Renal Diagnostics 🥼 Flashcards

(59 cards)

1
Q

Where does serum creatinine come from?

A

Breakdown of creatinine in skeletal muscle and from dietary meat intake.

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2
Q

What happens to creatinine in the kidney?

A

Released into circulation at a constant rate, and is freely filtered and excreted

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3
Q

What is a normal creatinine?

A

0.5-1.2

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4
Q

Where does BUN come from?

A

A product of protein catabolism

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5
Q

What kinds of things other than kidney problems can increase BUN?

A

Dehydration

GI bleed

Medications (Steroids and Tetracyclines)

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6
Q

What ratio can be used as a marker for volume status?

A

BUN/Creatinine ratio

BUN elevated= dehydrated

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7
Q

What is this:

Rough measure of the number of functioning nephrons

A

GFR

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8
Q

Can we directly measure GFR?

A

No

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9
Q

What measurement do we use to estimate GFR?

A

Creatinine clearance

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10
Q

What lab value will the pharmacist ask you for if you need help renally dosing a med?

A

Creatinine clearance

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11
Q

If someone is on dialysis, what stage of CKD are they at?

A

5 (no matter what their GFR is)

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12
Q

What stage CKD:

GFR: 90+

A

Stage 1

“Kidney damage with normal or increased GFR

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13
Q

What stage CKD:

GFR 60-89

A

Stage 2.

“Kidney damage with normal or decreased GFR)

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14
Q

What stage CKD:

GFR: 30-59

A

Stage 3

“Moderately decreased GFR”

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15
Q

WHat stage CKD:

GFR 15-29

A

Stage 4

“Severely decreased GFR”

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16
Q

What stage CKD:

GFR <15

A

Stage 5

“Kidney failure”

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17
Q

If you suspect lupus (SLE) what lab test do you need to order?

A

Antinuclear antibodies (ANA)****

double stranded DNA antibody

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18
Q

If you suspect GPA, what lab tests do you need to order?

A

C-ANCA

P-ANCA
**

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19
Q

What lab test do you need to order if you suspect Goodpasture syndrome
/

A

Anti-glomerular basement membrane antibodies (anti-GBM) ****

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20
Q

Why do we measure Prostate-Speciifc Antigen?

A

Screening method for early detection of prostate cancer

Monitor cancer after treatment

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21
Q

What can cause increased PSA levels

A

Prostate cancer

BPH

Prostatitis

Following prostate manipulation (ultrasound, biopsy, DRE)

not always elevated due to cancer

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22
Q

One of the first signs of kidney disease may be:

A

Protein in urine

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23
Q

Is protein in the urine ever normal?

A

No. Do not ignore it

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24
Q

RBC casts in the urine may indicate:

A

Glomerulonephritis

Vasculitis

25
WBC casts in the urine may indicate:
Tubulointerstitial disease Acute pyelonephritis Glomerular disorders
26
Epithelial cell casts in the urine may indicate:
Acute tubular necrosis* Glomerulonephritis
27
Hyaline casts in the urine may indicate:
Dehydration
28
What kind of crystal may appear in the urine?
Uric acid Calcium phosphate Calcium oxalate Cystine Magnesioum ammonium phosphate (struvite)
29
What does a urine culture and sensitivity tell you
Identifies causative organism of UTI Shows Antibiotic sensitivity and resistance
30
What is this: | “The earliest clinically detectable stage of diabetic nephropathy (or other early kidney damage)”
Microalbumin
31
Urine eosinophils are most commonly seen in _____________
Acute interstitial nephritis
32
What is Urine Protein Immunoelectrophoresis (UPEP) used to screen for?
Bence-Jones Proteins (multiple myeloma)
33
Why would you do a 24 hour urine collection?
Provides a better quantitative measurement for proteinuria or GFR
34
What is the name of the specific X-ray view used to evaluate urological stuff
KUB film | Kidneys ureters, and bladder
35
What can you see on a KUB film?
Calcification in the urinary tract (with some exceptions) Prostatic calculi Bladder distention
36
What kinds of stones will NOT be seen on a KUB film?
Small stones Radiolucent stones (URIC ACID)*** Stones overlying bony structures **************
37
What is a “stag horn” pattern on a KUB film?
Stones that involve the renal pelvis and extending into 2 or more calyces
38
What is the test of choice to exclude*** urinary tract obstruction?
Renal ultrasound | Non invasive, no contrast required
39
What kind of imaging is best used to evaluate renal vascular flow
Renal Doppler Utrasonography
40
Which is more sensitive to detect a renal mass: US or CT
CT
41
If you do an ultrasound of a kidney and see a “hypodense mass with internal *echoes*” what are you looking at
Acute pyelonephritis
42
What is the test of choice to diagnose nephrolithiasis
Non-contrast CT | Can detect uric acid stones not seen on KUB
43
What imaging do you use to distinguish between a benign and malignant cyst
CT scan
44
How long after using contrast in a CT do you have to hold Metformin
48 hours afterwards
45
If you see a “stranding” pattern on CT what do you suspect
Pyelonephritis
46
What is the gold standard for diagnosis of renal vein thrombosis
MRI
47
No gadolinium is GFR is less than ______
30
48
What are the contraindications for MRI/MRA
Chronic renal failure with GFR<30 Acute renal failure of any severity
49
What is an intravenous Pyelogram?
You inject contrast and take x rays to look at how the kidneys excrete it
50
Why dont we use intravenous pyelograms very much
Requires contrast dye Much more informative tests exist (CT) (Why give them contrast and then just do Ann x ray)
51
What might we use renal angiography for?
Preoperative mapping of renal vasculature (looking for blockages etc)
52
If you do a renal angiography and see the classic “string of pearls” appearance of the renal artery, what disease is it
Fibromuscular dysplasia
53
How do you do a cystourethrogram?
Bladder is filled with contrast X rays are taken while the patient is voiding (Contrast is ONLY in bladder=less damage to kidneys)
54
What can you use cystourethrogram to diagnose
Vesicoureteral reflux
55
What is a cystoscopy
A flexible or rigid camera tube is inserted through urethra and into the bladder to loook around
56
What do you need to tell your patient after you do a cystoscopy?
Post procedure hematuria is expected and should clear within 3** voids
57
What are the potential compliacation of cystoscopy
Sepsis Hemorrhage Perforation of the bladder** Dysuria
58
What test will be done on any male with testicular pain
Testicular ultrasound with DOPPLER
59
How do you do a prostate ultrasound and biopsy?
Transrectally (TRUS) Helpful in detection of prostate cancer in patients with high PSA