#2 Zaman - Renal Syndromes

Question 1

Patient’s labs come back with BUN/Cr ratio is 25:1, a FENa of 0.6% and urine sodium of 14 mEq/L. What type of azotemia does this individual have?

Answer 1

Prerenal Azotemia

In prerenal disease the tubules are intact and the kidney will avidly reabsorb sodium.

Question 2

Adam received his labs back and his BUN/Cr ratio is 13 and he has a FENa of 3.5%. His urine sodium is 45 mEq/L. What condition does Adam have?

Answer 2

Renal disease (ATN) Azotemia
[Adam (ATN) has Too much Na+]

Question 3

What are some causes for decreased BUN?

Answer 3

OPALSS are found Down Under
Over hydration
Pregnancy
Anabolic steroids
Liver disease
SIADH
Starvation/Malnutrition

Question 4

Azotemia is elevated BUN found in many conditions other than renal disease. What are some?

Answer 4

MET a RED^2 CAT that had a HigH GI.
Metabolism
Renal Disease
Reduced Renal perfusion
Dehydration
Catabolic steroids
High protein
Heart failure
GI bleed

Question 5

Patient comes in for a routine exam and the lab values come back with protein in the urine but was asymptomatic. What is a possible cause?

Answer 5

undiagnosed diabetes

Question 6

Which acute renal failure syndrome results in hypoalbuminemia, hypogammaglobinemia and loss of > 3.5g protein /24 hours?

Answer 6

Nephrotic syndrome

Question 7

What are some primary glomerular diseases that cause nephrotic syndrome? Secondary?

Answer 7

Primary:
Membranous glomerulonephritis 
Minimal change disease
Focal segmental glomerulosclerosis
Membranoproliferative GN

Secondary:
DM, Amyloidosis

Question 8

What are some features of inflammatory renal diseases associated with nephritic syndrome?

Answer 8

Hematuria
Red cell casts
Azotemia (increase in BUN)
Oliguria
WBC and RBC in urine
Protein loss is usually 3.5g)

Question 9

Your patient is nearing end stage renal failure. You expect what type of WASTE PRODUCT laboratory changes in uremia?

Answer 9

Increased:
Creatinine
Urea
Uric acid

Question 10

Your patient is nearing end stage renal failure. You expect what type of ACID BASE laboratory changes in uremia?

Answer 10

Metabolic acidosis with increased anion gap.

Question 11

Your patient is nearing end stage renal failure. You expect what type of ELECTROLYTE laboratory changes in uremia?

Answer 11

Hyperkalemia
Hyperphosphatemia
Hypocalcemia

Question 12

Your patient is nearing end stage renal failure. You expect what type of ENDOCRINE laboratory changes in uremia?

Answer 12

Decreased active Vit D
Elevated renin/aldosterone
Decreased erythropoietin
Increased PTH

Question 13

What is the highest prevalence of ESRD by primary diagnosis?

Answer 13

DM

Question 14

Will you be able to detect multiple myeloma on a reagent strip? Why or why not?

Answer 14

Reagent strips usually do not detect the Bence-Jones protein.