Renal Flashcards Preview

COMLEX 2 > Renal > Flashcards

Flashcards in Renal Deck (46):
1

Milk-alkali Syndrome can lead to?

Acute Renal Failure

2

When should you measure PTH levels in Milk Alkali Syndrome?

In milk-alkali syndrome, vigorous treatment of hypERcalcemia with saline diuresis and loop diuretics may lead to hypOcalcemia. With the hypocalcemia, PTH will rise and may reach levels above reference range. Therefore:
PTH levels should be determined BEFORE or AT THE INITIATION of tx.

3

Gitelman Syn (Bartter Syn if

AR disorder of Na-Cl cotransporter at distal tubule in early adulthood

HyPOKalemia and AlkaLOsis
Hypercalciuria
Inc. Renin, Aldosterone, and HCO3
Weakness, fatigue, spasm

4

CHF can lead to ischemia which can then lead to what in the kidneys?

What would you see on microscopic urine analysis?

Acute Tubular Necrosis

Muddy brown granular casts

5

Pts. with ATN will typically have a FeUrea of what?

>50%

6

Cystinosis inheritance?

Auto Rec

7

Cystinosis:
S&S
How does it cause problems?

Defective transport of cystine out of lysosomes that manifests as:
polyuria, polydipsia, dehydration,
non-anion gap met acidosis, rickets, FTT

8

ADPKD keywords

Hypertension
Hematuria (episodic)
Stroke fam hx
Hepatic cysts on CT, One parent has renal cysts too
Chromosome 16
Berry aneurysms

30 y.o.

9

What is the leading cause of death in ADPKD?

cardiovascular disease

10

What is the 1st line tx for VUR?

Daily Amoxicillin, TMP-SMX, or Nitrofurantoin

11

Medullary Cystic Disease

inc. uric acid --> gout in the young teen
eventual renal failure

12

What has been shown to prevent Contrast-Induced Nephropathy?

Aggressive hydration

13

Tx. Fibromuscular Dysplasia

Angioplasty + Renal A. Stent placement

14

What diabetic drug can't you give to someone with renal failure/impairment? Why?

Metformin --> Lactic Acidosis

15

Car crash pt. --> brown urine is likely?

Appropriate dx. to confirm?

Rhabdomyolysis

elevated Creatinine Kinase

16

Bladder pressure is used to dx. what?

Abdominal compartment syndrome

17

Suprapubic abd pain + fever + dysuria + pneumaturia + urine per rectum would be indicative of?

Colovesical fistula

18

What is the most common cause of colovesical fistula?

Acute diverticulitis

19

Primary Hyperaldosteronism

adenoma of glomerulosa of adrenal gland

20

Bartter Syndrome

Presents prior to 2 y.o.

Low Mg2+
High Urine Ca2+

21

What is Winter's Formula?
When is it used?

Expected pCO2 = [1.5 * HCO3-] + 8 +/- 2

During metabolic acidosis

22

Tx. asymptomatic renal cyst

Nothing

23

Triad of Renal Cell Carcinoma

Increased risk with?

To where does it usually metastasize?

Hematuria
Flank pain
Possible flank mass

Inc. risk with obesity and smoking

To lungs

24

Drug given in Microalbuminuria

Lisinopril

25

Most CKD pts. on dialysis die from?

cardiovascular disease

26

Liddle Syndrome

AD mutation of ENaC channel in distal tubule
HTN
HypOkalemia and alkaLOsis
HyPERnatremia
Low Aldosterone

27

What common medication should you remember can cause bladder distension via its anticholinergic side effects?

Benadryl

28

Post-Strep Glomerulonephritis

S&S

Dx?

What is a common consequence of PSGN?

Type 3 H.S. rxn

periorbital edema, coca-cola urine, HTN

UA
CBC, complement levels (remember IgG, IgM, and C3 deposit on basement membrane), strep Ag assays, antiDnase B Abs
"Lumpy bumpy" on immunofluorescence


HTN

29

Gentamicin is associated with what condition?

Renal Tubular Acidosis Type I --> Hypokalemia --> Flat T waves

30

NephrOtic Syndrome keywords

e.g.

prOteinuria 3.5 g/d and edema
frothy urine + fatty casts
decreased albumin
increased lipids


e.g.
Focal Segmental Glomerulosclerosis (FSGS)
Minimal change dz
Membranous nephropathy
Amyloidosis
Diabetic glomerulonephropathy

31

Nephritic Syndrome keywords

e.g.

Inflammation
Azotemia
Hematuria
Oliguria
hypertension
granular casts

e.g.
Post-strep glomerulonephritis (PSGN)
Rapidly progressive glomerulonephritis
IgA Nephropathy (Berger Disease)
Alport Syndrome
Membranoproliferative Glomerulonephritis

32

ARPKD keywords

Chromosome 6
ARPKD in a full sibling

33

Ethylene glycol poisoning

calcium oxalate crystals ("envelope")

34

Rapidly Progressive (Crescentic) Glomerulonephritis keywords

e.g.

Tx

crescent moon
hematuria, hemoptysis
poor prognosis

e.g.
Goodpasture (pANCA+)
Granulomatosis w/ polyangiitis (aka Wegener - cANCA+)

Tx: Plasmapheresis

35

Diffuse Proliferative Glomerulonephritis keywords

SLE's most common cause of death
"wire looping" of capillaries

36

IgA Nephropathy keywords

mesangial proliferation
immune complex deposits
assoc. w/ Henoch Schonlein Purpura
RBC casts

37

Alport syndrome keywords

type IV collagen mutation
X-Recessive
"Basket weave"

38

Membranoproliferative Glomerulonephritis (MPGN) keywords

Type I - Tram track Immune complex deposition, Hep B/ HepC
Type II - intramembranous immune complex "dense" deposits

39

Focal Segmental Glomerulosclerosis keywords

Foot processes effacement
African Americans, Hispanics
HIV, Heroin, Interferon

40

Minimal Change Disease keywords

children
normal glomeruli
Tx. Steroids

41

Membranous Nephropathy keywords

GBM thickening
Spike and Dome
Caucasian adults

42

Diabetic Glomerulonephropathy keywords

Kimmelsteil Wilson (eosinophilic nodular glomerulosclerosis)
GBM thickening

43

1st Line Tx. for non-pregnant woman with pyelonephritis requiring hospitalization?

Ciprofloxacin

44

1st line Tx. for Acute cystitis?

TMP-SMX

45

Staghorn calculi keywords

CVA tenderness (S&S nephrolithiasis)
Alkaline urine pH, urease-producing Proteus
Coffin-lid Mg-Ammonium-Phosphate crystals
Radioopaque (seen on xray)

46

What value for BUN:Cr would indicate pre-renal cause for Acute Kidney Injury?

BUN:Cr >20