GUR Flashcards
quid of hypernatremia
serum sodium> 145 meq/l
symptom of hypernatremia
Neurologic
neurologic problem in hypernatremia(2)
altered mental satus
seizures
causes of hypernatremia 6 D
Diuretics Dehydration Diabetes insipidus Docs(iatrogene) Diarrhea Disease(kidney sickle cell disease)
time to correct hypernatremia(2)
48-72 h
to prevent cerebral edema
quid of hyponatremia
na+< 136 meq/l
hypertonic hyponatremia
osmolality>295meq/l
normotonic hyponatremia
osmolality entre 280-295 meq/l
hypotonic hyponatremia
osmolality < 280 meq/l
cause of hypotonic hyponatremia with hypervolemia(4)
renal failure
nephrotic syndrome
cirrhosis
CHF
cause of hypotonic hyponatremia with hypovolemia(5)
diuretics vomiting diarhea third spacing dehydration
RX OF hypotonic hyponatremia with hypovolemia
Replete volume with NACL 0,9%
hypervolemic hyponatremia(3)
Nephrosis
Cirhhosis
cardiosis
rythm to correct hyponatremia
0,5-1 meq/l/hr
why you should correct hyponatremia cautiously
to prevent central pontine myelosis
quid of central pontine myelinosis(2)
quadraplegia
pseudobulbar palsy
quid of hyperkaliemia
K> 5 meq/l
causes of hypokaliemia(2)
renal
GI losses
symptom of hypokaliemia(4)
muscle weakness
cramps
ileus
hyporeflexia
EKG in hypokaliemia(2)
flat T waves
U waves
causes of hypercalcemia CHIMPAZEES
Calcium supplementation Hyperparathyroidism Iatrogenic/Immobility Milk alkali syndrome Paget disease Addisons/Acromegaly Neoplasm Zollinger ellison syndrome(MEN 1) Excess vit A excess vit D Sarcoidosis and other granulomatous disease
hypercalcemia
calcium> 10.2
most common causes of hypercalcemia(2)
hyperparathyroidism
malignancy
quid of hypocalcemia
calcium< 8
cause of false hypocalcemia
hypoalbuminemia
classic hypocalcemia symptoms(3)
cramps
tetany
following thyroidectomy
chvostek sign in hypocalcemia
facial spasm elicited from tapping of the facial nerve
trousseau sign in hypocalcemia
carpal spasm after arterial occlusion with BP cuff for example
symptom of hypocalcemia(3)
abdominal muscle cramps
tetany
perioral acral paresthesias
quid of hypomagnesemia
Mg<1,5
etiologies of hypomagnesemia(3)
DKA/pancreatitis
loss of magnesium
decrease of intake
decrease intake causing hypomagnesemia(4)
malnutrition
malabsorption
short bowel syndrome
total parenteral nutrition
loss causing hypomagnesemia(6)
diuretics diarrhea vomiting hypercalcemia drugs alcoholism
drugs causing hypomagnesemia
amphotericin
symptom of hypomagnesemia(5)
hyperactive reflexes seizures arrythmias paresthesia confusion
CAUSE OF PRERANAL ACUTE RENAL FAILURE(7)low renal perfusion
hypovolemia cardiogenic shock sepsis anaphylaxia drugs renal artery stenosis hepatorenal syndrome in cirrhosis
renal cause of acute renal failure(4)nephron injury
ATN( acute renal tubular necrosis)
acute /allergic intersticial nephritis
glomerulonephritis
thromboembolism
post renal causes of acute renal failure(5)post renal obstruction
prostate disease nephrolithiasis pelvic tumors recent pelvic surgery retroperitoneal fibrosis
causes of ATN(3)
renal ischemia
hemoglobinuria
myoglobinuria
prenal acute renal failure(4)
FeNA< 1
Una < 20
specific gravity of urine 1020
BUN/creat > 20
FeNA < 1 meaning
reins are trying to conserve Na
hyaline cast
prenal failure
red cell cast and dysmorphic red cells (2) quid
glomerulonephrits
intrinsic problem
white cells and eosinophils(3)
allergic intersticial nephritis
atheroembolic disease
intrinsic disease
ATN finding in urinalysis(3)
granular cast
renal tubular cells
muddy brown cast
quid of ATN
intrinsic disease
urinalysis finding in pyelonephritis(2)
white cells
white cell casts
classification problem in pyelonephritis
post renal
indication of dyalisisAEIOU
Acidosis Electrolyte disturbances Ingestion Overload fluid Uremic symptoms
electrolyte disturbance indicating dyalisis
hyperkaliemia
substance ingestion indicating dyalisis(6)
salicylates theophyline methanol barbiturates lithium ethylene glycol
uremic symptoms quid(6)
pericarditis encephalopathy bleeding nausea pruritis myoclonus
why acidosis in renal failure
inability to excrete H+
hematuria HTA and oliguria dx
nephritic syndrome
do you have proteinuria in nephritic syndrome
Less than 1.5
proteinuria in nephrotic syndrome
More or equal a 3.5 g /day
biology in nephrotic syndrome(4)
proteinuria
hypoalbuminemia
hyperlipidemia
hyperlipiduria
problem in nephrotic syndrome
increase permeability of the glomerulus
nephrtic syndrome a immune complex(2)
GNA
Ig A nephropathy(maladie de Berger)
pauci immune nephritic syndrome
wegener
syndrome nephritic avec anti GMB disease(2)
goodpasture syndrome
alport syndrome
clue for GNA(4)
edema
HTA
oliguria
smoky brown urine
labs of GNA(3)
low c3
high ASo
lumpy bumpy immuno fluorescence
cause of GNA
group A hemolytic strep
most common type of nephritic syndrome
IGA nephropathy ou maladie de berger
clue for berger(3)
upper respiratory tract infecion
nephritic syndrome
association with henoch shonlein purpura
C3 in berger
normal
rx of nberger
glucocorticoids
ACE for proteinuria
wegener clue(2)
upper and lower respiratory tract disease
renal problem
anapath of wegener(2)
granulomatous disease
necrotizing vasculitis
hemoptysis in wegener why
cavity in lungs
lab for wegener
C anca
biopsy in wegener
segmental necrotizing glomerulonephritis with few immunoglobulin deposits on immunofluorescence
rx of wegener(2)
corticoid
cytotoxic agents
clue for Goodpasture organ involvement
lung
rein
biosy in goodpasture(3)
linear anti GBM deposi on immunofluorescence
iron deficiency anemia
hemosiderrin filled macrophages in sputum
xray in goodpasture
pulmonary infiltrates
rx of goodpasture(2)
plasma exchange
steroids
quid of alport syndrome
hereditary glomerulonephritis
gender for alport
boy 5-20 ans
clue for alport(2)
hematuria
nerve deafness
biopsy for Alport
GBM splitting on electron microscopy
prognosis of Alport
progress to renal failure
causes of nephrotic syndrome(6)
Minimal change disease focal segmental glomerulo sclerosis Membranous nephropathy lupus nephritis diabetic nephropathy renal amyloidosis Membranoproliferative nephropathy
cause of renal amyloidosis(2)
multiple myeloma
chronic inflammatory disease(RA/TB)
dx of amyloidosis(3)
fat pad biopsy
congo red stain apple green
birefringence undr polarised light
most common nephropathy in caucasian adults
membranous nephropathy
calcul(4)
calcium oxalate/calcium phosphate
struvite(MGNH4PO4)
acid uric
cystine
most common calcul
calcium oxalate or phosphate
hexagonal crystals
cystine
size of stone to pass through the urethra
< 5mm
stone < 3 mm next step(2)
extracorporeal shock wave liotripsy
percutaneous nephrolitotomy
PCKD in infant inheritance
autosomal recessive
PCKD in adult
autosomal dominant
types of Renal tubular acidosis RTA(3)
1
2
4
defect in type 1 renal tubular acidosis
H+ secretion
defect in type 2 renal tubular acidosis
hco3- reabsorption
defect in type 4 renal tubular acidosis(2)
aldosterone deficiency or resistance
defect in K+ and H+ excretion and Na+ reabsorption
K+ in the different type of RTA(3)
high or low in type 1
low in type 2
high in type 4
PH urine in the different types of RTA(4)
> 5,3 in type 1
5.3 initially and < 5,3 once serum acidic in type 2
< 5,3 in type 4
etiologies in type 1 RTA(6)
hereditsry amphotericin cirrhosis autoimmune disorders scd lithium
etiologies in type 2 RTA (4)
HEREDITARY
CARBONIC ANHYDRASE inhibitor
fanconi syndrome
multiple myeloma
etiologies in type 4 RTA (4)
hyporeninemic hypoaldosteronism
chronic kidney disease from DM
HTA
HIV
rx type 1 et 2
citrate de K+
rx of type 4(3)
furosemide
fludrocortisone
low potassium diet
complication of type 1 RTA
nephrolithiasis
complication of type 2 RTA(2)
rickets
osteomalacia
complication of type 4 RTA
hyperkaliemia
corner stone of SIAH rx
fluid restriction
leading cause of ca in men(5)
lung prostate colorectal pancreatic leukemia
cause of elevated PSA(5)
BPH prostatitis UTI prostatic trauma carcinoma
screening test for prostate ca
annual direct rectal examination after 50
differentiel dx of hematuria S2I3T3
Stricture stones infection inflammation infarction tumor trauma TB
palpable flank mass in the setting of flank pain and hematuria
renal cell carcinoma
common presentation in renal cell carcinoma(2)
anemia
polycythemia
when to do orchiopexy in kid in case of cryptorchidism
after age one and before age 5