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ABIM > Nephrology > Flashcards

Nephrology Flashcards

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1
Q

AKI etiology after arterial cath

A
  1. CIN

2. atheroembolic emboli (if persistent 5 days after) + Eos

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2
Q

Renal injury after bowel prep

A

phosphate nephropathy - check phosphate level

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3
Q

avoid fleet enema

A

> 50 yo
CKD
DM

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4
Q

Abdominal compartment syndrome

A

IAP >20 w/ AKI (N 6-7)

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5
Q

Treatment of Abdominal compartment syndrome

A

decompressive laparotomy

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6
Q

Minimal change dz clues

A
  • sudden onset

- Hodgkins dz + NSAIDS

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7
Q

FSGS

A

AA patient with nephrotic syndrome
HIV
obesity

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8
Q

membranous nephropathy

A

malignancy associated (25% is from a secondary cause)

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9
Q

Ddx for nephrotic syndrome a/w AKI

A
  1. MCG w ATN or
    AIN
  2. membranous w. b/l renal vein thrombosis
  3. amyloid w cast nephropathy
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10
Q

definitive dx of nephrotic syndrome

A

renal bx

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11
Q

Role of prophylactic AC in nephrotic syndrome

A

none

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12
Q

Role of bicarb in CKD when bicarb is <22

A

slows progression of CKD (sodium bicarbonate or sodium citrate)

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13
Q

Consequences of untreated chronic metabolic acidosis

A

muscle loss

bone loss

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14
Q

Treatment for primary Minimal change

A

glucocorticoids
ace/arb
diuretics
cholesterol lowering meds if total >200

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15
Q

Monoclonal gammopathy of renal significance

A

MGUS + renal insufficiency –> renal bx

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16
Q

Treatment of IgA nephropath

A

ACE/ARB

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17
Q

Role of any immunosuppression in IgA

A

controversial - never will be the answer

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18
Q

Causes of calcium oxalate stones in malabsorption/diarrhea

A
  1. urne citrate is an inhibitor of crystallization that is reduced in metabolic acidosis
  2. enteric calcium binds to poorly absorbed fat allowing oxalate to be absorbed and excreted in the urine
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19
Q

clues to dysproteinema related kidney disease

A

older, hypercalcemia, anemia, evidence of proximal tubular dysfunction (hypoK, hypophos, metabolic acidosis,

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20
Q

diagnosis of diabetic nephropathy

A

clinical. doesn’t need bx if 8 years of dm + nephrotic

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21
Q

Constellation of symptoms a/w MM

A

Old, hypercalcemia, anemia, NAGMA, AKI

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22
Q

Treatment of ethylene glycol

A

fomepizole, fluids, HD

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23
Q

lab findings of ethylene glycol

A

NAGMA, osmlol gap

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24
Q

osmol gap

A

measured - calculated >10

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25
MOA of renal damage of ethylene glycol
calcium oxalate crystal deposition
26
AutoAB in 75% of primary cases of membranous glomerulopatny
PLA2R
27
Treatment of nephrogenic DI
thiazides
28
Tolvaptaan
vasopressin antagonist use for SIAD
29
heparin does what to K
hyperK+ (2/2 hypoaldosteronism)
30
>50% of RPGN etiology
ANCA associated vasculitis
31
SE of chronic Tylenol use in patients with CKD, liver dz or poor nutrition
pyroglutamic acidosis (AGMA)
32
Pyroglutamic acidosis
too much Tylenol depleting glutathione
33
Acid-base disturbance in patients with short gut
D lactic acidosis
34
Acid base disturbance with salicylate
respiratory alkalosis | or RA with AGMA
35
Hematuria
>3 rbc/hpf
36
AUA risk factors for lower urinary tract malignancy
> 35 w irritative voiding symptoms, smoking, aniline dyes or cyclophosphamide
37
risk factors to vanc nephrotoxicity
CKD, troughs >15, and concomitant use of loop diuretics
38
Correction of acute hyponatremia
can be rapid. 2-3mmol immediately
39
Correction rate of chronic hyponatremia
<10 in 24 hours.
40
imaging for new diagnosis of fibromuscular dysplasia
one time head to pelvic imaging to look for aneurysms.
41
Serum Cr elevation of more than 30% after initiation of ACE
look for fibromuscular dysplasia
42
When to test for primary aldosternonism
1. resistant HTN, adrenal mass 2. spontaneous hypokalemia 3. diuretic induced hypokalemia
43
Dialysis and statins
Recommends against, in patients with ESRD, unless they have residual function of kidneys
44
Gold standard for nephrolithiasis
Non contrast, helical CT
45
Management of primary membranous nephropathy
PLA2R highly specific - high rates of remission in 6-12 months. statin (if applicable) plus ace/arb and monitor. if things change or persistent nephrotic protein start immunosuppressants 2. After alternating months of steroids + alkylating agents (can use cyclosporine if can't use alkylating ages)
46
Distal type 1 RTA
hyperchlorema, hypoKalemia 2/2 inability to excrete acid
47
type 4 RTA
distal hyperkalemic (2/2 aldosterone def or resistance), NAGMA
48
type 2 (prox)
issue with bicarb reclaiming
49
Needed in the Dx of HELLP
MAHA (peripheral smear and bili level)
50
B2 micro globulin associated amyloid pts
seen in dialysis for at least 5 years, present with shoulder pain, carpal tunnel
51
Triad of hyperaldosteronism
metabolic alkalosis hypokalemia resistant HTN
52
How to evaluate metabolic alkalosis
urine Cl
53
saline responsive metabolic alkalosis lab
urine cl <15
54
management of hypermagnesemia
saline lasix IV calcium
55
electrolyte issues 2/2 hypomag
hypoK | hypoCa (increased PTH increase)
56
Primary bug of post infectious GN
s. aureas (more so co exists, rather than post strep - 7 day lag)
57
Gout ppt element that causes a chronic tubulointerstitial disease
Lead - ca
58
Acidosis associated with crohns or short gut
D lactic acidosis | AGMA, non osmol
59
AGMA, osmol gap
ethylene glycol, methanol
60
OP meds for HTN and conception
labetolol, nifedipine, methyldopa
61
Immunosuppresants ok in pregnancy
AZA, tacrolimus, cyclosporine
62
urine dipstick detects what kind of protein
albumin (not light chains) | - useful if you have a high protein/cr ration but small protein on urine to detect things other than albuminuria
63
GFR of when to start evaluating for kidney transplant
GFR <30
64
TIPS indication
1. variceal hemorrhage 2. refractory ascites Risk: increased HE, renal injury 2/2 contrast
65
Etiology of hyperNa with urine ism 300-600
urea osmotic diuresis or glucose diuresis
66
HTN med for difficult to control blood pressure w CKD
add a Loop (esp with cKd, cirrhosis, heart failure) | thiazides have less use as a diuretic with GFR <30
67
4 variables to predict CKD progression
1. age 2. sex 3. GFR 4. albumin - cr ratio
68
presentation of renal amyloid
nephrotic bland ua inflammatory conditions TX: toci (IL-6)
69
NSAID nephropathy
1. AIN 2. Membranous (pyuria, abc casts, proteinuria) 3. MC
70
Concern in ESRD pt with macroscopic hematuria or flank pain
RCC! | they have increased risk
71
When to initiate HD in CKD patients
don't need to start until symptomatic (uremic, fluid overload, acidosis)
72
Nephrotic syndromes
1. minimal change 2. membranous 3. membranoproliferative (only has low complements -rest wnl) 4. FSGS
73
Membranous nephropathy
Solid Cancer!! age appropriate screening
74
FSGS
think AA! Obesity! HIV
75
Membranous nephropathy
``` Caucasian! higher risk of clots (renal vein thrombosis - LDH) carcinoma SLE, RA Tx: ACEI, immunomodulation ```
76
membranoprolif
hep C (low complements)

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