PA urinalysis Flashcards
(31 cards)
What electrolyte disorder to ARBs and ACEi’s cause?
Hyperkalemia
What electrolyte disorder to most diuretics cause?
Hypokalemia
Red/brown urine with NO blood/RBCs suggests:
Rhabdomyalysis
What electrolyte disturbance often accompanies Rhabdomyalysis?
Hyperkalemia (due to muscle cell lysis)
Muddy brown granular casts are pathognomonic for:
Acute tubular necrosis
WBC casts are suggestive of:
Pylonephritis OR Allergic Interstitial Nephritis
Fatty casts and oval fat bodies are pathognomonic for:
Nephrotic syndrome
Calculate FENa:
PcrUna/PnaUcr
What does a FENa<1% suggest in AKI?
PreRenal origin.
What can diphenhydramine do to the kidneys?
Damage them via post-renal obstruction. Prevents passage of urine. Tx with Foley.
What can you always expect Furosemide (Lasix) to do to BMP?
Increase serum Cr (dilutional)
RBC casts are pathognomonic for:
Glomerulonephritis (nephritic syndrome)
Kid comes in with nephritic syndrome after having a sore throat…what is it?
Post-streptococcal glomerulonephritis.
Kid comes in with swollen feet (no blood in urine). What is it?
Minimal change disease (until proven otherwise)
What causes AKI and elevated serum Ca?
Multiple myeloma
How do you treat someone with HTN and elevated sCR (or albuminuria)?
Ace inhibitor! Will lower BP AND decrease albumin in urine. (Check K at 2 weeks though).
What will ACE inhibitors and ARBs due to SCr?
Increase up to 20-30%
What must you always do to a serum Na in diabetic patients with high glucose?
Correct it for blood glucose. they are competitive.
A young (20-40 yo), healthy patient with blood in urine but no casts, WBCs, or protein probably has:
IgA nephropathy. Don’t be fooled by lack of protein in urine. Sometimes it’s just blood. It’s a nephritic syndrome.
How does increased distal Na delivery cause K+ wasting?
Increased distal Na will increase activity of Aldosterone and ENaC channels which will make the endothelial cells less polarized and encourage K+ secretion.
Liddle’s syndrome
Hypokalemia, metabolic alkalosis and HTN. Due to overactive Na channel in CD (and compensatory K+ excretion)
Bartter’s syndrome
Hypokalemia, NO HTN. Also associated with hypercalciuria. mutation in transporter in thick ascending loop causes decreased Na absorption. (like a loop diuretic)
Gitelman’s syndrome
Mutation in thiazide-sensitive Na-Cl transporter in DCL causes decreased Na reabsorption, increased K secretion, DECREASED calcium secretion.
Pt. has hypokalemia but is normotensive with HYPOcalciuria.
Licorice toxicity presents like which other disease?
Liddle’s
