Renal Flashcards
(23 cards)
Side effects of immunosuppressants. (Cyclosporine, Tacrolimus, mycophenolate)
Cyclosporine: Nephrotoxicity, hyperkalemia, tremors, hypertension, GUM HYPERTROPHy, HIRSUTISM.
Tacrolimus: Same as cyclosporine except does not cause gum hypertrophy and hirsutism.
Aziathioprine:diarrhea, leukopenia and hepatotoxicity
Mycophenolate: Marrow suppression
Renal vein thrombosis is most seen in which nephrotic syndrome
Can be seen in all but most associated with membranous nephropathy
Dietary recommendations for people with recurrent renal colick
Reduce dietary protien and oxalate
Increase calcium intake
Decreases Na intake
Increase fluid intake
HIV associated nephropathy
Focal and segmental glomeruloscerosis
What is the most common type of kidney stone
Calcium oxalate
Gold standard for diagnosing kidney stones
Non contrast CT
Which type of kidney stone is radio lucent
Uric acid stone
What medication is used to treat the syndrome of inappropriate antidiuretic hormone secretion if water restriction fails
Demeclocycline which induces nephrogenic diabetes insipidus
What are some causes a false hyponatremia
Things that cause hyper osmolarity
Hyperglycemia, hypoproteinemia, hyper lipidemia.
Causes of hyponatremia in postoperative with patients
Combination of pain and narcotics with overaggressive administration of IV fluids
Adrenaline sufficiency may also Cause this (expect high potassium)
Cause of hyponatremia in pregnant patients about to deliver
Oxytocin, has antidiuretic hormone like effect
What type of IV fluid should not be used for hypernatremia
D5W should not be used for hypernatremia
Relationship between Digoxin and potassium
The heart is particularly sensitive to hypokalemia in patients take digoxin. Monitor potassium levels in patients taking digoxinr
What other electrolyte abnormality impairs potassium absorption or correction
Low magnesium. Low magnesium impairs the bodies ability to retain potassium. Correction of low magnesium levels allows potassium levels return to normal
Patient presents with Tetany, Chvostek sign (pain with tapping on jaw), trousseau sign (muscle spasm with inflation of tourniquet or blood pressure cuff).
What EKG abnormalities is seen
Hypocalcemia QT prolongation(The opposite is seen in Hypercalcemia)
What other Electrolyte abnormality might interfere with calcium correction
Low magnesium. Must correct magnesium to correct calcium
How does pH affect calcium
Alkalosis causes calcium to shift intracellularly and thus mimick hypocalcemia
Patient develops a clot 5-10 days after starting heparin.
Think heparin induced thrombocytopenia type II. Unlike HIT 1, HIT 2 increased risk for thrombosis
HIT 1 is not immune mediated.
HIT2 is anti-body mediated, cause anti-bodies to heparin-platelet factor 4. It causes platelet activation, thrombocytopenia and prothrombotic state
Urine sodium and osmolarity in SIADH
High osmolarity and high urine sodium due to increased water absorption
Patient presents with elevated serum calcium as well as urine calcium to creatinine ratio less than 0.01
Think familial Hypocalciuric hypercalcemia
urine calcium to creatinine ratio in primary hyper parathyroidism is greater than 0.02
Main mechanism of renal damage is multiple myeloma
Toxic effect of light chains cast on the renal tubules.
Less significant are the damages to glomeruli (amyliodosis and monoclonal Ig deposits)
Cause and serologic finding of lupus nephritis
Caused by immune complex mediated damage
Serum C3 level is decreased
Metastatic germ cell tumor with increased serum beta hCG
Choriocarcinoma
