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Flashcards in UWorld - GU Deck (56):
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Patient on dialysis most likely to die from?

Cardiovascular disease >Infection >dialysis withdrawal

1

Patient with nephrotic syndrome has an increased risk of developing?

Stroke or MI because they are hypercoagulable

2

Complicated cystitis versus uncomplicated?

Very young, very old, diabetic, immunocompromised, pregnant, abnormal anatomy

3

When are you worried about contrast induced nephropathy? Consider using?

Diabetes or baseline creatinine >1.5.

Consider using non-ionic contrast

4

FSGS associated with?

African-American, HIV heroin use, obesity

5

Patient history of rheumatoid arthritis presents with proteinuria. Likely kidney pathology?

Amyloidosis

6

Treatment of Goodpasture's?

Emergency plasmapheresis

7

Think of rhabdomyolysis with this lab finding?

CPK > 20,000

8

Lab findings suggest ATN?

1. Urine osmolality < 350
2. Urine sodium > 40
3. FEna> 2%

9

Side effects of EPO?

1. HTN
2. Headaches
3. Flu-like
4. RBC aplasia

10

Crystalloid vs colloid solutions?

Saline vs albumin

11

Signs of RCC?

Triad: hematuria, flank pain, palpable abdominal mass

Also can see: scrotal varicocele, ectopic EPO

12

Pt with C3 deposition in kidneys? Mech?

Membranoproliferative GN type II (IgG antibodies aka C3 nephritic factor against C3 convertase)

13

Causes of euvolemic hypoNa?

SIADH, hypothyroid, hypoadrenal, psychogenic polydipsia

14

Drug that causes ADH resistance?

Drug that sensitized kidneys to ADH?

Li

Carbamazepine

15

Tx of psychogenic polydipsia?

Water restriction

16

ways to correct hyperK? (Quickest first)

1. Ca
2. Glucose + insulin (15-20 min)
3. Kayexalate takes 1-2 hours
4. Beta-2 agonists

17

Hypophosphatemia can cause?

Rhabdo, paresthesias, respiratory failure

18

Possible cause of difficult to correct hypoK?

HypoMg

19

Smoke inhalation can cause what acid-base disorder?

Met acidosis: CO binds to heme, decreased O2 to tissues, lactic acidosis

20

Met alk - formula to assess compensation?

PaCO2 = .9*bicarb +16 +/-2

21

Vomiting - mech of alk?

Volume loss triggers RAAS
Na/H antiporter activated

22

Tx of euvolemic hyperNa vs hypovolemic hyperNa?

D5W vs NS then D5W

23

Adrenal tumor causing virilization releases?

DHEA-S (-S variant only comes from adrenal gland)

24

Ca correction?

(4/5) (4.0- albumin) + Ca

25

Types of met alk?

1. Cl sensitive - hypocloremic (urine Cl<20) and hypovolemic. Give saline.
2. Cl resistant - normal Cl. Normal volume. Saline ineffective.

27

Causes of Cl resistant metabolic alkalosis?

Bartter syndrome (defect in TAL Na resorption)
Gitelman syndrome
Black licorice

28

Renal vein thrombosis leading to pain and gross hematuria most commonly associated with what finding on kidney biopsy?

Membranous GN

29

GN post infection - possibilities? Distinguishing features?

1. IgA nephropathy - ~5 days after infection, normal complement levels.
2. Post-strep GN 10-20 days post infection. Low complement

30

Most common type of GN related to cancer? Exception?

Membranous. Hogkin's related to MCD

31

Pt with chronic renal failure - effect on bleeding time, PT, PTT? Cause? Tx?

increased, no change, no change

due to platelet dysfunction from uremic coagulopathy.

DDAVP

32

Immunosupressant side effects: cyclosporine vs tacrolimus vs azathioprine vs mycophenylate?

Neuro, Nephro, GI, HTN, gingival hyperplasia, hirstutism

as above without gingival hyperplasia and hirstutism

diarrhea, leukopenia, hepatotoxicity

Marrow supression

33

Symptoms of allergic interstitial nephritis? Causes?

AKI, arthralgias, WBC casts with eosinophils

rifampin, penicillian, cephalosporin, bactrim

34

Types of kidney stones:

Normal pt? if has a family hx? If has cancer (high cell turnover)? with hx of UTIs?

Ca oxalate; cystene; uric acid; struvite

35

Acylovir - adverse effect on kidney?

renal tubular obstruction

36

tx for uric acid stone?

urine alkylization with potassium citrate

37

Epididymitis in younger vs older males?

Chamydia and gonorrhea

vs

E coli

38

UA shows: deformed RBCs and casts vs unchanged RBCs?

glomerular vs tubular injury

39

Management of nephrolithiasis?

1. Imaging scan – CT
2. Narcaotics and NSAIDs
3. If stone 2 L per day
4. Consult Uro if anuria, urosepsis or ARF

40

Dietary recommendations for patients with renal calculi?

1. Decrease protein abd oxalate intake
2. Decrease sodium intake
3. Increased fluid intake
4. Increase calcium intake

41

Management of a patient with suspected pyelonephritis?

Blood cultures followed by IV antibiotics

42

Patient with acute prostatitis – Next step?

Culture mid-stream urine sample

43

Cause of renal artery stenosis in lung vs old?

Fibromuscular dysplasa vs artgeromatous plaque

44

Acute interstitial nephritis vs acute renal failure - UA findings? Antibiotics that cause each?

Eosinophils and WBC casts vs epithelial cell casts

Aminoglycosides vs penicillins

45

Analgesic abuse - effect on kidneys?

FSGS

46

HIV - effect on kidneys?

FSGS

47

Causes of priapism?

1. Children - Sickle cell and leukemia
2. Trauma
3. Neurogenic (SC injury and cauda equina)
4. Meds - trazadone and prazosin

48

Possibilities if radiograph doesn't show a stone in a pt with a typical renal colic? (and Tx)

1. If urine pH< 3 mm (HCT)
3. Non-stone causes (clots)

49

First change in diabetic nephropathy? First quantifiable change?

Hyperfiltration; basement membrane thickening

50

Indications for cystoscopy?

#Hematuria without signs of infection of glomerular disease, or with risk of malignancy
#Recurrent UTIs
#Obstructive symptoms (signs of bladder stone)
#abnormal bladder imagine of urine cytology

51

Membranous Nephropathy Associated with?

#Adenocarcinoma
#NSAIDS
#Hep B
#SLE

52

Membranoproliferative GN associated with?

#Hep C
#lipodystrophy

53

Minimal Change Disorder associated with?

#NSAIDS
#Lymphoma

54

IgA Nephropathy associated with?

URI

55

Pt with Ca Oxalate stones - recommendations?

#increase fluids
#Increase Ca intake
#decrease Na and oxalate (no chocolate, vit C)
#Decrease protein intake

56

Meds that cause hyperK?

ABCD
#ACE inhibitors
#Beta blockers
#Cardiac glycosides (Digoxin)
#[K-sparing] Diuretics (amiloride, spirolactone)
#NSAIDS

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