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Question 1

Cl- INDEPENDENT metabolic alkalosis

Answer 1

(direct stimulus to H+ secretion)

• hypERaldolsteronism
• Cushing’s
• steroid admin
• ectopic ACTH prod (pituitary tumor)
• adrenogenital syndrome
• licorice
• bartter’s sundrome
• severe hypOkalemia

Question 2

Cl- DEPENDENT metabolic alkalosis

Answer 2

(extracellular volume and Cl- depletion)

• vomiting
• NG suction
• diuretics
• pillow adenoma
• post-hypercapnia

Question 3

AKI

Answer 3

• acute fall in GFR
• INC serum BUN/Creatinine
• comm prob in hospitalized pts

Question 4

uremic pericarditis tx

Answer 4

URGENT dialysis

*EKG might be wnl

Question 5

hyperaldosteronism

Answer 5

hypOkalemic with metabolic ALKALOSIS

Question 6

malignant HTN

Answer 6

• encephalopathy
• papilledema
• hematuria, proteinuria, kidney failure

EMERGENCY –> cerebral infarcts, MI

Question 7

essential HTN

Answer 7

primary HTN

• 40-50s
• failed PRESSURE natures, high HP not corrected by dumping NA to urine
• MOST COMM of all HTN

Question 8

secondary HTN

Answer 8

vol stat (kidney disease -> poor Na handling
ang II (renal a. stenosis, bod senses hypo perfusion --> ang II --> htn
aldosterone
adrenergic tone

Question 9

vomiting –> Cl- ____ metabolic _____

urine is

Answer 9

vomiting –> Cl- DEPENDENT metabolic ALKALOSIS

urine is ACIDIC

Question 10

glomerular filtration is det by

Answer 10

Starlings forces (PGC, PBS, and ΠGC)

the intrinsic membrane properties (Kf, S)

the total number of nephrons (N) according to the equation:
GFR = N x Kf x S x (PGC – PBS – ΠGC)

Question 11

increase cellular K+ uptake

Answer 11

insulin
beta-agonists
bicarbonate

Question 12

NSAIDS arterial action

Answer 12

constrict afferent a.

Question 13

low FeNa

Answer 13

intact tubules responding to vol depletion

perfusion related AKI

Question 14

hypOcalcemia –> which diuretic?

Answer 14

LOOP

Question 15

hypERcalcemia –> which diuretic?

Answer 15

THIAZIDE

Question 16

ECV det by ________

Answer 16

Na excretion! (FeNa, urine Na)

tells you whether being perfused or not

Question 17

Na in urine

Kidney perfusion status?

Answer 17

well-perfused

Question 18

No Na in urine

Kidney perfusion status?

Answer 18

UNDERPERFUSED kidney

body is holding on to all the Na it can

Question 19

what is most directly regulating kidney perfusion

Answer 19

ECV

Question 20

plasma osmolality

Answer 20

2*Na+(glu/18)+(BUN/2.8)

Question 21

need ___ if vol depleted

need ___ if hyperosmolar and thirsty

Answer 21

need SALT if vol depleted

need WATER if hyperosmolar and thirsty

Question 22

Na content

Answer 22

volume

a CLINICAL assessment

Question 23

[Na]

Answer 23

water

Question 24

chronic kidney disease criteris

Answer 24

any present for 3+ mo or more

1. GFR <60
2. kidney transplant
3. marker of kidney damage
   - proteinuria
   - abnl urine sediment
   - abnl imaging
   - renal tubular syndromes

Question 25

target BP for low risk pt

Answer 25

<140/90

Question 26

target BP for high risk pt

Answer 26

<130/80

Question 27

first line in uncomplicated HTN

Answer 27

diuretics

Question 28

blockade of RAAS proves addnl benefit above bp lowering in pts w/

Answer 28

HF nephropathy diabetes

Question 29

high plasma osmolality water depleted still dilute urine

Answer 29

diabetes insipidus

Question 30

K shift out of cells

Answer 30

hyperosmolarity exercise cell lysis

Question 31

K shift in

Answer 31

insulin | B-agonists

Question 32

when see Cl look for which units?

Answer 32

VOLUME cleared over time

Question 33

osmolality of 560

Answer 33

ADH activation aquaporins concentrating urine

Question 34

stim for ADH in HF

Answer 34

low ECV detected by aortic/carotid bodies

Question 35

signs of volume depletion

Answer 35

hypotension orthostasis skin tenting

Question 36

albuminuria stages

Answer 36

A1: <30 A2: 30-300 A3: >300

Question 37

____ blockade slows progression of CKD

Answer 37

RAAS blockade

Question 38

pelvic kidney inc risk of

Answer 38

infection of ureter and kidneys