RENAL Flashcards by lauren hudson

Casts for post strep glomerulonephritis

RBC Casts

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What type of bacteria is associated with with PSGN

G A Beta hemolytic strep pyogenes

GAS

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PSGN is common most in what age

5-12 years old

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Urine color in PSGN

Coca Cola urine

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/mc reason for PSGN worldwide

IgA Nephropathy [Berger Disease]

Hematuria 1-2 days after URI

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3 common findings in PSGN

Hematuria
RBC casts
Proteinuria

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What is Azotemia ?

Elevated BUN and Creatinine

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Mangement PSGN

Supportive care = fluid restriction loop diuretics antihypertensive meds

ABX care = treat the Strep PCN

Last line = dialysis

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Nephrotic syndrome thoughts

Anasarca
Protein uria [ 3.5 g over 24 hours ]
Lipid in the urine pool,.- FROTHY URINE
Low ALBUMIN ]
Orbital edema
Infection

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MC reason for nephrotic syndrome in kids

Minimal change disease

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Casts seen in nephrotic syndrome

Fatty casts

Maltese cross pattern under polarized light

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Renal bx of nephrotic syndrome [membranous nephro]

Podocyte loss of foot processes

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3 medications that can be used in nephrotic syndrome

ACE Arbs

Statins

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Neprhtitic syndrome casts

RBC casts = PSGN

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Nephrotic syndrome or nephritic syndrome produces more protein

Nephrotic does more than 3.5 g / day with EDEMA

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3 type of AKI

Pre

Intra

Post

“Kidney”

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BPH can cause what type of AKI

Post

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Watery diarrhea can cause waht type of AKI

Pre renal AKI

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BUN to creatine what should the ratio be

Greater than 20:1 = PRE RENAL

Less than 20:1 = INTRINSIC

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MC type of AKI

ATN = tubular necrosis

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3 pre renal AKI causes

Cardio shock
Hemmorhage
Sepsis

Decreased perfusion ; think before the kidney; blood flow problem

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Renal AKI causes

Toxins
Drugs
Infection
Hypoperfusion

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3 type of post renal AKI

Enlarged prostate
Kidney stone
Tumors

Obstructive issues

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3 type of diseases that can cause glomerulonephritis to know

Lupus
Anti GBM
Henoch Schlenoch Purpura

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Metallic tase in mouth think what

If malaise and decreased urine output = general

Creatinine increase of what = AKI

Greater than 50 % increase from baseline

Low FE of NA+ suggests an AKI where

Pre Renal affecting the kidney

Best image for obstruction or hydronephrosis

Kidney U/S

ATN casts =

Muddy brown casts

Indications for dialysis AEIOU

Acidosis Electrolytes = remove high K+ Ingestions Overload Uremia = pericarditis , encephalopathy

MC cause of CKD

Diabetes ; CKD dx = longer 3 months

CKD findings common 4

Uremia Anemia HyperK Fluid retention

Casts assoc with CKD

Broad waxy casts

Mutation of what kind can cause PCKdz

PCKD1 and PCKD2

PCKDz has what kind of presentation

Palpable kidney Get renal U/S ; see huge cystssss

3 management for PCKDz

Increase fluid Hydration Restrict Sodium Vasopressin blockers = tolvaptan ACE or ARB if with HTN Dialysis / Transplant if ERDz

Worst complication of PCKdz

Cerebral aneurysm ; happens 5-10% of the time

Heart valve disorder associated with PCKDz

Mitral valve prolapse

metabolic alkalosis is usually if a person is

Vomiting !

Metabolic acidosis 3 common findings

Kussmauls = breathe off CO2 Headache lightheadedness Decreased muscle reflexes

Metabolic alkalosis 3 common findings

Twitching or spasms Increased reflexes Bradypnea

Low bicarbonate = less than what

Low PCo2 = less than what

PCO2 less than what is considered respiratory alkalosis [compensatory]

PCo2 greater than what is considered respiratory acidosis [compensatory]

Bicard greater than what Causes bicarbonate to drive the alkalosis

Greater than 28

Anion gap equation ; and what is considered elevated

Na+ - Cl- -HCO3 ;; greater than 12 = ELEVATED

With COPD commonly think what type of acid base issue

Respiratory acidosis

3 other causes of respiratory acidosis

CNS depression = opiates Myasthenia Gravis NMSK disorders = GB

Hyperventalation causes what

Respiratory alkalosis because you are losing CO2

3 common causes of respiratory alkalosis

Salicylate toxicity Acute asthma attack Pulmonary Embolism

Describe sxs of respiratory acidosis

Things go DOWN Coma Death

PCO2 necassary for respiratory acidosis =

Greater than 45 and acidic

PCO2 necassary for respiratory alkalosis

Less than 35 and alkalotic

Bicarbonate for metabolic alkalosis [compensatory]

Greater than 29

Bicarbonate for metabolic acidosis [compensatory]

Less than 22

what is the acronym for acid base disorders as a rule

ROME PCo2 normal = 40 Bicarbonate normal = 25 Physio pH = 7.4

With PCO2 think what compensation and same for HCO3 ?

PCO2 = Lungs HCO3 = Kidney

Intracatbale vomiting can cause what

Low potassium Metabolic alkalosis

Tumor lysis syndrome usually does what

Lysis cells which means K+ goes up

3 potassium intracellular shifting agents / states

Insulin Albuterol Alkalosis

Renal over excretion of potassium ; 3 reasons?

Thiazides HypoMagnesium Hyperaldosteronism

3 manifestation of Hypokalemia

Cramps Delirium Tetany

Potassium is low if less than

3.5

When do you give IV K+ instead of PO

Less than 3 usually and dont forget Mg

Hyperkalemia cell stabilizing medication

Calcium gluconate

3 common reasons for Hyperkalemia

Burns Drugs = ACE , DIgoxin , K+ Diuretics Addisons Disease

High K+ is usually as high as

Greater than 5.2

What type of overdose can cause hyperkalemia sine wave

TCA overdose

Insulin Albuterol Bicarbonate How do they affect K+

Insulin = shifts potassium into the cell Albuterol = upregulates cAMP and shifts K+ into cell s Bicarbonate = shifts potassium into the cell

Furosemide causes what for hyperK+

Renal excretion of K+

Neuro complication of rapid low sodium correction

Osmotic demyelination syndrome

Urine Na+ low makes you think a what cause low ECF volume think -vomiting -diarrhea

Pre renal [before the kidney] metabolic

Urine Na+ high with low ECF volume ; think a what cause -Addisons disease -CKD

Kidney [intrrenal]

SIADH is a what volume status disease

Normovolume The urine will have more osmolality than the serum

If the serum has more osmolality than the urine think what

Water intoxication [ TEA or BEER]

If we are fluid overload with low NA+ ; think what -Cirrhosis -Nephrotic syndrome

Increased interstitial salts

If we are fluid overload with high urinary salt [greater 20] think? -HS -Steriods

Kidney failure

3 triad of sxs in renal cell carcinoma

Flank pain Palpable mass Gross hematuria

MC type of renal cell carcinoma

Clear cell carcinoma

What is a reason to go look for this in a male [ renal cell carcinoma ]

Right sided varicocele

Describe Wilm’s tumor

Nephroblastoma with -anirdia = absent iris -developmental delays

Most common renal kidney cancer in kids

Wilms tumor

1st test for Wilms =

U/S Then CT or MRI

RENAL Flashcards

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