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Step 2 > Renal > Flashcards

Renal Flashcards

1
Q

Nephrotic

First 2
associations?

A

Minimal changes - Hodgkin (Cytokine) - steroids, clinical dx in kids

FSGS - HIV, heroin, IFN - no steroid

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2
Q

Nephrotic - Last 4

Associations?

A

Membranous, HBV, HCV, NSAIDS. spike and dome
subEpi. Renal vein thrombosis

MP T1 - HBV, HCV, Tram tracking - subendo

MP T2 - DEC C3. NF+ convertase. Intramembranous

DM - hyaline, KW nodule. Eff>aff. Hyperfiltration

Amyloidosis - Apple green congo, Chronic SAA.

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3
Q

Nephritic - First 2- Associations?

A

PSGN - DEC C3, hypercellular Glom - Subepi

DPGN - SLE, Wire looping. Subendo

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4
Q

Nephritis - Last 3 - associations.

Tx for the last one?

A

IgA nephropathy - Occurs after viral. blood in UA. Mesangial. NORMAL C3!!! dont confuse w/ PSGN.

Alport - Xr - T4 genetic - Ears, eyes, hematuria

Goodpastures - Anti-T4 ab, lung and kidney - Emergent plasmapx.

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5
Q

Tx to help stone pass?

A

Hydration, analgesia, A1 blocker (tamsulosin)

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6
Q

4 types of stones - APPEARANCE - assocations, tx

A

Ca Oxalate - Dumbell/envelop. Vit C, Chrons, Normocalcemic. First one - observe. 2nd - tx HCTZ

Ammonium MG P - Struvite - Staghorn. Urease+. Tx - acidify

Uric Acid - Risk: dry, arid, leukemia, GOUT. Radiolucent

Cysteine - Test for sample w/ Cyanide, Nitroprusside

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7
Q

Causes, association, presentation, lab

AIN

vs

ATN

A

AIN - Diuretics, PCN, NSAIDS, Sufla. EOS! White casts

ATN - Ischemic or Nephrotoxic (AmigoG, Pb, myoglobin) - Muddy brown casts

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8
Q

R. Papillary necrosis - when do you see this?

vs

Diffuse Cortical Necrosis

A

Frank hematuria - DM, Acute pyelo, HbSS, NSAIDS.

Vasospasm, DIC.

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9
Q

Chronic renal failure - coag and platelet findings?

A

Normal INR, Normal PT/pTT

Normal plt count but INC BT. Tx DDAVP (INc F8)

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10
Q

Rental tubular acidosis acid base status and lab finding?

Who is at risk?

A

Metabolic acidosis w/ normal anion gap .

Preserved kidney function - May see HyperK (especially in poorly controlled DM)

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11
Q

In void cycle

intiial hematuria

vs

terminal hematuria

Vs

TOTAL hematuria

A

Initial - urethral damage

Terminal - bladder/prostate - may see clots as well

Total - kidney, ureter damage

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12
Q

Best way to prevent UTI when cathing?

A

Intermittent cath > antibacterial wash

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13
Q

Single renal cyst found - ax - what now?

How to know it is a simple cyst?

A

Simple cyst - thin wall, no solid parts, not loculated.

asx - reassurance and observe

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14
Q

Interstitial cystitis presentation, UA findings, tx?

A

INC frequency, dyspareunia, RELIEF WITH VOIDING (aka the irritable bowel of pee), NORMAL UA!!

Tx amitriptaline, analgeics. Found in women, psych comorbid

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15
Q

RCC - originates from? histo findings? Gross findings>?

presentation (3 factors)

A

RCC - proximal

Histo - Clear cell

Grossly - Yellow Mass

Findings: Hematuria> Mass> Flank pain

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16
Q

AGE AND PRESENTATIOn

Neuroblastoma

Wilms?

A

NB - 1 - poorly circumsribed, crosses midline, HVA INC

WIlms - 2-5y.o - midlinem, smooth, WAGR, Beckwith Wiederman

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17
Q

Renal oncocytoma - gross and histo?

A

Central scar. Large Eos cell.

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18
Q

Transitional CA -

A

Lower tract, field defect. Smoking, Rubber.

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19
Q

Squamous CCA - - origins, etiology

A

Chronic irritation, smoking, schistosoma

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20
Q

Angiomyolipoma - seen in whom? risk?

A

Tuberous sclerosis kids, hamartoma (benign )

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21
Q

Adeno CA in UG tract?

A

Urachal remnant -Associated w/ extrophy

22
Q

Thiazide - complications x 4

A

Hyper

Glycemia
Lipidemia
Uricemia
Calcium

23
Q

Uncomplicated cystitis - workup and tx?

A

Tx W/O CULTURE.

Culture if tx fails once.

bactri, Nitrofurantoine, Quinolone

24
Q

Rhabdomyolysis renal workup findings?

A

Blood on UA, NONE on sed microscopy

25
Q

Pedi UTI - What to do?

A

2mo-2y. Bladder, renal US.

recurrent UTI -> voidiing cystourethrogram

26
Q

AD PKD - presentation?

associations?

A

Mass, hematuria, HTN

hepatic cyst, divertulosis, berry aneurysm, abd, inguinal hernia

27
Q

Renal osteodystrophy findign

A

After ESRD, DEC GFR leads to phosphate retention. See INC P, with DEC Ca, with INC PTH. Similar to Pseudohypoparathyroidism.

28
Q

Overflow incontinence – presentatio

A

full bladder w/ frequent low volume leaks in DM

29
Q

Overflow incontince pharm tx vs Urge incontinence?

A

Overflow - Cholinergic agonists (Bethanechol) vs Urge – Anticholinergic (oxybutynin)

30
Q

Urge Incontinence– Initial tx

A

– conservative – “bladder training” with frequent scheduled voiding.

31
Q

Multiple myeloma kidney damage due to which spot on nephron?

A

– Renal tubular > Glomerular (amyloidoisisi )

32
Q

MOST EFFECTIVE means of DEC DM nephropathy

A

blood pressure control. Not glucose control.

33
Q

SIADH urine findings - osm and Urine Na?

A

has HIGH URINE SODIUM with High Urin osmolality!

34
Q

Tx of Myoglobinuria

A

Salien
Mannitol
Bicarb

Myoglobin is a toixin - mannitol allows INC urine flow rates taht DEC contact time between tubular cells and myoglobin.

35
Q

Lab values of hepatorenal are consitent w?

A

Prerenal azotemia

36
Q

Most accurate test for AIN?

A

Hansel /Wright Stain - detects Eos!

UA cannot detect Eos

37
Q

WHich stones get Lithotripsy?

A

0.5 to 2~cm.

Later than 2cm may need surgery.

38
Q

Anticoagulation in pt w/ renal insufficiency (GFR less than 30)

A

MUST GIVE UNFRACTIONATED HEPARIN – Cannot give LMWH, fondaparainux, and rivaroxaban to pt w/ renal problems. Bridge to Warfarin.

39
Q

Posterior urethral injury

A

high riding prostate, inability to urinate. Scrotal hematoma

40
Q

Fatty cats? Broad/waxy casts?

A

Fatty – Neprhotic. Broad/waxy = Chronic renal failure

41
Q

Immedaite and long term treatemetn of uric stones?

A

Potassium Citrate (alka) helps prevent recurrent stones.

42
Q

Imaging modality for uric acid stone –

A

radiolucent – cant be seen on Xray, but CT noncom can see them

43
Q

Varicocele think?

A

RCC

44
Q

Renal artery stenosis in fibromuscular dysplasia tx

A

– Angioplasty with stent> ACE/medical therapy

45
Q

Crystalline nephropathy (acyclovir) dmg via?

A

Rental tubular obstruction

46
Q

Hyposthenuria –

A

found I pt with sickle cell disease – inability to concentrate urine. Frequent nocturia. Sickle cells sickle in vasa rectae and impair countercurrent exchange.

47
Q

Vesicoureteral reflux vs posterior urethral valves?

A

Vesicoureteral reflux -> scarring. Posterior urethral valves – most common cause of chronic renal failure in children.

48
Q

Pyelo meds

A

Cipro, Amp+Gent. Bactrim and Nitrofurantoin are for UNCOMPLICATED CYSTITIS. Complicated -> Cipro as well.

49
Q

Massive hematuria that resolves, with UA sig only for blood

A
  • Renal papillary necrosis – extraglomerular, often resolves spontaneously. Other problems in Ss patients – inability to concentrate urine in tubes.
50
Q

Infective endocarditis in IVDU w/ DIASTOLIC MUMUR with 2:1 AV block

A

– Aortiv valve endocarditis w/ with perivalvular abscess. Tricuspid regurg would be SYSTOLIC!

51
Q

Urethral stone ith onset of high fever and INC pain

A

immediate abx and percutaneous stent

Step 2 (12 decks)

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