Answer 18

Benign cysts on the kidney:

uniform density

round or oval

unilocular

no perceptible wall

*no treatment is necessary unless symptoms develop