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Undeleted > Exam 3 Important stuff I need to remember > Flashcards

Exam 3 Important stuff I need to remember Flashcards

1
Q

Dx of acute kidney injury

A

increased of 0.3 serum creatinine (days to wks)

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2
Q

Causes of decreased serum creatinine

A

pregnancy

cirrhosis

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3
Q

Cause of falsely low creatinine assay

A

jaundice

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4
Q

Cause of falsely high creatinine assay

A

DKA

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5
Q

2 Drugs causing increased serum creatinine

A

trimethoprim

cimetidine

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6
Q

Med contraindicated in AKI

A

NSAIDs, they decrease PGE which cause afferent vasodilation

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7
Q

FENA value and meanings

A

2% for ATN/diuresis

if FENA decreased with diuretic=ineffective diuresis

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8
Q

FEurea value and meanings

A

50% for ATN/CKD

used with diuretics because they do no impact FEurea

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9
Q

Suggestion of isothenuria

A

ATN with no response to ADH

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10
Q

Urine lab values for Pre-renal azotemia (Na/Osm/gravity/FENA/BUN:Cr)

A

Na500
specific gravity>1.015
FENA 20:1

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11
Q

Urine lab values for ATN (Na/Osm/gravity/FENA/BUN:Cr)

A 
Na>40
Osm=280
specific gravity=1.010
FENA>2%
BUN/Cr =15:1
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12
Q

Casts with ATN

A

granular casts with muddy brown (RBC)

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13
Q

Casts with CKD

A

waxy casts

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14
Q

Hyperkalemia cardio sx

A

peaked T waves

widened QRS

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15
Q

Med tx for hyperkalemia

A

Ca (increases threshold)
insulin/beta2 stimulants (K into cells)
kayexalate (K/Na exchange in colon)

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16
Q

UTI prophylaxis for recurrent infections

A

TMP-SMX

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17
Q

Viral cystitis cause

A

adenovirus 11, 21

seen seasonally

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18
Q

Neonate UTI

A

from hematogenous spread

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19
Q

Infatn UTI

A

from ascending route

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20
Q

Med choice for ped HTN

A

HCT for no end organ damage

ACEI/ARB for CKD or DM with HTN

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21
Q

Cause of urge incontinence

A

detrusor overactivity

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22
Q

Cause of stress incontinence

A

increased intra-abd pressure, with no bladder contraction

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23
Q

Exacerbation of stress incontinence

A

estrogen

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24
Q

Risks for UT maligancy

A

smoking hx
analgesic abuse
pelvic irradation

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25
Q

Use of intravesical therapy

A

stages Ta, T1, Cis bladder cancer

noninvasive cancers

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26
Q

When do you do a radical cystectomy

A

non-met, muscle invasive bladder cancer

27
Q

Meds causing kidney stone formation

A 
Vit C/D
triamterene
protease inhibitors
lasix
acetazolamide
28
Q

Stones soluble in alkaline urine

A

uric acid

cystine

29
Q

Drug for uric acid stones

A

allopurinol

30
Q

Drug for struvite stones

A

lithostat

31
Q

Drugs for cystine stones

A

thiola

D-penicillamine

32
Q

Urosepsis pathogen factors

A

LPS and Lipid A

type 1 and P-fimbriae

33
Q

Early goal tx for urosepsis

A

hemodynamic stability

34
Q

Crashing uroseptic tx

A

nephrostomy

35
Q

Testicular detorsion tx timeframe and ultrasound finding

A

6 hrs

no flow on echo (heterogenous)

36
Q

Testicular rupture tx timeframe

A

72 hrs for surgery

37
Q

Epididymitis ultrasound finding

A

increased flow to epididymis

38
Q

Penile fracture rupture

A

albuginea and tumescent corpora cavernosa

39
Q

Fournier’s gangrene

A

pain in penis/scrotum out of proportion to exam
increased with DM/EtOH/immunosuppressed
E coli causes commonly

40
Q

Arterial vs ischemic priapism

A

arterial has no pain, from cavernous a. damage

ischemic has blood stasis

41
Q

Causes of priapism

A

Sickle-cell
leukemia infiltration
trazodone/phenothiazines/cocaine

42
Q

Tx for priapism

A

for Sickel Cell, transfuse Hb
aspiration/irrigation of corpora
phenylephrine injection
shunt if not tx w/in 1 hour

43
Q

Kidney decline with age

A

increased decline over the age of 40 (from 0.1 to 0.8cc/min/yr)

44
Q

CKD consequences of adapations

A

intraglomerular HTN/glomerular hypertrophy cause glomerulus scarring
increased ammoniagensis causes scarring of intersitium

45
Q

CKD adaptations

A 
increased renal afferent vasodilation
increased renal efferent vasoconstriction
hypertrophy of tubule
above cause increased GFR
increased ammonia for H+ removal
46
Q

BP control with CKD pts

A

ACEI/ARBS- slow progression of damage

CCB’s for transplant pts

47
Q

Side effect of ACEI/ARBs with CKD

A

increased creatinine levels

stabilize after a time

48
Q

Cause of anemia with CKD

A

erythropoietin deficiency
seen at Stage 4 of CKD
normocytic normochromic anemia

49
Q

Tx of CKD anemia

A

with EPO

get Hb over 10mg/dL

50
Q

Serum level changes in CKD

A

increased PTH and FGF-23

decreased Ca2+ and 1,25 Vit D

51
Q

Primary vs secondary hyperparathyroidism

A

primary-adenoma causes increased Ca/decreased phosphate

secondary-from hyperplasia responding to decreased Ca/increased phosphate

52
Q

Types of renal osteodystrophy with CKD

A

osteitis fibrosa cystica (increased PTH)
osteomalacia (decreased bone vol)
mineralization (decreased 1,25 Vit D)

53
Q

Bone disease prevention with CKD goal

A

keep phosphate below 5.5mg/dL

54
Q

Major cause of death from CKD

A

medial calcification (arteriosclerosis)

55
Q

Tx for excess volume in CKD

A

thiazides up to stage 3
loop diuretics at stage 4 and 5
due to thiazide dependence on GFR

56
Q

Pain mgt meds for kidney stones

A 
morphine sulfate (narcotic)
ketorolac (NSAID)
57
Q

Meds for kidney stone passing

A

nifedipine (CCB)-decreased ureteral contraction

tamsulosin/teraosin (alpha1-anatagonists)-decreased peristalsis

58
Q

Ca2+ stone prevention

A

fluids (over 2 L/day)
thiazides + amiloride
NOT triamterene (causes stones)

59
Q

Tx for primary hyperoxaluria

A

pyridoxine

60
Q

Tx for secondary hyperoxaluria

A

cholestryamine (binds oxalate)

61
Q

Meds for cystine stones

A

tipronin/d-penicillamine

break disulfide bonds b/t cysteines

62
Q

Struvite stone tx without surgery

A

urease inhibitor

acetohydroxamic acid

63
Q

Tx for nephrogenic diabetes insipidus

A

thiazides or indomethacin

goal to decrease urine flow

64
Q

Tx for Li+ induced diabetes insipidus

A

amiloride-decreases Li+ absorption

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