- hyponatremia - serum osmo less than 275 - urine osm less than 100 euvolemic patient

Block 65, 66: Renal Flashcards by Bina Malapur

bladder pain that is worsened by filing and relieved by voiding, diagnosis? other symptoms?

interstitial cystitis

- urgency, frequency, and chronic pelvic pain

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cystocele

bladder prolapse into anterior vaginal wall

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what sodium level do patients have severe SIADH and how do you treat? how do you treat mild SIADH

less than 120
hypertonic (3percent) saline

normal fluids

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Diagnosis of SIADH

hyponatremia
serum osmo less than 275
urine osm less than 100
euvolemic patient

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initial corner stone therapy for renal stone diasese

Hydration

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left lower abdominal pain radiating to the groin, vomiting, and unremarkable findings on abdominal exam has

obstructive ureterolithiasis

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perferred modality for diagnosing ureteral stone are

ultrasonography or noncontrast spiral CT of abdomen

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what does tuberculosis causing chronic primary adrenal insufficiency cause in the body

Addisions: Aldosterone deficiency

non-anion gap
hyperkalemic and hyponatremic metabolic acidosis

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Aminioglycosides coveres what

serious gram-negative infections

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toxicity of aminoglycosides

nephrotoxic

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amikacin is what type of drug

aminoglycoside abs

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type of drug: Levofloxacin

fluoroquinolone

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Asymptomatic hypercalcemia
elevated or inappropriately normal PTH
low urinary calcium excretion

Familial hypocalciuric hypercaclemia

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how is primary hyperparathyroidism different from familial hypocalciuric hypercalcemia

primary hypeparathyroidism has increase urinary calcium excretion ( urine calcium/creatinine clearance ratio)

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treatment for hyperkalemia with significant ECG changes

calcium gluconate

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how do beta adrenergic impact potassium

shifts potassium intracellular

- watch out in COPD patients

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acidosis impact on potassium

hyperkalemia

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3 ways K enters a cell

insulin, beta-adrenergic, hematopoiesis
GI loss
hyperaldosteronism, diuretics

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what 2 values are needed for best picture of acid-base status

CO2

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contrast-induced nephropathy

transient spike in creatinine within 24 hours of contrast

- return to normal within 5-7 days

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what can be given to minimize the risk of contrast-induced nephropathy

IV hydration with isotonic bicarbonate or normal saline

- acetylcysteine

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what should you suspect with large amounts of blood on urinalysis with relative absence of RBCs on urine microscopy

Myoglobinuria caused by rhabdomyolysis

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when is anion gap calculated

metabolic acidosis

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what is normal anion gap

6-12

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when is osmolar gap calculated

ethanol, methanol or ethylene glycol toxicity

risk of correcting hyponatremia too quickly

CNS osmotic demyelination syndrome

triad for renal cell carcinoma

flank pain hematuria palpable abdominal renal mass

Unilateral varicoceles that fail to empty when a patient is recumbent raise suspicion for?

underlying mass pathology, such as renal cell carcinoma

characterize diabetic nephropathy

proteinuria | progressive decline in GFR

pathologic hallmark of diabetic nephropathy

nodular glomerulosclerosis | - diffuse glomerulosclerosis is more common

aspirin causes what acid base disturbance

respiratory alkalosis | metabolic acidosis

what is low urine sodium

less than 10

membranoproliferative glomerulonephritis is associated with what

hep C

hepatorenal syndrome is seen in patients with

severe liver cirrhosis secondary to system and renal hypoperfusion

does renal function improve with acute renal failure

typical findings for acute renal failure

- creatinine greater than 1.5 - low urine sodium - no blood, casts, protein in urine,

Recurrent stones since childhood, positive family history, typical hexagonal crystals on urinalysis, and positive cyanide nitroprusside test

cystinuria

when should a person not get metformin

- ill patients with acute renal failure - liver failure - sepsis

common medications that cause hyperkalemia

- nonselective bet-adrenergic blockers - potassium-sparing diuretics - ACE inhibitors - ARBS - NSAID

what type of drug is amiloride?

potassium sparing diuretic

renal vein thrombosis is a complication of what nephrotic syndrome

membranous glomerulopathy

metabolic changes with vomiting

hypochloremic metabolic alkalosis hypokalemia increase bicarbonate

treatment for vomiting induced metabolic alkalosis

isotonic sodium chloride | potassium

patient with headache, sunburns, thrombocytopenia, glomerulonephritis, low C3 and C4 levels has

SLE

what causes membranoproliferative glomerulonephritis

persistent activation of the alternative complement pathway

microscopic finding for membranoproliferative glomerulonephritis

dense intramembranous deposits that stain C3

nephrotic-range proteinuria and hematuria, diagnosis

membranoproliferative glomerulonephritis

side effect of rifampin

red urine

after taking TCA, have abdominal pain and fullness/tenderness along the midline below the umbilicus ?

urinary retention - prevent destrusor contraction and sphincter relaxation - urinary cath and discontinue meds

when do you see asterixis

- hepatic encephalopathy - uremic encephalopathy - CO2 retention

AEIOU

``` acidosis electrolytes (K) ingestion overload uremia ```

electrolyte problems in alcoholics ? how

hypomagnesemia that causes hypokalemia - intracellular Mg, inhibit K secretion by renal outer medullary potassium channels into urine - No Mg, no K

hypertension, palpable bilateral abdominal masses and microhematuria

ADPCKD

Dysuria, urinary frequency, suprapubic tenderness suggests

uncomplicated cystitis

treatment for complicated cystitis

oral fluroquinolones

treatment for uncomplicated cystitis

- Trimethoprim-sulfamethoxazole - nirtofurantion - fofomycin

men with what have an higher increase of anticholinergic problems when they have what

benign prostatic hyperplasia

most common renal vascular lesions seen in hypertension are

arteriosclerotic lesions of afferent and efferent arterioles and glomerular capillary tufts

characterize diabetes mellitus nephropathy

- increased extracellular matrix - basement membrane thickening - mesangial expansion - fibrosis

patients with nephrotic syndrome has increased risk for what

1. atheroscloerosis ( due to hyperlipidemia) | 2. arteriovenous thrombosis ( loss of antithrombin III)

Saline-responsive metabolic alkalosis is associated with

low urinary chloride excretion | volume contraction

saline-unresponsive metabolic alkalosis associated

urinary chloride greater than 20

what is used to treat severe metabolic acidosis

IV sodium bicarbonate