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Internal Medicine > Deja - Internal - Nephrology > Flashcards

Deja - Internal - Nephrology Flashcards

1
Q

ARF - Signs and symptoms NOT 2o to uremia:

A
  1. Metabolic acidosis.
  2. Hyperkalemia –> Arrhythmias.
  3. Fluid overload –> Pulm. edema, CHF, HTN.
  4. Hyperphosphatemia.
  5. HTN 2o to excess renin secretion.
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2
Q

Oliguria - Definition:

A

Less than 400cc/24h.

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3
Q

What tests would you initially order to evaluate for ARF?

A
  1. Urine/serum electrolytes.
  2. Urine/serum BUN/Cr.
  3. Urinalysis including urine osmolarity.
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4
Q

What is FENa?

A

Stands for fractionals sodium excretion and is the best diagnostic test to help discriminate between the different types of ARF.

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5
Q

FENa in Prerenal, renal, and post renal?

A

Pre –> >2%.

Postrenal –> >4%.

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6
Q

Name the type of ARF associated with the following urinary sediment findings: Red cell casts, urine eosinophils, WBCs, granular casts.

A

Red cell casts –> GN.
Urine eosinophils –> AIN.
WBC casts –> AIN.
Granular casts –> ATN.

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7
Q

What medications classically cause ATN?

A

CLAAP

Contrast
Lithium
Aminoglycosides
Amphotericin
Pentamine
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8
Q

What are the causes of AIN?

A

Inflammation of the renal parenchyma caused by:

  1. Medications: diuretics, NSAIDs, penicillin.
  2. Infection: CMV, EBV, Toxo, Syphilis.
  3. Systemic diseases: Sarco, Sjögren.
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9
Q

Uremic syndrome - Cardiovascular:

A
  1. HTN

2. Pericarditis

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10
Q

Uremic syndrome - Pulmonary:

A
  1. Pleural effusions

2. Pulm. edema.

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11
Q

Uremic syndrome - CNS:

A
  1. Asterixis

2. Clonus

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12
Q

Uremic syndrome - Hematology:

A
  1. Anemia due to low erythropoietin.

2. Incr. bleeding time due to platelet dysfunction.

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13
Q

Uremic syndrome - GI:

A
  1. Nausea

2. Vomiting

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14
Q

Uremic syndrome - Metabolic:

A
  1. Acidosis.
  2. Electrolyte imbalances (especially hyperkalemia).
  3. Hypocalcemia (lack of vitD).
  4. Azotemia.
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15
Q

What can be used to measure the severity of CRF?

A

GFR.

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16
Q

In CRF, there is decreased synthesis of what 2 entities?

A
  1. VitD

2. EPO

17
Q

Electrolyte abnormalities seen in CRF:

A
  1. Hyperkalemia
  2. Hypocalcemia
  3. Hyperphosphatemia
18
Q

Indications for dialysis:

A

AEIOU

Acidosis
Electrolyte abnormalities
Ingestion of toxins
Overload of fluid
Uremic symptoms
19
Q

How can urinary cholesterol be identified?

A

If urine is seen under polarized light, there will be “MALTESE CROSSES”.

20
Q

Other names for minimal change disease?

A

Nil disease or lipoid nephrosis.

21
Q

Nephrotic syndrome - MC primary cause in adults:

A

FSGS or membranous glomerulonephritis.

22
Q

Nephrotic syndrome - 2 forms, type I is slowly progressive and type II has autoantibodies against C3 and is more rapidly progressive.

A

Membranoproliferative glomerulonephritis.

23
Q

Nephrotic syndrome - Associated with refractory HTN:

A

FSGS

24
Q

Nephrotic syndrome - Frequently recurs:

A

Minimal change disease

25
Q

Nephrotic syndrome - Granular deposits of IgG and C3:

A

Membranous glomerulonephritis.

26
Q

Nephrotic syndrome - Present in young, black men with refractory HTN:

A

FSGS

27
Q

Nephrotic syndrome - Associated with HIV, IVDA, SCA:

A

FSGS.

28
Q

Nephrotic syndrome - “Spike and dome” on histology due to excess basement membrane:

A

Membranous glomerulonephritis.

29
Q

Nephrotic syndrome - Slowly progressive with minimal response to steroids:

A

Membranous GN

30
Q

Nephrotic syndrome - Associated with hep, SLE, syphilis, malaria, penicillamine, gold, CA:

A

Membranous GN.

31
Q

Main treatment for FSGS:

A

Steroids with cyclophosphamide - Poor prognosis.

32
Q

Main treatment for membranous GN:

A

Steroids, can add cyclophosphamide in refractory cases.

33
Q

Main treatment for membranoproliferative GN:

A

Steroids. Plasmapheresis can be added.

34
Q

Name the systemic diseases that can lead to nephritic syndrome.

A
  1. SLE
  2. SCA
  3. HIV
  4. Diabetes
  5. Myeloma
35
Q

ARF - Signs and symptoms 2o to uremia:

A
  1. Asterixis
  2. Nausea
  3. Vomiting
  4. Anemia
  5. Pericarditis
  6. Pruritus
  7. Urea crystals on the skin (“uremic frost”).
  8. Fatigue
  9. Oliguria

Internal Medicine (106 decks)

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