Renal, but shit I got 99% Flashcards Preview

UWorld journal > Renal, but shit I got 99% > Flashcards

Flashcards in Renal, but shit I got 99% Deck (57):
1

Hyperurcemia as a s/e diruetics

Thiazide
Furosemide

2

What drugs will decrease mortality in CHF

ACE/ARB
BB
spironolactone

3

What is at least 1 good reason to rx a thiazide

htn

4

What is at least 1 good reson NOT to use a thiazide

Thiazides are implicated in Lithium toxicity

5

What do thiazides do

Block DCT-- Na/Cl channel

happens to also ↓ Ca excretion

6

What is a genetic problem that looks exactly like life long thiazide use

Gitelman

7

What 2 drugs treat Calcium renal stones

Thiazide
Citrate

8

Namethe thiazides

Hydrochlorothiazide
Chlorthalidone
Metolazone

9

What is triamterene

K sparing diuretic
acts on collecting tube

10

Why does CKD have hypocalcemia as a trait

In CKD, PO4 cannot clear due to ↓ GFR

PO4 binds Ca--> hypoca

↑ PHT due to ↓ Ca

Further a problem b/c kidney not making vit d--> even less Ca

11

How do you fix a low Ca in CKD

Calcitriol and Ca supplements

12

What are the most important steps in evaluating metabolic alkoloasuis

Volume Status
Urine Cl

13

What are the most common reasons for metabolic alk

Vomiting- Loss of H/ Cl
Thiazide/ Loop- loss of H/ Cl

14

What is almost always present for development of acute pylo

Vesicoureteral reflux or other anatomic problem

usually more likely to get normal UTI

15

What are the 3 different types of Rapidly progressive glomerulonephritis

1- Anti-GMB RPGN (goodpature)

2- Immune Complex RPGN (PSGN, SLE, IgA/ henoch sconein purpura)

3- Pauci Immune RPGN (no immunoglob) ex weCners- anca

16

When Does ADPKD present

40-50 years
newborns- cycts way too small to see

17

When do Waxy Casts present

CKD

18

What is the best way to detect early nephrOpathy

UA albumin

19

What receptors does ADH act on

V1- vasoconstriction

V2- antidiuretic

20

Where is PAH reabsorbed

para-aminohippuric acid is not reabsorbed anywhere

21

When would you see a WBC cast

Pyelo
Transplant reject
tubulointerstitial inflammation

22

How do you calculates filtration fraction

FF= GFR / RPF

23

What are the side effects of loop diuretics

Ototoxicity
HypoK
Dehydration
Allergy (sulfa)
Alkalosis
Nephritis
Gout

OH DAANG

24

Why do loop diuretics cause ototoxicity

loops inhibit Na/K/2Cl in ascending loop

similar inhibition in inner ear--> ototoxicity

25

How is acyclovir metabolized

Renal

May crystallize in tubes--> tubular damage

Aggressive hydration = prevention

26

Describe the proteinuria of minimal change disease

highly SELECTIVE proteinuria- loss of charge selectivity

loss of only small proteins (albumin)

NO loss of large (IgG)

27

What is the most common primary renal tumor

Renal Cell carcinoma

often asymptomatic

Polycythemia often seen due to tumor --> ↑ EPO

28

What is Conn syndrome/ what is rx

primary hyperaldosteronism

rx: eplerenone (less s/e vs spironolactone)

29

What does aldosterone excess look like

Hypertension, met alk, ↓ renin

30

What kind of incontinence does Oxybutynin treat

Urge

Anti-M drug

31

How would you treat post op failure to void

Bethanechol - direct M agonist

a1 blocker

32

What is a normal post void volume

Less than 50 CC

33

How is bradykinin metabolized

By ACE

that's why ACE has ↑ bradykinin

34

How does cyclosporin work

Calcineuron inhibitor ( prevents IL 2 and thus T cells)

35

What does grapefruit juice do to p450

inhibits p450

36

What diuretic can treat glaucoma

acetazolamide- carbonic anhydrase inhibitors
↓ HCO3 ↓ Aqueous humor --> better pressure

37

What might MCD be related too

defect in immune fx, b/c MCD is often seen with uri, vacancies, etc

38

define overflow incontinence

due to incomplete emptying
when bladder pressure exceeds sphincter--> continuous urine leakage

39

Define stress incontinence

loss of pelvic floor support

cough--> ↑ pressure--> brief UA loss

40

What is the triad of hemolytic uremic syndrome

-microangiopathic hemolytic anemia
-thrombocytopenia
-acute kidney injury

41

Describe Henoch Schonlein purpura

vasculitis

IgA immune deposition in skin, kidney, joint, intestine

presents with palpable purpura

42

Describe Kawasaki

medium vessel arteritis

Fever, conjunctivitis, cervical LAD, strawberry tongue

43

What is a common cause of death in ADPKD

berry aneurysm

44

How does one calculate net filtration

(Pc- Pi) - (nc-ni)

hydrostatic difference - oncotic difference

45

How is paraaminohippuric acid filtered

Freely filtered

Carrier mediated process into tube cells (secretion from blood to tube)

46

Which part of the kidney will have the argest issues with ischemia

straight proximal tubule
Thick ascending limb

These areas use ↑↑ ATP and thus have highest O2 demand

47

What causes acute tubular necrosis

decreased renal perfusion

hypovolemia, shock, surgery

48

what is a bad prognostic factor for PSGN

presentation in adults

kids do better

49

What does angiotensin 2 do in the kidney

constricts efferent

ACE inhibitor therefor--> dilated efferent

50

What would look special in ethylene glycol poisoning in ATN (vs other ATN)

ethylene glycol will have Calcium Oxalatecrystals

51

What is the most common site for mets from a RCC

lung

RCC shows abundant clear cytoplasm

52

What is the defect in fabray

x linked a-galactosidase A deficiency

53

What should all DM patients with kidney problems be started on

ACE inhibitors
ARB

helps prevent the progression of diabetic nephropathy

54

What lab value can tell you GFR

Insulin or creatinine clearance

55

What lab value can tell you renal plasma flow

PAH clearance

56

How do you calculate the clearance of anything (s)

Clearance = ([UAs] x UA flow rate) // ([PlasamS])

57

How do you calculate the excretion of anything (s)

excretion= (GFR)([plasma-s]) - (tubular reabsorption s)