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3B GH > Renal > Flashcards

Renal Flashcards

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1
Q

causes of CKD

A 
DM
age
IgA nephropathy
reflux
obstruction
renovascular disease
HTN
PKD
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2
Q

Ix in CKD

A 
FBC
U and E
ANCA/ANA, complement (glomerulonephritis/vasculitis)
urine dipstick
PCR
US
renal biopsy
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3
Q

Sx in advanced CKD

A 
fatigue (anaemia)
breathless (fluid)
anorexia, vomiting (uraemia)
pruritis
restless legs
bone pain
leg swelling
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4
Q

lifestyle modifications in CKD

A

HTN control
DM control
low salt diet
stop smoking

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5
Q

CKD Mx options

A

transplant
peritoneal dialysis
HD
conservative

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6
Q

contraindications for renal transplant

A

absolute: cancer w/mets (imm sup after)
relative: HF (anaesthetic + perfusion of 3 kidneys), CVD
temporary: active infection, HIV w/viral replication, unstable CVD

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7
Q

main complication of peritoneal dialysis

A

peritonitis

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8
Q

contraindications of PD

A

stoma
hernia
abdo surgery
blind

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9
Q

pros of peritoneal dialysis

A

retain some kidney fn
home and holidays
don’t have to have fistula/needles
constant blood levels = well

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10
Q

pre-renal causes of AKI

A 
ACE/ARB/NSAIDs
hypovolaemia
hypoTN
HF (pump failure)
vascular disease
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11
Q

renal causes of AKI

A 
drugs
trauma
glomerulonephritis
infection
acute tubular necrosis
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12
Q

post-renal causes of AKI and Ix

A 
enlarged prostate (Ca/BPH)
pelvic Ca compressing ureter
bladder Ca
stone
renal US (hydronephrosis, dilated ureters)
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13
Q

mx of postrenal AKI

A

urethral catheter

percutaneous nephrostomy

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14
Q

features of nephrotic syndrome

A

oedema
proteinuria
hypoalbuminaemia
hypercholesterolaemia

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15
Q

electron microscope feature of minimal change

A

flattening of foot processes

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16
Q

life-threatening complication of Granulomatosis with polyangiitis (wegeners) and good pastures

A

haemoptysis

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17
Q

why do nephrotic pt.s have hypercholesterolaemia

A

liver tries to make more albumin to replace loss, leads to cholesterol production

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18
Q

in what circumstances would you advise a patient to stop their ACE/ARB and why

A

pregnancy - teratogenic

D and V - can cause AKI

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19
Q

how does proteinuria worsen kidney disease

A

protein excreted in glomerulus, then reabsorbed in tubules. Causes inflamm in tubules -> scarring

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20
Q

most common cause of autosomal dominant PKD is what gene

A

PKD1 on chromosome 16

codes for polycystin 1

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21
Q

Mx of hyponatraemia

A

hypovol - saline
normal vol - fluid restrict
hypervol - furosemide, ACE, fluid restrict

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22
Q

Mx of hypokal

A

oral K+/ IV KCl slow or heart stops

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23
Q

mx of hyperkal

A

calcium gluconate + insulin + glucose.
Salb neb.
Calcium resonium

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24
Q

haematuria only apparent at the start of micturition is usually due to…

A

urethral disease

[trauma/infection/tumour]

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25
haematuria at the end of micturition suggests bleeding from...
prostate or bladder base
26
haematuria as even discolouration throughout urine suggests bleeding from...
bladder or above
27
Mx of hypocalc
Ca2+ PO CKD - may require alfacalcidol Severe: calcium gluconate IV
28
mx of hypercalc
Fluids. Furosemide. Pamidronate (bisphos) | Treat the cause
29
Sx and signs of peritonitis in a peritoneal dialysis patient
pyrexia abdo pain cloudy effluent +ve cultures
30
complications of HD
hypoTN - headache, dizzy, nausea cramps [Na+ level] air embolus clot
31
what does ramipril do to GFR
slows down by efferent dilatation
32
how are NSAIDs dangerous to the kidney
reduce renal blood flow by afferent constriction
33
what factors other than kidney fn can affect creatinine
ethnicity male^ age^ muscle mass^
34
what would you see on a bone marrow biopsy to confirm myeloma?
high number of plasma cells
35
drugs that cause hyperkalaemia
spironalactone [K+ sparing] | ACE inhib
36
ecg changes in hyperkalaemia
tall tented T waves small/ absent/ inverted P wave wide QRS
37
Mx of hyperkalaemia
calcium gluconate insulin + glucose [insulin drive K+ into cells] treat cause ``` others: salb neb loop diuretic [furos] calcium resonium dialysis ```
38
reasons for emergency dialysis
high urea -> pericarditis HF/ sepsis -> fluid overload -> pulm oedema hyperkalaemia
39
primary differential of dysuria
UTI
40
differential diagnoses for polyuria
DM diabetes insipidus hypercalc
41
differentials for pain confined to the loin [not radiating to groin and anteriorly, as in renal colic]
pyelonephritis renal cyst pathology renal infarct
42
risk factors for AKI
``` CKD age male DM CV diseease malgnancy chronic liver disease complex surgery ```
43
name 5 of the 7 commonest causes of AKI
1. sepsis 2. major surg 3. cardiogenic shocl 4. other hypovolaemia 5. drugs 6. hepatorenal syndrome 7. obstruction
44
causes of pre-renal AKI
reduced vascular vol [haemorrhage, D+V, burns, pancreatitis] redcued cardiac output [cardiogenic shock, MI] systemic vasodilation [sepsis, drugs] renal vasoconstirction [NSAIDs/ARB/ACEi, hepatorenal syndrome]
45
renal causes of AKI
glomerulonephritis, acute tubular necrosis. drug Rn, infection, infiltration [sarcoid]. vasculitis, HUS, TTP, DIC
46
causes of post-renal AKI
stone, renal tract malignancy, stricture, clot. | Pelvic malignancy, prostate, retroperitoneal fibrosis.
47
AKI Mx
``` ABCDE treat ^K+ [calc chloride/gluconate, insulin-glucose, salb] fluid catheter/ fluid balannce treat cause e.g. sepsis ABx stop nephrotoxic drugs dialysis [nephrostomy/surg for post-renal] ```
48
Ix in AKI
``` US urine dip FBC, U+E, LFT platelets [HUS/TTP] film renal biopsy in intrinsic [Ig, paraprotein, complement, ANA/ANCA/anti-GBM] ```
49
signs of hypovol
``` low BP low UO low JVP poor tissue turgor ^pulse weight loss long cap refill ```
50
signs of fluid overload
``` ^BP ^JVP lung creps peripheral odema gallop rhythm ```
51
Mx of fluid overload in AKI
O2 fluid restrict diuretics if symptomatic RRtherapy
52
give 5 causes of haemoaturia
1. malignancy [kidney/ureter/bladder] 2. calculi 3. IgA nephropathy 4. Alport syndrome 5. other glomerulonephritis 6. PKD 7. schisto 8. anticoags
53
in a patient with non-visible haematuria on dipstick, what other factors, in the history, exam or investigations, would indicate renal aetiology/ indicate renal referral?
HTN low eGFR proteinuria FH
54
how would you monitor a patient with non-visible haematuria where no cause was found
eGFR BP A:C ratio
55
causes of glucose on dipstick
DM pregnancy sepsis proximal renal tubule pathology
56
causes of ketonuria
ketoacidosis | starvation
57
give some causes of white blood cells on urine microscopy
``` UTI glomerulonephritis tubulointerstitial nephritis renal transplant rejection malignancy ```
58
on urine microscopy: 1. causes of red cell casts 2. causes of white cell casts 3. causes of granular casts
1. glomerulonephritis 2. glomerulonephritis, pyelonephritis, interstitial nephritis 3. CKD
59
define 'complicated' UTI
structural or functional abnormality of the GU tract | e.g. obstruction, catheter, stones, neurogenic bladder, transplant
60
give 5 risk factors for UTI
``` sexual activity urinary incontinence faecal incont constipation spermicide low oestrogen, menopause dehydration obstruction/stone DM imm.supp. catheter tract malformation preg ```
61
Sx of cystitis
``` frequency dysuria urgency suprapubic pain polyuria haematuria ```
62
Sx of acute pyelonephritis
``` fever rigor vomiting loin pain/tenderness costovertebral angle pain cystitis Sx [freq. etc] shock ```
63
Sx of prostatitis
``` pain [perineum, rectum, scrotum, penis, bladder, lower back] fever malaise nausea urinary Sx ```
64
Ix in UTI
``` dipstick MSU culture FBC, U+E, CRP, blood culture (if systemically unwell), glucose US (cystoscopy, urodynamics, CT) ```
65
most common organism for UTI
E. coli
66
Abx for female UTI
trimeth or nitrofurantoin. if fails, culture + sensitivty
67
Abx for male UTI, with Sx that suggest prostatitis
longer course [4 weeks] ciprofloxacin
68
most common causes of CKD in the UK
1. DM 2. glomeruloneph 3. HTN/renovascular disease
69
CKD Sx
``` SOB peripheral oedema anorexia N+V restless legs fatigue weakness pruritis bone pain amenorrhoea impotence ```
70
give 5 exam findings in CKD
``` peripheral oedema uraemic flap anaemia signs yellow tinge raised JVP HTN pulm oedema or effusion PD catheter/tunnelled line/AV fistula transplant scar/palpable 3rd kidney palpable polycytic kidneys ```
71
blood findings in CKD
``` normocytic anaemia U+E [^creat etc] ^glucose low Ca2+ ^phosphate ^PTH ANA/ANCA/antiphospholipid antibodies/paraprotein etc ```
72
what urine Ix are reqiured in ckd
dipstick MC+S alb:creat bence jones
73
what imaging reqiured in ckd
US | isotope scan
74
risk factors for ckd decline
``` smoking HTN DM metabolic dist vol deplete infection NSAIDs ```
75
mx to slow CKD progression
HTN Mx ACEi/ARB glycaemic control lifestyle - EXERCISE, weight loss, smoking cessation, low salt intake
76
Give examples of CKD complications
``` anaemia acidosis oedema bone mineral disorders restless legs enceph ```
77
Mx of anaemia in CKD
EPO iron, B12, folate if deficient [dont miss other causes of anaemia e.g. GI bleed]
78
Mx of acidosis in CKD
sodium bicarb supplements
79
Mx of oedema in CKD
fluid and Na+ restrict loop diuretics loop + thiazide
80
Mx of restless legs in CKD
exclude iron def sleep hygiene advice gabapentin [off licence + beware side effects]
81
how does PKD present?
become symptomatic due to ^size or haemorhage ``` loin pain haematuria cyst infection renal calculi high BP progressive renal failure ```
82
extrarenal aspects of PKD
``` liver cysts intracranal aneurysm >SAH mitral prolapse ovarian cyst diverticular disease ```
83
diagnostic Ix for PKD and the diagnostic criteria
US 15-39 3 cysts 40-59 2 cysts in each
84
mx of PKD
``` 3/4L water /day treat HTN [ACE/ARB > thiazide > BB] treat infections cyst decompression RRT ```
85
which antihypertensive drug should not be used in PKD and why?
CCB | reduced calcium entry is part of the pathology
86
briefly describe how haemodialysis works
blood is passed through a dialysis machine over dialysis fluid flowing the opposite direction. Waste products (solutes) pass down concentration gradient into dialysis fluid through a semi-permeable membrane
87
problems with haemodialysis
access: - fistula thrombosis/stenosis/hand ischaemia. - tunnelled line infection/ blockage cerebral oedema hypoTN time consuming
88
briefly describe how peritoneal dialysis works
uses peritoneum as semi-permeable membrane. Fluid infused in peritoneal cavity, solutes diffuse across
89
problems with peritoneal dialysis
catheter site infection peritonitis hernia loss of membrane fn over time
90
complications of renal transplant
surgical: bleed, thrombosis, infection, urinary leaks, lymphocoele, hernia delayed graft function rejection: acute [antibody mediated, cellular], chronic [antibody mediated] infections malignancy CVD
91
factor that increase risk of graft loss in renal transplant
``` donor: ^age comorbidity deceased [vs living] cardiac death [vs brain death] rejection infection BP/CVD recurrent renal disease in graft ```
92
blood iX in glomerulonephritis
``` FBC U+E LFT CRP immunoglobs electrophoresis complement autoantibodies ANA ANCA anti-dsDNA anti-GBM blood culture hepatitis serology anti-streptolysin O titre ```
93
urine Ix in glomerulonephritis
MC+S bence jones proteins A:Cr ratio RBC casts
94
how is glomerulonephritis diagnosed
renal biopsy
95
what is the commonest primary glomerulonephritis in high income countries?
IgA nephropathy
96
how does IgA nephropathy present?
``` asymptomatic non-visible haematuria OR episodic visible may be within 12-72hrs of infection ^BP small proteinuria ```
97
Mx of IgA nephropathy
ACEi/ARB for BP sometimes pred/cyclophos/azathiop fish oil
98
what is the pathophysiology behind henoch schonlein purpura?
systemic variant of IgA nephropathy | IgA deposition in skin/joints/ gut/kidney
99
features of henoch schonlein purpura?
purpuric rash on extensors [LEGS] polyarthritis abdo pain [GI bleed] nephritis
100
renal biopsy in henoch schonlein purpura is identical to biopsy in which other glomerulonephritis
IgA nephropathy
101
diagnosis of HSP is usually clinical, but can be confirmed by what Ix?
positive immunofluorescence for IgA and C3 [complement] in the skin
102
post strep glomerulonephritis occurs after infection in what 2 locations?
throat or skin
103
what is the pathophysiology behind post strep glomerulonephritis?
streptococcal antigen deposits in the glomerulus, leading to immune complex formation and inflammation
104
presentation of post strep glomerulonephritis
``` haematuria +/- oedema ^BP oliguria ```
105
Mx of post strep glomerulonephritis
supportive | Abx
106
pathophysiology behind anti-GBM disease [goodpastures]
auto-antibodies to type IV collagen [present in glomerular and alveolar basement membranes]
107
presentation of anti-GBM disease [goodpastures]
oligo/anuria haematuria aki renal failure pulmonary haemorrhage: SOB, haemoptysis
108
diagnosis of anti-GBM disease [goodpastures] is made on...
anti-GBM in serum/biopsy
109
Tx of anti-GBM disease [goodpastures]
plasma exchange corticosteroids cyclophosphamide
110
nephrotic syndrome is a triad of...
proteinuria hypoalbuminuria oedema
111
nephrotic syndrome is due to primary renal disease or secondary to a systemic disorder. Give some examples of secondary causes.
``` DM lupus nephritis myeloma amyloid pre-E ```
112
differential diagnosis for the presentation of nephrotic syndrome
CCF | liver disease
113
Mx of nephrotic syndrome. what investigation is vital to establish cause [in adults]?
``` fluid + salt restrict furosemide +/- thiazide ACEi/ARB [reduces proteinuria] treat cause e.g. corticosteroids in minimal change ``` renal biopsy
114
complications of nephrotic syndrome
thromboembolisms [DVT/PE/ renal vein thrombosis] infection hyperlipidaemia
115
why is there ^risk of infection in nephrotic syndrome? | And what type of infections are seen?
urinary loss of Ig etc - urinary, resp, CNS infection infection in areas of fluid accumulation - cellulitis, peritonitis, empyema
116
Mx of ^infection risk in nephrotic syndrome
pneumococcal vaccine | post-exposure prophylaxis in varicella in non-immune
117
drugs that can cause minimal change
lithium | NSAIDs
118
most minimal change disease is idiopathic. But what else can cause it?
drugs [NSAIDs, lithium] | paraneoplastic [haem CA, usually hodgkins]
119
does minimal change casue renal failure
no - if progressive consider missed FSGS [focal segmental]
120
what Ix.s are used in diagnosing minimal chnage + what results?
renal biopsy, light microscopy normal. electron microscopy shows effacement of podocyte foot processes
121
Tx minimal chnage
pred. frequent relapse - cyclophosphamide/ calcineurin inhibitors
122
blood and urine findings in SIADH
hyponat low or normal urea and creat low plasma osmol high urine osmol high urine Na+
123
signs and Sx of hypernatraemia
``` thirst lethargy, weakness irritable confusion, coma, fits signs of dehydration ```
124
causes of hypernatraemia
``` diarrhoea, vomiting, burns: (fluid loss) diabetes insipidus osmotic diuresis e.g. DKA primary aldosteronism iatrogenic e.g. too much saline ```
125
serum Na+ findings and osmolality findings (urine +serum) in diabetes insipidus
hypernatraemia | high plasma osmolality, low urine osmolality
126
Mx of hypernatraemia
water orally if possible 5% glucose IV 0.9% saline if hypovolaemic [its still hypotonic]
127
signs and Sx of hyponatraemia
anorexia nausea malaise headache, irritable, weakness. FALLS IN ELDERLY. Confusion, low GCS, seizure.
128
Mx of hyponatraemia
[correct the cause] hypervolaemic - fluid restrict, demeclocycline [ADH antag]. Vaptans. dehydrated - 0.9% saline euvolaemic - 0.9% saline + furosemide. Vaptans.
129
danger of rapid correction of hyponatraemia using 0.9% saline
central pontine myelinolysis (demyelination of the pons, irreversible, often fatal)
130
when can central pontine myelinolysis occur? | and what is the presentation?
malnourished alcoholics, rapid correction of hyponat lethargy, confusion, pseudobulbar palsy, weak arms + legs, coma, locked-in syndrome
131
causes of hyponatraemia. Pt is dehydrated with high urine Na+
(Na+ and water lost by kidneys) addisons renal failure diuretics osmolar diuresis [^glucose or urea]
132
causes of hyponatraemia. Pt is dehydrated WITHOUT high urine Na+
(Na+ and water lost, but NOT via kidneys) ``` D+V fistula burns rectal villous adenoma small bowel obstruction trauma CF heat exposure ```
133
causes of hyponatraemia. Pt is oedematous
nephrotic syndrome CCF liver failure renal failure
134
Hyponatraemic, Euvolaemic patient with high urine osmolality. What is the cause of their hyponatraemia?
SIADH
135
give 5 causes of SIADH
malig (SCLC, pancreas, prostate, thymus, lymphoma) CNS (meningoenephalitits abscess, stroke, SAH, subdural, head injury, GBS, neurosurg, vasculitis, SLE) chest (TB, pneumonia, abscess, aspergillosis, SCLC) endocrine (hypothyroid) drugs (opiates, psychotropics, SSRIs, cytotoxics)
136
Tx of SIADH
treat cause fluid restrict consider salt +/- Furosemide vaptans
137
Mx of acute heart failure/ severe pulmonary oedema [including Ix plz :) ]
sit upright high flow O2 if hypoxia ``` CXR ECG for arrhythmias U+E, trop, (BNP) ABG (echo) ``` diamorphine furosemide GTN, nitrate infusion CPAP
138
differentials for orbital oedema
1. allergies [make up/ stings] 2. angioedema 3. infection [orbital cellulitis, EBV, sinusitis] 4. graves 5. connective tissue disease [dermatmyositis, SLE, sarcoid, amyloid]
139
Mx of diabetic nephropathy
``` DM control BP control ACEi/ARB for CV + renal protection Na+ restrict statins ```
140
how does lupus cause nephritis
deposition of antibody complexes -> inflamm, tissue damage
141
what are the antibodies against in SLE
nuclear components of cells [stuff inside the nucleus] e.g. anti-dsDNA, which is a ANA [anti-nuclear]
142
how do you diagnose lupus nephritis
clinical ANA, anti-dsDNA biopsy
143
Mx of lupus nephritis
ACE-/ARB for renal protection hydroxychloroquine for extra-renal disease more severe (class III-V) - mycophenolate, glucocorticoids, cyclophos, ritux
144
what causes non-pitting oedema?
lymphoedema [radiotherapy, malignant infiltration, infection, filariasis, primary/milroy's]
145
causes of bilateral leg oedema
``` RHF low albumin [renal/liver failure] venous insufficiency vasodilators [nifedipine, amlodipine] pelvic mass pregnancy, preE ```
146
Mx of renal small vessel vasculitis
pred cyclophos/ritux plasma exchange (in renal failure/ pulm haemorrhage)
147
describe the different way in which myeloma can cause of renal disease
1. renal tract infection due to immunoparesis 2. IgA light chain deposition in glomerulus > proteinuria 3. IgA light chain casts obstruct tubules 4. hypercalcaemia
148
Tx of renal dysfunction in myeloma
hydration bisphosphonates for ^Ca2+ chemo including dex
149
A pregant patient presents with AKI. Her bloods show a haemolytic anaemia, [ low Hb, ^LDH, low haptoglobin, fragment on blood film] + thrombocytopenia. She reports noticing some blood in her urine and that it was frothy. Diagnosis?
Haemolytic uraemic syndrome. | Can be precipitated by pregnancy
150
Mx of HUS
supportive severe may need: transfuse, plasma exchange, dialysis, treat HTN
151
5 aspects of thrombotic thrombocytopenic purpura
``` microangiopathic haemolytic anaemia thrombocytopenia AKI neuro [headache, palsy, seizure, confusion, coma] fever ```
152
Mx of thrombotic thrombocytopenic purpura
plasma exchange corticosteroids low dose aspirin while recovering rituximab
153
what does atherosclerotic renovascular disease do to the renin-angiotensin system
upregulation -> ^BP
154
what is reabsorbed at the proximal tubule of the kidney
``` Na+ HCO3- phosphate glucose amino acids ```
155
what is absorbed at the distal tubule of the kidney
Na+ | Cl-
156
what is reabsorbed at the thick ascending loop of the kidney
Na+, K+, 2Cl-
157
what is excreted at the non-cortical part of the collecting of the kidney
water
158
where in the kidney does mannitol act
PCT
159
where do thiazides act in the kidney
DCT
160
where do K+ sparing diuretics act in the kidney?
cortical collecting duct
161
where do vaptans act in the kidney?
collecting duct
162
Tx of proximal renal tubular acidosis
bicarb and K+ replacement
163
what is mannitol used for
^ICP ^IOP (holds water in tubules by osmosis and into urine)
164
what is Acetazolamide
diuretic. used in glaucoma, altitude sickness, metabolic acidosis
165
give the names of 2 loop diuretics
furosemide | bumetanide
166
how do loop diuretics work?
blokc Na+/K+/2Cl- transporter. ^ing concentrate of filtrate so reducing water resorption ^loss of water, Na+, Cl-, K+, phosphate, Mg2+, Ca2+, H+
167
side effects of loop diuretic use
hypokalaemia hypovolaemia metabolic alkalosis ototoxicity
168
how do thiazide [bendroflumethiazide] and thiazide-like [indapamide] diuretics work?
inhibit NaCl transporter, so inhibit Na+/Cl- reabsorption, thereby ^ing concentration of solute to ^ water loss.
169
side effects of thiazide diuretics
``` hypokalaemia hyponatraemia hypoMg2+ precipitate gout by sparing uric acid glucose intolerance ```
170
of loop diuretics and thiazide diuretics, which is used for peripheral oedema [HF/ascites] and which for HTN?
furosemide - peripherla oedema | thiazide - HTN
171
where does aldosterone act in the renal tubule + what does it do?
collecting duct | retain Na+, excrete K+
172
what is the pathology behind distal renal tubular acidosis
failure of acid (H+) secretion
173
how is distal renal tubular acidosis diagnosed
urine fails to acidify despite metabolic acidosis
174
Tx for distal renal tubular acidosis
bicarb | manage underlying
175
what are K+-sparing diuretics used for + how do they work?
HF cirrhosis aldosteronism K+ wasting states decrease Na+ and K+ excretion
176
adverse effects of K+-sparing diuretics
hyperkalaemia | acidosis
177
how do the aminoglycosides [gentamicin, streptomycin etc] cause AKI?
tubular necrosis
178
how can you prevent radiocontrast nephropathy?
pre-hydrate with IV saline + continue after discontinue other nephrotoxic meds 24 hrs pre and post procedure tell radiologist about RFs so they can use lowest dose
179
causes of unilateral leg oedema
``` DVT cellulitis bite tumour necrtizing fasciitis trauma compartment syndrome arthritis bakers cyst ```
180
causes of pulmonary oedema
CV: LVF (IHD/MI), vavular, arrhythmia, malignant HTN ARDS: trauma, drugs, sepsis fluid overload neurogenic [head injury]
181
how does rhabdomyolysis damage the kidney?
1. myoglobin released from muscle breakdown is filtered at glomerulus -> obstruction -> inflamm 2. low NO and high cytokines -> renal vasoconstriction
182
presentaiton of rhabdomyolysis - symptoms + important recent history/ predisposing factors
muscle pain swelling AKI sx red-brown urine history of: trauma, surgery, immobility, hyperthermia, seizures
183
how do you diagnose rhabdomyolysis? [4 Ix features]
1. serum myoglobin [but short half life] 2. plasma CK 3. cola urine false +ve for blood on dipstick, but no RBC on microscopy 4. ^K+, ^phosphate, low Ca2+
184
Tx rhabdomyolysis
supportive treat hyperkal fluids to maintain UO til myoglobinuria ceased [RRT]
185
what is urate nephropathy + what particular situaiton/ condition is it seen in?
uric acid crystals precipitate within the tubulointerstitium -> low GFR + inflamm tumour lysis syndorme [high tumour burden + sensitvity to chemo]

3B GH (16 decks)

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