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Renal II Final AH > All Kirila Lectures > Flashcards

All Kirila Lectures Flashcards

1
Q

Which diuretics cause acidosis?

A

CAI

K+ sparing

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2
Q

How does the paCO2 compensate for HCO3 in metabolic alkalosis?

A

PaCO2 INC .7 for every 1 INC in HCO3

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3
Q

Drug to treat BPH?

Contraindication?

A

Alpha-1 antagonist (terazocin)

Selective Beta blocker

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4
Q

Who does atherosclerosis occur most often in?

Bilateral or not?

Associated risks?

A

Males older than 50

33% bilateral

Tobacco, lipids, DM

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5
Q

What are the 3 types of coarctation?

A

Interrupted
Pre ductal
Postductal

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6
Q

What is diminished in the early stage of CKD?

A

Reserve function

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7
Q

Elevated BUN plus confusion is what?

A

Uremia

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8
Q

Rib notching on PA chest and 3-sign on lateral chest with cardiomegaly indicate what?

A

Coarctation of heart

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9
Q

What can cause a blockage in the urethra???

A

Stricture
Congenital valve
Phimosis

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10
Q

What drug to treat migraines?

A

Beta blocker

CCB

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11
Q

Renal vein renin ratio of what indicates a dx of renovascular HTN?

A

1.5 or greater

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12
Q

What fibromuscular dysplasia occurs in infants and young adults more frequently?

A

Intimal FD

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13
Q

GFR equation COCKcroft male?

Female?

A

GFR = (140-age) X (kg) / (SerumCr X 72)

Male GFR X 0.85

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14
Q

Describe RTA type IV

Causes?

A

Hyperkalemic, hyporenin, hypoaldosterone
Decreases NH4 excretion and decreased HCO3 production

Analgesic nephropathy, sickle cell, SLE, DM

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15
Q

What drugs can increase serum potassium?

A

PATTS

Pentamidine
Amiloride
Triamterene 
Trimethoprim
Spironolactone
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16
Q

Where are the 3 sites located for a post-renal blockage?

A

Ureteric
Bladder neck
Urethra

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17
Q

What does an elevated BUN mean?

A

Azotemia

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18
Q

What kind of casts are seen with allergic interstitial nephritis?

A

White cell (from eosinophils)

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19
Q

Stage 1 of CKD?

A

kidney damage with normal/increased GFR above 90

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20
Q

IV drug users with bacterial infections are due to what?

A

Endocarditis

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21
Q

Stage 2 of CKD?

A

GFR = 60-89

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22
Q

What type of renal artery stenosis shows increased Intravascular volume?

Renin response?

ACE response?

A

Bilateral and 1 kidney

Varied

Unpredictable

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23
Q

What imaging may be best to visualize the kidneys?

A

Ultrasound of the abdomen

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24
Q

Drug to treat Pheochromocytoma?

A

Alpha blocker then beta

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25
Q

What can cause a bladder neck blockage?

A 
Neurogenic bladder
BPH
Calculi
Cancer
Blood clot
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26
Q

What is the most common type of fibromuscular dysplasia?

A

Medial

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27
Q

Describe K, PO4, and uric acid in FSGS?

Ca, albumen, hemoglobin?

What state is patient in?

A

All high

All low

Metabolic acidosis

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28
Q

What pO2 defines hypoxia?

A

Less than 60

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29
Q

Drug treatment for hypertrophic cardiomyopathy?

Contraindication?

A

Beta blockers, CCB

Diuretic, ACEI

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30
Q

What fibromuscular dysplasia occurs in the mid-distal portion of the renal artery?

A

Perifibromuscular

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31
Q

The combination of HTN and hypokalemia indicate what?

A

Hyperaldosteronism (Conn’s syndrome)

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32
Q

How is serum creatinine effected in AKI?

A

Elevated by above 50% or by .5-1 above baseline

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33
Q

A physical exam showing HTN, JVD, pericardial changes, muscle wasting, asterixis, and ecchymoses indicates what?

A

FSGS

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34
Q

What kind of casts are found in tubular necrosis?

A

Bloody, brown

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35
Q

What drug to treat chronic renal insufficiency?

A

Loop diuretic

CCB

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36
Q

What type of renal artery stenosis shows decreased Intravascular volume?

How is renin mediated in this type?

How is BP affected with ACE-I?

A

Unilateral

Increased

Falls

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37
Q

What has a better response to angioplasty: atherosclerosis or fibromuscular dysplasia?

Which is more progressive?

A

Fibromuscular dysplasia

Atherosclerosis

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38
Q

How do uremic toxins affect transmembrane voltage?

A

INC intracellular Na
DEC intracellular K
Inhibition of Ca flux

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39
Q

A dexamethasone suppression test is used for the diagnosis of what?

A

Cushing’s

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40
Q

What are the 2 types of metabolic alkalosis?

A

Cl responsive, urine Cl less than 10-20 mEq/L
Improves with NaCl and volume
Due to vomiting, NG suction, diuretics

Cl unresponsive, urine Cl greater than 10-20
Unresponsive to saline
Due to endocrine causes

41
Q

What is the increase in serum creatinine +/- decrease in urine output over hours to days?

A

Acute kidney injury

42
Q

Stage 3b of CKD?

A

GFR = 30-44

43
Q

What is the type B2 lactic acidosis?

A

Drugs/toxins like ethanol, methanol, ethylene glycol, ASA

44
Q

What kind of anemia may occur with CKD?

What occurs in uremic Pts?

A

Normocytic, normochromic

Hemolysins

45
Q

Effective volume depletion in 3rd spacing is what kind of kidney injury?

46
Q

What does CLEVER PD cause?

A

metabolic alkalosis

47
Q

What is the type B1 lactic acidosis?

A

Systemic disorders like DM, liver failure, sepsis, seizures

48
Q

What medication is given to treat metabolic alkalosis for mineralocorticoid excess?

A

Spironolactone

49
Q

What can cause a ureteric blockage?

A 
Calculi
Blood clot
Sloughed papilla
Cancer
External compression
50
Q

Stage 5 of CKD?

A

GFR less than 15, (ESRD)

51
Q

FeNa greater than 1-2% means what?

A

Tubular function not intact

52
Q

Describe type I RTA

Causes?

A

Distal, decreased secretion of H+

SLE, Sjogren’s, toluene

53
Q

Metabolic acidosis due to decrease in bicarbonate can be caused by what?

A

Loss of HCO3 - GIT
Increase hydrogen load (DKA)
Decrease hydrogen excretion by kidney (uremic acidosis)

54
Q

What drug preferentially dilates veins more than arterioles and is good for use in MI, LVF, CABG?

A

Nitroglycerin

55
Q

What drug to treat GI Bleed?

Contraindication?

A

Non-selective Beta blocker

Beta blocker

56
Q

What is the most common complication of ESRD?

57
Q

What are the #1 and #2 primary causes of renal failure according to a 2005 Pie graph??

A

1 - DM

2 - HTN

58
Q

GFR is about equal to what?

A

Creatinine clearance

59
Q

CHAMPS causes what?

Stands for what?

A

Hyperventilation

CNS disease
Hypoxia
Anxiety
Mechanical ventilation
Progesterone
Salicylates/Sepsis/Stress
60
Q

What is the captopril test for?

Shows what?

A

Diagnosis of renovascular HTN

Rise in renin, and large fall in BP after administration

61
Q

Stage 4 of CKD?

A

GFR = 15-29

62
Q

What causes a peaked T wave and severe cases a widened QRS with loss of a p wave?

A

Hyperkalemia

63
Q

What is long-standing, irreversible impairment of renal function called?

A

Chronic kidney disease

64
Q

What drug to treat cocaine use?

A

Labetalol

Clonidine

65
Q

CKD causes susceptibility to infections, specifically what structures?

A

Lymphoid structures, lymphocytopenia

66
Q

What causes flattened T wave and in severe cases ST depression?

A

Hypokalemia

67
Q

Describe RTA type II

Causes?

A

Proximal, decreased absorption of HCO3

Multiple myeloma, heavy metal poisoning, Wilson’s, amyloid

68
Q

What is the most common type of dialysis used for AKI?

A

Intermittent hemodialysis

69
Q

What are the relative contraindications for a renal transplant?

A 
Older than 70
Psychiatric disease
HeppC
Primary focal sclerosis
Multiple myeloma
Amyloid
Oxalosis
70
Q

Coarctation of the aorta causes what?

A

Narrowing of medial layer of aorta

71
Q

What are the following changes due to?

Carpal tunnel
Tensosynovitis
Shoulder arthropathy
Bone cysts
Cervical spondyloarthropathy and pseudo tumors
A

Long term dialysis

72
Q

Who does fibromuscular dysplasia occur most often in?

Bilateral or not?

A

Women under 40

60% bilateral

73
Q

What does MUDPILES CCAT stand for?

A 
Methanol
Uremia
DKA
Paraldehyde
Isoniazid, iron
Lactic acidosis
Ethylene glycol
Salicylates 
CO
Cyandide
Alcohol
Toluene
74
Q

Stage 3a of CKD?

A

GFR = 45-59

75
Q

What is the type A lactic acidosis?

A

Tissue hypoxia due to shock, several anemia, HF or CO poisoning

76
Q

Butterfly wing distribution on chest X-Ray indicates what?

Means what?

A

Peripheral vascular congestion

Increased permeability of alveolar capillary membranes

77
Q

According to the JNC-8, non-blacks (but includes people with diabetes), initial antiHTN treatment should include what type of medications?

A

Thiazides
CCB
ACE-I
ARB

78
Q

What drug treatment after MI?

Contraindication?

A

Beta blocker, ACE-I

Direct vasodilator

79
Q

What classifies as a HTN emergency?

A

Any high BP and damage to one organ system

80
Q

A 30 y/o male with dysuria and perineal pain with a negative urine culture most likely has what?

A

Chronic prostatitis

DANNY

81
Q

When treating metabolic acidosis, what rx of NaHCO3 do you give?

A

1 amp 8.5%, 50 mEq/50cc

82
Q

What cancer is most responsible for causing ascites?

83
Q

What are the absolute contraindications of a renal transplant?

A 
Active GN
Active infection
Active/recent malignancy
HIV
HepB surface Ag
Vascular disease
84
Q

What is the type B3 lactic acidosis?

A

Inborn error of metabolism like G6PD deficiency

85
Q

What kind of dialysis treatment may be seen in extremely unstable ICU patients?

A

Continuous renal replacement therapy

86
Q

HARDUPS explains what?

Stands for what?

A

Normal anion gap metabolic acidosis

Hyperalimentation
Acid infusion, acetazolamide
RTA
Diarrhea
Ureteral sigmoid or ileal diversion
Pancreatic fistula 
Spironolactone
87
Q

What drug to treat stroke or TIA?

88
Q

A normal anion gap metabolic acidosis is due to changes in what ions?

Caused by what?

A

HCO3 falls and Cl rises

HARDUPS

89
Q

What are the effects of uremic toxins on metabolism?

A

Hypothermia (DEC Na transport)
K+ intracellular deficit
Metabolic acidosis

90
Q

Drug treatment for tacyarrythmias?

A

Beta blocker, verapamil

91
Q

FeNa below 1% means what?

A

Tubules intact, pre-renal cause

92
Q

What bone changes are seen with uremia?

A

Terminal phalanges
Long bones
Distal clavicles

93
Q

What hypoxemia?

A

Subnormal oxygenation in blood

94
Q

CLEVER PD stands for what?

A 
Contraction of volume
Licorice
Endocrine (Conn's, Cushing's, Bartters)
Vomiting
Excess alkali
Refereding alkalosis

Post hypercapnia
Diuretics

95
Q

Where does coarctation of aorta commonly occur?

A

Ligamentum arteriosum

96
Q

According to JNC-8, anyone over 18 y/o with CKD should be given what?

A

ACE-I or ARB

97
Q

Drug treatment for CHF?

Contraindication?

A

ACEI, diuretic

Beta blocker, CCB

98
Q

What is the Winter equation?

A

Expected PCO2 = 1.5 (measured HCO3) + 8 +/- 2

Renal II Final AH (1 decks)

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