Rx_2.4 (Renal) Flashcards Preview

USMLE Step 1 > Rx_2.4 (Renal) > Flashcards

Flashcards in Rx_2.4 (Renal) Deck (12)
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1

Renal biopsy w/subendothelial deposits + [image] ==> dx?

  • "wire loop" glomerular lesions ==>
  • lupus nephritis [aka diffues proliferative glomerulonephritis]

2

Achalasia characteristics and association

  • achalasia = failure of smooth m. fibers of lower esophagus and LES to relax ==> problems w/swallowing
  • associated w/chagas disease

3

Morbilliform rash association

viral exanthems

4

Sx characteristics of Lupus

  • sx
    • malar rash
    • arthritis
    • oral and nasal ulcers
    • fever
    • malaise
  • other manifestations of lupus
    • CV = pericarditis
    • Resp = pleural effusion
    • hemat = anemia, cytopenias

5

Vomiting + diarrhea ==> acid-base dx?

  • vomiting ==> metabolic alkalosis
    • due to loss of acid
  • diarrhea ==> non-anion gap metabolic acidosis
    • due to loss of base
  • vomiting + diarrhea ==> mixed acidosis and alkalosis
    • acute dehydration ==> elevated anion gap 

6

Genetic mutation ==> PKU

  • AR
  • dysfxn of phenylalanine hydroxylase: phenylalanine ==> tyrosine w/BH4 (tetrahydrobiopterin)
  • lack of enzyme ==> increase in phenylketones ==> [without low phenylalanine diet] intellectual disability

7

Signs/dx of PKU

  • perinatal screening
  • musty body odor
  • intellectual disability if not treated

8

Dangerous adverse event associated w/NSAIDs (+ mechanism)

  • renal failure
  • pt.s on diuretics ==> release of AII (in response to decrease volume stats) ==> vasoconstriction
  • kidney stimulates PG release in order to maintiain vasodilation @ afferent arteriole and maintain perfusion
  • NSAIDs = COX-1/COX-2 inhibitors ==> decreased PGE ==> constriction of afferent arterioles ==> prerenal renal failure

9

Characteristics of hydrochlorothiazide

  • thiazide diuretic
  • first-line to tx new-onset HTN
  • MOA: inhibits Na reabsorption in hte early distal convuloted tuble of nephron ==> diuresis
  • SE:
    • hyperuricemia (==> gout attack)
    • hyperlipidemia
    • hypercalcemia

10

Acetazolamide: MOA, use, toxicity

  • MOA: carbonic anhydrase inhibitor
    • ==> self-limited NaHCO3, diuresis and decreased total-body HCO3
  • Use:
    • glaucoma
    • metabolic alkalosis
    • altitude sickness
    • pseudotumor cerebri
  • Toxicity
    • hyperchloremic metabolic acidosis
    • paresthesias
    • sulfa allergy

11

Mannitol: MOA, use, toxicity

  • MOA: osmotic diuretic
    • increased tubular osmolarity ==> increased urine flow
    • ==> decreased intracranial/intraocular pressure
  • Use
    • drug overdose
    • increased intracranial/intraocular pressure
  • Toxicity
    • Pulmonary edema
    • dehydration
    • contraindicated in anuria & CHF

12

Renal biopsy findings in IgA nephropathy

mesangial deposits

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