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Uworld Step 2 > Block 65, 66: Renal > Flashcards

Block 65, 66: Renal Flashcards

1
Q

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

A

interstitial cystitis

- urgency, frequency, and chronic pelvic pain

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2
Q

cystocele

A

bladder prolapse into anterior vaginal wall

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3
Q

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

A

less than 120
hypertonic (3percent) saline

normal fluids

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4
Q

Diagnosis of SIADH

A
  • hyponatremia
  • serum osmo less than 275
  • urine osm less than 100
    euvolemic patient
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5
Q

initial corner stone therapy for renal stone diasese

A

Hydration

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6
Q

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

A

obstructive ureterolithiasis

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7
Q

perferred modality for diagnosing ureteral stone are

A

ultrasonography or noncontrast spiral CT of abdomen

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8
Q

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

A

Addisions: Aldosterone deficiency

  • non-anion gap
  • hyperkalemic and hyponatremic metabolic acidosis
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9
Q

Aminioglycosides coveres what

A

serious gram-negative infections

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10
Q

toxicity of aminoglycosides

A

nephrotoxic

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11
Q

amikacin is what type of drug

A

aminoglycoside abs

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12
Q

type of drug: Levofloxacin

A

fluoroquinolone

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13
Q

Asymptomatic hypercalcemia
elevated or inappropriately normal PTH
low urinary calcium excretion

A

Familial hypocalciuric hypercaclemia

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14
Q

how is primary hyperparathyroidism different from familial hypocalciuric hypercalcemia

A

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

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15
Q

treatment for hyperkalemia with significant ECG changes

A

calcium gluconate

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16
Q

how do beta adrenergic impact potassium

A

shifts potassium intracellular

- watch out in COPD patients

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17
Q

acidosis impact on potassium

A

hyperkalemia

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18
Q

3 ways K enters a cell

A
  • insulin, beta-adrenergic, hematopoiesis
  • GI loss
  • hyperaldosteronism, diuretics
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19
Q

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

A

pH

CO2

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20
Q

contrast-induced nephropathy

A
  • transient spike in creatinine within 24 hours of contrast

- return to normal within 5-7 days

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21
Q

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

A
  • IV hydration with isotonic bicarbonate or normal saline

- acetylcysteine

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22
Q

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

A

Myoglobinuria caused by rhabdomyolysis

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23
Q

when is anion gap calculated

A

metabolic acidosis

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24
Q

what is normal anion gap

A

6-12

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25
Q

when is osmolar gap calculated

A

ethanol, methanol or ethylene glycol toxicity

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26
Q

risk of correcting hyponatremia too quickly

A

CNS osmotic demyelination syndrome

27
Q

triad for renal cell carcinoma

A

flank pain
hematuria
palpable abdominal renal mass

28
Q

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

A

underlying mass pathology, such as renal cell carcinoma

29
Q

characterize diabetic nephropathy

A

proteinuria

progressive decline in GFR

30
Q

pathologic hallmark of diabetic nephropathy

A

nodular glomerulosclerosis

- diffuse glomerulosclerosis is more common

31
Q

aspirin causes what acid base disturbance

A

respiratory alkalosis

metabolic acidosis

32
Q

what is low urine sodium

A

less than 10

33
Q

membranoproliferative glomerulonephritis is associated with what

A

hep C

34
Q

hepatorenal syndrome is seen in patients with

A

severe liver cirrhosis secondary to system and renal hypoperfusion

35
Q

does renal function improve with acute renal failure

A

no

36
Q

typical findings for acute renal failure

A
  • creatinine greater than 1.5
  • low urine sodium
  • no blood, casts, protein in urine,
37
Q

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

A

cystinuria

38
Q

when should a person not get metformin

A
  • ill patients with acute renal failure
  • liver failure
  • sepsis
39
Q

common medications that cause hyperkalemia

A
  • nonselective bet-adrenergic blockers
  • potassium-sparing diuretics
  • ACE inhibitors
  • ARBS
  • NSAID
40
Q

what type of drug is amiloride?

A

potassium sparing diuretic

41
Q

renal vein thrombosis is a complication of what nephrotic syndrome

A

membranous glomerulopathy

42
Q

metabolic changes with vomiting

A

hypochloremic metabolic alkalosis
hypokalemia
increase bicarbonate

43
Q

treatment for vomiting induced metabolic alkalosis

A

isotonic sodium chloride

potassium

44
Q

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

A

SLE

45
Q

what causes membranoproliferative glomerulonephritis

A

persistent activation of the alternative complement pathway

46
Q

microscopic finding for membranoproliferative glomerulonephritis

A

dense intramembranous deposits that stain C3

47
Q

nephrotic-range proteinuria and hematuria, diagnosis

A

membranoproliferative glomerulonephritis

48
Q

side effect of rifampin

A

red urine

49
Q

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

A

urinary retention

  • prevent destrusor contraction and sphincter relaxation
  • urinary cath and discontinue meds
50
Q

when do you see asterixis

A
  • hepatic encephalopathy
  • uremic encephalopathy
  • CO2 retention
51
Q

AEIOU

A 
acidosis
electrolytes (K)
ingestion
overload 
uremia
52
Q

electrolyte problems in alcoholics ? how

A

hypomagnesemia that causes hypokalemia

  • intracellular Mg, inhibit K secretion by renal outer medullary potassium channels into urine
  • No Mg, no K
53
Q

hypertension, palpable bilateral abdominal masses and microhematuria

A

ADPCKD

54
Q

Dysuria, urinary frequency, suprapubic tenderness suggests

A

uncomplicated cystitis

55
Q

treatment for complicated cystitis

A

oral fluroquinolones

56
Q

treatment for uncomplicated cystitis

A
  • Trimethoprim-sulfamethoxazole
  • nirtofurantion
  • fofomycin
57
Q

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

A

benign prostatic hyperplasia

58
Q

most common renal vascular lesions seen in hypertension are

A

arteriosclerotic lesions of afferent and efferent arterioles and glomerular capillary tufts

59
Q

characterize diabetes mellitus nephropathy

A
  • increased extracellular matrix
  • basement membrane thickening
  • mesangial expansion
  • fibrosis
60
Q

patients with nephrotic syndrome has increased risk for what

A
  1. atheroscloerosis ( due to hyperlipidemia)

2. arteriovenous thrombosis ( loss of antithrombin III)

61
Q

Saline-responsive metabolic alkalosis is associated with

A

low urinary chloride excretion

volume contraction

62
Q

saline-unresponsive metabolic alkalosis associated

A

urinary chloride greater than 20

63
Q

what is used to treat severe metabolic acidosis

A

IV sodium bicarbonate

Uworld Step 2 (30 decks)

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