HY Renal Flashcards
Patients with intravascular volume depletion (eg, congestive heart failure, diarrhea, excessive diuresis) and chronic kidney disease depend on renal prostaglandin production to dilate the afferent glomerular arteriole and maintain the glomerular filtration rate. _____ inhibit prostaglandin synthesis, which can cause prerenal azotemia in at-risk patients.
Nonsteroidal anti-inflammatory drugs
Patients with CKD often develop erythropoietin (EPO) deficiency. Treatment with recombinant EPO for prolonged or high-dose treatment can have serious side effects, most notably increased risk of hypertension and ______ .
thromboembolism
Malabsorption caused by celiac disease can lead to _____. causing decreased serum phosphorus, increased serum parathyroid hormone, and low (or normal) serum calcium.
vitamin D deficiency
+ anti-tissue transglutaminase IgA antibodies = Celiac’s
HYPOaldosteronism is the cause of type ___ renal tubular acidosis.
IV
Acute salicylate toxicity causes a primary respiratory _____ and a primary metabolic _____ with an anion gap due to increased _____ production.
alkalosis
acidosis
lactate
______ are indicated in non-obstructive urinary retention (Atonic bladder), paralytic ileus, and glaucoma.
Cholinomimetics
Direct: Bethanocol, Carbachol, Methacholine, Pilocholpine
Indirect: Donezepil, Rivastigmine, Galantaine, Edrophonium, Neostigmine, Physostigmine, Pyridostigmine
The most likely cause of fever and fatigue with new-onset cardiac murmur is
infective endocarditis (IE)
EM - Lamellated appearance of GBM
Alport Syndrome
Penicillamine, a first-line therapy for Wilson’s disease, is a copper-chelating agent that solubilizes copper, which is then excreted in the urine. AE →
Membranous Nephropathy
Benign prostatic hyperplasia leads to progressive bladder outlet obstruction. Over time, increased urinary pressures can cause hydronephrosis and renal parenchymal ___ with _____. This can progress to chronic kidney disease.
atrophy
Scarring
Beta-adrenergic blocking drugs inhibit _____ release by blocking beta-1 receptor-mediated regulation of the renin-angiotensin-aldosterone system.
renin
Hyperventilation ____ PCO2
Lowers –> Alkalemia
(Basic bitches hyperventilate
Rounded polygonal or cuboidal cells
Yellow Mass, Clear Cells
RCC
RCC likes to MET where (2)
Lungs (canonballs)
Bone (osteloytic)
High Hematocrit =
Polycythemia (too many RBCs)
Myeloproliferative Disorders can cause what in the kidneys?
Uric Acid Kidney stones
Urease + (Protease, Klebsiella, S. Saphrophyticus)
organism UTI causing Nephrolithiasis
What type/shape?
Ammonia, Mg, Phosphate
Staghorn!!!!
look like rectangles (Coffins)
Wedged shaped crystals
Form Rosettes
Calcium Phosphate
Rhomboid/ Diamond crystals in urine
Uric Acid
4 causes of Hypokalemic Metabolic Acidosis
Loop abuse (overdose)
Thiazide abuse (overdose)
Vomit
Gastric pumping
*H+ loss initiates alkalosis and volume depletion then activates RAAS
Azetazolamide:
MOA
Adv. Effects (1)
Carbonic Anhydrase Inhibitor
Metabolic Acidosis (after like 2 days)
Mannitol:
MOA
Adv. Effects (1)
Osmotic diuretic
↑ tubular fluid osmolarity
↑ urine flow
↓ intracranial/intraocular pressure
Pulmonary Edema
*Contraindicated in HF
Mannitol elevates blood plasma
Osmolarity
Spironolactone:
MOA
Adv Effects
Competitive Aldosterone Receptor Antagonist
Gynecomastia- Anti-androgen effects Hyperkalemic Arrythmias (All K+ sparing do this)
Thiazides:
MOA
Adv Effects
Inhibit NaCl cotransporter in early DCT
Lowersdiluting capacity
Lowering Ca2+excretion
hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia. Sulfaallergy. Hypernatremia
(GLUC SSALT)
Triamterene and amiloride block apical _______ at the Collecting tubule.
ENa+ channels
ENac
3 causes of normal anion gap Metabolic Acidosis from Bicarb loss
Diarrhea
RTA
Excess Saline Infusion
5 causes of elevated anion gap Metabolic Acidosis from elevated acids in the body
DKA Lactic Acidosis Uremia (Renal Failure) Salicylate (Aspirin) overdose Toxicities: Ethylene Glycol/ Methanol
(D-SLUT)
Creatinine and PAH clearance can be used to calculate
FF (Filtration Fraction)
FF= Creatinine clearance /PAH clearance
Do loops work on thick or this ascending limb?
THICK
4 drugs that may be selected to give with loops and thiazides to limit K+ wasting
Spirono, Eplerenone, Amiloride, Triamterene
SEAT
*can cause metabolic acidosis
2 diuretics for increased intracranial pressure
Mannitol
Azetazolamide (CAI)
