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STEP II > Renal > Flashcards

Renal Flashcards

1
Q

RBC Casts

A

Glomerulonephritis

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2
Q

WBC casts

A

interstitial nephrItis

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3
Q

Fatty Casts

A

NephrOtic syndrome

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4
Q

Muddy-brown casts

A

acute Tubular necrosis

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5
Q

Prerenal Azotemia UA

A
  • Cause = dec. perfusion –> want tot KEEP water
  • Urine Osmolality: >500 (high)
  • FeNa: Low (
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6
Q

Renal Azotemia UA results

A
  • Tubular or glomergular damage –> cant resorb!
  • Urine Osmolality: High (>500-800)
  • FeNa: HIGH (>2%)
  • Urine Na: HIGH (>40)
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7
Q

Rhabdomyolysis

A
  • Crush injury or immobility
  • High Myoglobin (renal toxic)
  • High K + Ca
  • Tx: IVF + Mannitol
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8
Q

Management of CKD

A
  • Low protein + Low salt diet
  • ACE inhibtor (dec. risk ESRD & control HTN)
  • Ca-Citrate (phosphate binder)
  • Vit D & Ca supplemetn
  • Erythropoietin
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9
Q

Dialysis Indications (6)

A
  1. Pulmonary Edema
  2. Refractory HTN
  3. Hyper K w/ EKG changes
  4. HyperMg
  5. Metabolic Acidosis
  6. Drug Toxicity: Methanol. Ethylene glycerol, Lithium, ASA
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10
Q

Nephritic vs, Nephrotic

A

Nephritis:

  • Inflammatory process
  • Hematuria (RBC casts)
  • Mild Proteinuria (3.5
  • Edema (2/2 hypoalbuminemia)
  • Hyperlipidemia (fatty casts)
  • Hypercoaguable state (antithrombin loss)
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11
Q

Membranous Nephropathy

A
  • # 1 in adults
  • Hep C + B, Syphilius, SLE, NSAIDs
  • Granulary Immunoflour (Phospholipase A2)
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12
Q

Focal Segmental Glomerulosclerosis

A
  • Blacks + Hispanics
  • HIV + Heroine + Sickle cell
  • Effacement of foot processes
  • Sentimental sclerosis
  • Tx: Steroids + Immunosuppression
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13
Q

Membranoproliferative Glomerulonephritis

A

Type 1:

  • Mesangial splittin (“Tram tracks”
  • Hep B + C + SLE

Type 2:

  • Intramembranous (dense deposits)
  • C3 neprotic factor
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14
Q

Minimal Change Disease

A
  • # 1 in kids
  • Lymophoma
  • Foot process effacement
  • Tx: Steroids
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15
Q

Poststreptococcal Glomerulonephritis

A
  • # 1 cause of nephritic
  • 2 weeks after strep infection
  • Immune complex depositiion (Type III hypersensativity)
  • Granular on immunoflour.
  • “coca cola” colored urine
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16
Q

Alport Syndreom

A
  • Collagen IV mutation
  • Glomerular membrane splitting
  • Deafness
  • Eye problems
17
Q

Berger Disease

A
  • Episodic hemautris FOLLOWING Upper respiratory or GI illness
  • asst with Henoch-Scholein purpura
  • Mesangeal proliferation
  • IgA deposits on Immunoflour
18
Q

Rapid Progressive Glomerulonephritis

A
  • Crescent lesion (fibrin, macrophages, C3)
    Causes:
  • Goodpasture (GN + Pulmonary hemorrhage + antiGMB = linear immunoflour)
    -Wegeners (cANCA + GN + Pulmonary + Upper Resp sx)
  • Churg Straus (pANCA + Eosinophlia + asthma)
  • Diffuse Proliferative (Ig-C3 Complex deposition on immunoflour + “Wire looping”
19
Q

Acute Interstitial Nephritis

A 
- Allergic Rxn --> fever, eosinophilia, AKI
Causes (6):
1. Contrast 
2. Drugs (6)
(penicillin, Phenytoin, PPI, Sulfa, Rifampin, Diuretics, NSAIDs)
3. Infections 
4. SLE
5. Sjogerns
6. Sacoidosis
20
Q

Renal Tubular Necrosis

A
  • Granular, Muddy-brown casts
    1. Injury
  • Toxin (Aminoglycosides, Lead, Cisplatin, Rhabdomyolysis)
    Ischemia
    2. Maintenance: Olguiria lasts 1-3wks
  • hyperK + Metabolic acidosis
    3. Recovery: Polyuria
  • hypoK
21
Q

Ca Stones

A
  • Most common
  • Idiopathic (#1 cause); ethylene glycol, Vit C. Overdose, Chrons
  • Radiodense
  • dumbell shaped
  • Tx: Thiazide diuretics
22
Q

Ammonium-Mag-PO4 stones

A
  • Urease (+) bacteria (Proteus, Klebsiella, Staph)
  • Radiodense
  • Coffin shaped
  • Tx: Surgical removal
23
Q

Uric Acid Stones

A
  • Olgiuia
  • RadioLUCENT
  • Rhomboid shaped
  • Tx: Alkaline urine
24
Q

Cystine Stones

A
  • Cystinuria (kids)
  • Radiodense
  • Hexagon
25
Q

Kidney Stone Dx testing?

A 
Abdo US (for hydronephrosis)
CT is gold standard
26
Q

Urinary tract Obstruction Dx testing?

A
  • US first

- IVP is gold standard

STEP II (13 decks)

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