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Step 2 CK renal > R4 > Flashcards

R4 Flashcards

(51 cards)

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1
Q

Calcefic uremic arteriophaty(calciohlaxis) CM?

A

Painful nodule or ulcer
Skin necrosis
Common in adiposity area like the trunk
Intact pheripherial pulse(unlike atherosclerosis-related one)
Soft tissue calcification on imaging
Biopsy: arterial calcification/occlusion and subintimal fibrosis.

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2
Q

Risk factor?

A 
ESRD
Hypercalcemia and hyperphosphatemia
Hyperparathyroidism
Obesity/DM
warfarin(vitamin K increase synthesis of serum protein that prevents calcification)
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3
Q

Serum Magnesium and calciphylaxis?

A

magnesium prevent extracellularly Ca accumulation—so hypomagnesemia increase the risk

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4
Q

serum Glucose and ESRD?

A

ESRD decrease insulin clearance –recurrent hypoglycemia risk

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5
Q

the first thing to evaluate in the hyperkalemic patients?

A

Review medication

aldosterone level in case of persistent hyperkalemia

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6
Q

nuro-complication of hyperkalemia?

A

paraesthesia

paralysis

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7
Q

Hyperglycemia and hyperkalemia?

A

glucose > 300 is a risk for hyperkalemia

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8
Q

sign and symptom of Hypercalcemia?

A

Neuropsychiatric(confusion,stupor and comma)
GI distress
Muscle weakness
Nephrogenic DI–Excessive diuresis–Hypovoluma-AKI

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9
Q

Relation to lung ca?

A

SCLCa–PTH like peptide(hypercalcemia)

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10
Q

managment?

A

depend on serum Ca level and presence of a symptom

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11
Q

Serum ca> 14/presence of symptom?

A

Acute managment
Normal saline hydration plus calcitonin
Avoid loop diuretics unless fluid overloaded(HF)
Long term managment
Biposponate(zoledronic acide,pamidronate)

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12
Q

Moderate(12-14)?

A

No immediate managment required unless symptomatic

Treat similarly as sever calcimia

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13
Q

asymptomatic or Ca<12?

A

No immediate managment required

Avoid thiazide, lithium, volume depletion, and prolonged bed rest

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14
Q

Symptoms of hypocalcemia?

A 
Confusion or memory loss.
Muscle spasms.
Numbness and tingling in the hands, feet, and face.
Depression and hallucinations.
Muscle cramps.
Weak and brittle nails.
Cramping
Trousseau sign
Chovestik sign
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15
Q

Effect of serum PH on Ca level?

A

H and Ca compet to bind to albumin
Affect the free ionized Ca
Acidosis–Low Ca bind to albumin–Hypercalcimia
Alkalosis–High ca bind to albumin–Hypocalcemia

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16
Q

Effect of serum PH on Po4 level?

A

Acidosis–Increase movement of PO4 to EC–Hyperphosphatemia

Alkalosis—decrease movement of PO4 to EC–Hypophosphatemia

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17
Q

A positive troussue sign is characterized by?

A

the appearance of a carpopedal spasm which involves flexion of the wrist, thumb, and MCP joints along with hyperextension of the IP joints.

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18
Q

The Chvostek sign?

A

a contraction of ipsilateral facial muscles subsequent to percussion over the facial nerve

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19
Q

Drug to be avoided in AKI?

A

Metformin_-pricipitate LA
ACEI/ARB–worsen AKI
High dose aspirin

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20
Q

GI loss and hypokalemia?

A

UGI(Vomiting)–metabolic alkalosis–renal K loss

LGI(Diarrhea)–Contain High K–direct K loss

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21
Q

Hypokalemia symptoms?

Study These Flashcards
A 
Muscle twitches.
Muscle cramps or weakness.
Muscles that will not move (paralysis)
Abnormal heart rhythms.
Kidney problems.
22
Q

Serum potassium level in accelerated hematopoiesis?

23
Q

clinical features of crystal-induced AKI?

Study These Flashcards
A 
Usually asymptomatic
nausea/flank or abdominal pain
AKI<7 days of exposure(usually 24-48 hr)
Hematuria, Pyuria and crystal
Increase risk in volume depletion and CKD
24
Q

Risk factor?

Study These Flashcards
A 
Acyclovir(usually High dose IV)
Sulphonamide
Methotrexate
Ethylene glycol
Protease inhibitor
Uric acid(TLS)
25
managment?
Drug discontinuation Volume repletion Loop diuretic
26
mechanism?
less water-soluble crystal--Precipitate in RT--tubular obstruction and direct toxicity
27
Cerebral aneurysm and ADPKD?
Increase by age(20% at age 60) Polycystins protein(defected protein in ADPKD) defect also affect vascular integrity The presence of HTN(Due to renal ischemia, increase renin secretion) facilitate aneurysm progression and risk of rapture.
28
How to D/T AKI from prerenal cause and ATN?
D/T mechanism
29
BUN/Cr ratio?
P-->20 | ATN--10-15
30
Urine Na?
P--<20 | ATN-->40
31
fractional Na excretion?
p--<1% | ATN>2%
32
urine osmolarity?
P-->500 | ATN--<300
33
Urine specific gravity?
P-->1.020 | ATN--<1.020
34
Microscopy?
P: bland | ATN--Muddy brown cast
35
Ca level and AKI?
AKI--Hyperphosphatemia--hypocalcemia | Except in the case of AKI due to MM--Hypercalcemia
36
Diabetic nephropathy feature?
Hypocalcemia Shrunken kidney Proteinuria
37
Mixed cryoglobulinemia CM?
Highley associated with Hep C(can be in HIV, HBV) Palpable purpura in lower extremity Pheripherial neuropathy Liver involvement(hepatomegaly and Increase TA) Arthralgia Systemic symptoms Glomerulonephritis
38
pathogenesis?
vasculitis characterized by IC deposition in small and medium sized vessels
39
Diagnosis?
Cryoglobulins(Imunoglobuline precipitate in cold To) Contain rheumatoid factor and polyclonal IgG biopsy: Small vessel leukocytoclastic vasculitis
40
Therapy?
Treat underlying cause
41
another disease that causes arthralgia, glomerulonephritis, and hypocomplementimia?
SLE(but common in young women, malar/discoid non-palpable rash and ANA positive)
42
Another disease that can cause leukocytoclastic vasculitis?
Microscopic polyangiitis(but normal complement and Panca +)
43
urge incontinence symptoms?
sudden, overwhelming, and frequent need to void
44
managment?
Lifstyle4 modification Bladder training Antimuscarinic drug
45
a renal complication of cyanide toxicity?
Metabolic acidosis | AKI
46
contrast-induced nephropathy risk factor?
Age >75 CKD Reduced renal perfusion(e.g hypotension) High contrast load
47
Clinical manifestation?
an acute rise in creatinine 24-48 hr | gradual return to baseline
48
pathogenesis?
ATN(muddy brown cast) | Renal vasoconstriction cause prerenal azotemia
49
Prevention?
Periprocedural normal saline Use lower amount contrast Hold NSAID
50
Why does a patient with nephrotic syndrome have a risk of MI and stroke?
Hyperlipidemia(TG and cholesterol)--atherosclerosis risk | hypercoagulability state
51
CM of Addison disease?
``` Hyperkalemia metabolic acidosis Hyponatremia(secondary to SIADH for hypovolumia) hypoglycemia eosinophilia ```

Step 2 CK renal (5 decks)

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