Rx_2.9 (Renal) Flashcards Preview

USMLE Step 1 > Rx_2.9 (Renal) > Flashcards

Flashcards in Rx_2.9 (Renal) Deck (12)
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1

Hemoptysis + anemia + renal fail ==> dx/

  • goodpasture's syndrome (most likely)
    • consider vasculitis
  • anti-GBM antibodies ==> damage @ lung and kidney basement membranes

2

First-line therapy for UTIs

TMP-SMZ

3

TMP-SMZ: MOA, SE

  • MOA: inhibits folate synthesis ==> inhibition of of nucleotide synthesis
  • SE
    • megaloblastic anemia
      • enlarged red cells
      • PMN w/hypersegmented nucleus

4

Adult polycystic kidney disease inheritance

AD

5

Biopsy findings in PSGN

  • enlarged, hypercellular glomeruoli
  • dense humps on epithelial side of GBM

6

alpha-ketoacid dehydrogenase deficiency ==> Dx?/Tx?

  • Maple Syrup Urine Disease
  • enzyme deficiency ==> inability to catabolize branched-chain amino acids
    • Isoleucine 
    • Leucine
    • Valine
    • ("I Love Vermont's Maple Syrup)
  • Tx = avoid consumption of these amino acids

7

Presentation of cystinuria

  • defect @ amino acid reabsorption @ proximal tubule ==> wasting of lysine, arginine, cystine, ornithine
  • elevated cystine ==> recurrent nephrolithiasis formation

8

Tx of cystinuria

  • hydration
  • acetazolamide ==> alkalization of urine

9

Dosage adjustments in patients w/impaired renal or hepatic fxn

  • same loading dose, decreased maintenance dose
  • LD = (CP x Vd)/F
  • MD = (Cp x CL x t)/F
    • CL = clearance
    • t = dosing interval

10

First step in MCD

  • immediate tx w/steroids
  • renal biopsy indicated if failure of steriods

11

Tx for goodpasture's

  • corticosteroids
  • cyclophosphamide

12

Alport disease presentation

  • inherited mutation @ Type IV collagen
    • important @ eyes, ears, kidneys
  • present @ early childhood w/:
    • ocular defects
    • defness
    • hematuria

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