Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

own Kaplan IM > 8. nephrology > Flashcards

8. nephrology Flashcards

1
Q

how does IV contrast cause renal failure?

A

vasospasm of afferent arteriole (decrease perfusion to glomeruli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long after an infection does post-stre glomerulonephritis occur?

A

1-2 weeks after infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

renal toxicity of a medication is due to the ….. of the medication

A

trough (space interval of medications to decrease toxicity of medication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the side effect of aminoglycosides (gentamicin)?

A
  1. renal toxic

2. ototoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the difference between azotemia and uremia?

A

azotemia: renal insufficiency but no need for dialysis
uremia: renal insufficiency resulting in need for dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are complications of uremia? (9)

A
  1. need for dialysis
  2. anemia (decrease epo production)
  3. hyperrkalemia
  4. pericarditis
  5. hypocalcemia (decrease active vit D)
  6. infections (wbc cant degranulate)
  7. metabolic acidosis and fluid overload (b/c cant get rid of organic)
  8. altered mental status
  9. bleeding (platelets cant degranulate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the treatment for uremia induced bleeding?

A

DDAVP (desmospressin causes release of subendothelial stores of vWf and factor 8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are causes of pre-renal azotemia?

A
  1. dehydration/shock/ blood loss
  2. renal artery stenosis
  3. hepatorenal syndrome
  4. ACE inhibitor effect on kidney
  5. low albumin states (nephrotic and liver disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are causes of post- renal azotemia?

A
  1. bladder stone/clot
  2. bladder cancer
  3. prostate hypertrophy/cancer
  4. bilateral ureteral disease (retroperitoneal fibrosis, strictures bilateral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the driving force of GFR in kidney?

A

hydrostatic pressure in the glomeruli capillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the initial clue to pre-renal azotemia?

A

BUN: creatinine ratio >20

b/c more time for urea to be reabsorbed b/c slow flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can falsely elevate BUN?

A
  1. increased protein in diet

2. GI bleeding (protein release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what happens to urine sodium in pre-renal azotemia?

A

urine sodium <10 (low b/c body reabsorbs sodium to increase intravascular volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what happens to the urine osmolality in pre-renal azotemia?

A

urine osmolality is high (>500); concentrated urine

high specific gravity >1.010

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A pt. presenting with hypertension with renal insufficciency most likely suffers from ……

A
  1. primary hyperaldosteronism
  2. renal artery stenosis
    (distinguish w/ aldosterone/renin ratio)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A pt. with liver disease who develops renal insufficiency that does not respond to 1.5 litres of colloid (albumin) most likely suffers from …..

A

hepatorenal syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What dilates the afferent arteriole of the glomeruli?

A

Angiotension 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do ACE inhibitors result in pre-renal azotemia?

A

inhibit conversion of angiotensin 1 to angiotensin 2 preventing constriction of efferent arteriole (results in delation of efferent arteriole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is it that ACE inhibitors diminish the rate of prgression to renal failure and uremia in pts with diabetes, HTN, multiple myeloma?

A

dilation of efferen….> decreased hydrosttatic pressure in glomeruli..> decrease intraglomerular HTN (neverr withold ACE inhibitor)

20
Q

What is the best blood pressure medication for pt with diabetes?

A

ACE inhibitors

21
Q

What is orthodeoxia?

A

Change positions (sitting up) cause oxygen desaturation

22
Q

What disease is associated with orthodeoxia?

A

hepatopulmonary syndrome

23
Q

what medications can cause retroperitoneal fibrosis (leading to post - renal azotemia)?

A
  1. bleomycin (along with pulmonary fibrosis)

2. methotrexate

24
Q

what chemo medication results in hemorrhagic cystitis?

A

cyclophosphamide

25
Q

what are the most common causes of neurogenic bladder?

A
  1. diabetes

2. MS

26
Q

what is the normal post-voidingg residual volume?

A

50ml of urine (if elevated, implies obstructtion to flow out of bladder)

27
Q

what are causes of interrstitial renal insufficiency?

A
  1. allergic
  2. toxic
  3. pigments (hemoglobin/myoglobin)
  4. proteins (bence jones)
  5. crystals
28
Q

A pt. with a BUN/cr of 10, high urine sodium, urine osmolarity (similar to serum osmolarity; isothenuria), and FeNa>1% most likely sufferrs from…..

A

acute tubular necrosis

29
Q

How does NSAIDs result in pre-renal azotemia?

A

inhibit prostaglandins which prevent afferent arteriole dilation (results in constriction of arteriole)

30
Q

What constricts the efferent arteriole of the glomeruli?

A

Angiotensin 2

31
Q

What type of casts/ sediment is associated with acute tubular necrosis?

A

granular, muddy brown, pigmented cast

dead tubular cells sloughed off

32
Q

What drugs can result in allergic interstitial nephritis, drug induced hemolysis, and/ or rash?

A
  1. penicillins
  2. cephalosporins
  3. sulfa drugs
  4. allopurinol
  5. rifampin
  6. quinolones
    (1 dose can cause problem)
33
Q

What medications can result in acute tubular necrosis?

A
  1. aminoglycosides (gentamicin)

2. amphotericin

34
Q

A pt presents with renal insufficiency with associated fever, rash, and eosinophils most likely suffers from …

A

Allergic interstitial nephritis

35
Q

What is the most accurate test for eosinophils in the urine?

A

Hansel stain (or Wright stain)

36
Q

What are causes of myoglobinuria (rhabdomyloysis)?

A
  1. severe crush injury
  2. seizures
  3. statins
    4, severe exertion
    vere crush injury
  4. seizures
  5. statins
    4, severe exertion
37
Q

What is the initial best step in management of a pt with severe crush injury or seizure?

A

EKG or potassium level (hyperkalemia causes peaked t waves)

38
Q

What is the initial best test for rhabdomyolysis?

A

urinalysis (dipstick positive for blood but no RBCs seen)

39
Q

What is treatment for rhabdomyolysis?

A
  1. hydration (decrease contact time)
  2. mannitol (osmotic diuretic-> decrease contact time)
  3. alkalinize urine w/ bicarb
40
Q

What is confirmatory test for rhabdomyolysis?

A

elevated CPK (>10,000)

41
Q

What is treatment for hyperkalemia without EKG changes?

A
  1. insulin with glucose

2. bicarbonate

42
Q

What is the treatment for ethylene glycol intoxication?

A
  1. ethanol or fomepizole (prevents formation of oxalate)

2. dialysis

43
Q

A pt with Crohn disease develops renal insufficiency due to …

A

oxalate crystals (calcium bound to fat in gut instead of w/ oxalate)

44
Q

What treatment should pt with cancer being treated with chemotherapy be given to prevent urate crystal associated renal insufficiency?

A

allopurinol and hydration

45
Q

What is the most common cause of hypercalcemia?

A

primary hyperparathyroidism

46
Q

A pt who underwent a vascular catheter procedure (angioplasty) who develops renal failure, bluish discoloration of extremities and livedo reticularis most likely suffers from …

A

atheroembolic disease

own Kaplan IM (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions