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Flashcards in Renal/GU Deck (40)
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1

Rate of correction of chronic hyponatremia and hypernatreima and consequence

Hypernatremia correction-> cerebral edema
Hyponatremia correction-> central pontine myelinolysis
0.5meq/L

2

Presents with thirst, neuro sx, doughy skin

hypernatremia

3

presents with confusion, lethargy, muscle cramp, hyporeflexia, nausea

hyponatremia

4

presents with n/v, intestinal colic, areflexia, weakness, flaccid paralsis, arrythmia paresthesia

hyperkalemia

5

presents with fatigue, muscle weaknes, ileus, hypotension, yporeflexia, rhabdo, asc paralysis

hypokalemia

6

EKG for hypokalemia

T wave flattening, U waves, ST-segm depr

7

treatment hypercalcemia

IV hydration + furosemide, avoid thiazide diuretics

8

Type I vs II vs IV RTA: Defect, K+, urine pH, tx

Type I: H+ secr (distal), urine ph >5.3, replace HCO3
Type II: HCO3 reabs (proximal), urine ph 5.3 initially, thiazides and volume depletion
Type IV: aldost def (distal), high K, urine ph

9

indications of pre renal AKI (FeNa, UNa, Spec grav, BUN/Cr)

FeNa 1.02, BUN/Cr >20

10

Consequences of AKI

metabolic acidosis, hyperkalemia--> arrythmia
HTN, volume overload

11

Definition CKD (time and GFR); when symptomatic?

>3mo, GFR

12

Consequences and tx of CKD

Metabolic derangement: azotemia, metabolic acidosis, hyperkalemia, ACD, hypocalcemia, hyperphosphatemia, impaired coag
Tx: ACEi/ARB, DDAVP for abn bleeding, low fluid/Na/K/PO diet, PO4/calcitriol, EPO

13

Nephritic syndrome: sx and workup

hematuria, mild proteinemia
Complement, ANA, ANCA, anti-GBM

14

Ca levels loop vs thiazide diuretcs

Loop: decr Ca
Thiazide: Incr Ca

15

Nephrotic syndrome: sx and workup

proteinuria (>3.5), edema, hypoalb, hyperlip

16

Low serum C3, lumpy-bumpy immunofluorescence: dx and tx

PSGN, nephritic; supportive/diuretics

17

microscopic hematuria following resp or GI infxn; normal C3: dx and tx

IgA nephropathy; Tx: glucocort, ACEIs

18

cANCA+, segmental necrotizing glomerulonephritis: dx and tx

Wegener's, high-dose corticosteroids, cytotoxic agents

19

linear anti-GBM deposid, hemosiderin-filled macrophages in sputum

Good pasture
plastma exchange + steroids

20

GBM splitting on EM: dx and tx

Alport's, progresses to renal failure

21

microscopic hematuria, bx shows sclerosis in capillary tufts; hx HIV/ IVDU: dx and tx

dx: FSGS
Tx: prednisone, cytotoxic, ACE/ARB

22

renal bx: spike and dome appearance, HBV/ syphilis: tx and dx

dx: membranous nephropathy
tx: prednisone and cytotoxic

23

thickened GBM and mesangial matrix: dx and tx

diabetic nephropathy
Type 1: ACEi
Type 2: ARB

24

Mesangial prolif, subendothel/epithl IC deposition: dx and tx

lupus nephritis
prednisone and cytotoxic

25

nodular glomerulosclerosis, apple-green birefringence with Congo red stain

renal amyloidosis
prednisone melphalan

26

tram track appearance, hx of HCV, SLE, endocarditis

membranoproliferative nephropathy
corticosteroids and cytotoxic

27

Stones: square shape, radio opaque: dx and tx

calcium oxalate/PO4
hydration, Na, thiazide diuretic

28

Stones: staghorn calculi, assoc with infxn, rectangle crystal, radioopaque

dx: struvite
tx: treat infxn, surgical removal, hydration

29

stones: diamond shape crystal , radiolucent, hx gout

uric acid crystal
hydration, alkalinize with citrate, purine restriction

30

Stones: hexagon, radioopaque: dx, workup, tx

cystine
+cyanide nitroprusside
hydration, alk urine, pnicillamine