Goljan Gold

Question 1

What should you give with saline to increase its efficacy?

Answer 1

Glucose (Na+ and glucose are taken into cells via a cotransporter)

Question 2

BUN:creatinine helps differentiate:

Answer 2

Pre-renal azotemia from renal failure

Question 3

BUN is 80; creatinine is 8. Cause?

Answer 3

Renal failure (BUN:creatinine ratio is 10:1, so you know both urea and creatinine are increasing = renal failure)

Question 4

BUN is 40; creatinine is 1. Cause?

Answer 4

Pre-renal azotemia (BUN:creatinine ratio is 40:1, so you know only urea is increasing while creatinine is normal thus kidney must be functioning ok = pre-renal azotemia)

Question 5

Only glomerulonephritis that can be diagnosed with immunoflourescence?

Answer 5

IgA nephropathy

Question 6

If it ends in -itis, it is what type of disease?

Answer 6

Immune complex (type III hypersensitivity)

Question 7

Hep C?

Answer 7

Membranoproliferative disease

Cryoglobulins

Question 8

Hep B?

Answer 8

Membranous nephropathy

Polyarteritis nodosa

Question 9

Class of drugs highly associated with drug-induced nephrotoxicity?

Answer 9

Aminoglycosides (gentamicin)

Question 10

What is this pt’s total body Na?

Answer 10

Increased

(ALWAYS increased if pt has pitting edema)

Question 11

How would you treat this pt?

Answer 11

*Volume depletion*

Initially isotonic saline (0.9%) to raise BP

Then replace the type of fluid pt lost

Question 12

What Rx inhibits this process?

Answer 12

Acetazolamide

Question 13

Dx? Causes?

Answer 13

Hypokalemia (U wave, flattened T wave, ST depression)

Diuretics, primary hyperaldosteronism, vomiting, insulin (activate Na/K-ATPase), alkalosis

Question 14

Dx? Causes?

Answer 14

Hyperkalemia (peak T wave, widened QRS, flattened P wave)

Crush injury, tumor lysis, rhabdo, untreated diabetes (no insulin = no K into cells)

Question 15

Tx?

Answer 15

Reverse the cause of the hypokalemia, can give IV K+

Question 16

Tx?

Answer 16

FIRST Ca2+ GLUCONATE

Insulin

Albuterol

Resin

Dialysis