IM Renal - Rd 2

Question 1

TB can cause what organ dysfunction?

This results in what?

Answer 1

Primary Adrenal Insufficiency

Non AG metabolic acidosis

Question 2

Pt that has 80% occlusion of a renal artery should be managed how?

Answer 2

ACE-i

Question 3

What is the leading cause of euvolemic hypernatremia?a

Divided into what types?

Answer 3

Diabetes insipidus

Complete - UOsm < 300
Partial - UOsm 300-600

Question 4

What is interstitial cystitis known as?

How does it present?

Answer 4

Painful bladder syndrome

Exacerbated by bladder filling and sex, relieved by voiding

Question 5

What presents with anasarca, HTN, abnormal UA showing microscopic hematuria and proteinuria?

Answer 5

Acute nephritic syndrome w/fluid overload

Question 6

Pt with Hyponatremia should be corrected at rate no faster than what?

Answer 6

0.5 mEq/L/hr

Question 7

What does the ABG in ASA toxicity most likely show?

Answer 7

Low PaCO2 d/t primary respiratory alkalosis
Low HCO3 d/t primary metabolic acidosis
Near normal pH d/t 2 acid-base disturbances

Question 8

What is enteroclysis?

Used to diagnose what?

Answer 8

Uses contrast to test the small intestine

Dx small bowel tumors

Question 9

What is the earliest renal abnormality seen in diabetic nephropathy?

What is the 1st to be quantified? Next?

Answer 9

Glomerular hyperfiltration

Thickening of BM, then mesangial expansion

Question 10

How does saline responsive metabolic alkalosis present?

Answer 10

Urine Cl < 20

Question 11

What is the MC cause of abnormal hemostasis in chronic Renal Failure?

Treat how?

Answer 11

Platelet dysfunction

Desmopressin

Question 12

What antimuscarinic drug is used to increase bladder capacity and decrease detrusor contractions?

Side Effects?

Answer 12

Oxybutynin

Dry mouth, constipation, blurry vision

Question 13

How do you treat neurogenic bladder with meds?

MOA?

Answer 13

Bethanechol

Cholinergic agonist

Question 14

MPGN is caused by what?

How does it present?

Answer 14

Persistent activation of the alternative complement pathway d/t C3 nephritic factor

Nephrotic-range proteinuria and hematuria

Question 15

Pt w/hyponatremia and has HA, N/V, weakness, and lethargy should be treated how?

Answer 15

3% hypertonic solution

Question 16

Kidney stones in pts w/Crohn disease is d/t what?

Answer 16

Oxalate absorption d/t fat malabsorption binding up all the Calcium

Question 17

Pt that is not responding to VIGOROUS saline resuscitation w/liver problems has what?

Occurs d/t development of what?
This causes what?

Answer 17

Hepatorenal syndrome

Splanchnic arterial dilation
Activation of RAAS w/dec perfusion and dec glomerular filtration

Question 18

Pt w/hyponatremia w/serum osmolality < 290 and a urine osmolality < 100 has what?

If urine osmolality is > 100 but Urine Na < 25 what do they have?

Answer 18

Primary polydipsia or beer potomania

SIADH, AI, Hypothyroid

Question 19

Bactrim can cause what electrolyte SE’s?

Answer 19

Hyperkalemia

Inc Cr w/out affecting the GFR

Question 20

Pts that have nephrotic syndrome have increased risk for what?

Why?

Answer 20

Atherosclerosis

Nephrotic syndrome causes Hyperlipidemia

Question 21

Pt that has uric acid stones can be treated prophylactically with what?

Through what mechanism?

Answer 21

Potassium citrate

Alkalinization of the urine

Question 22

When do you give IV bicarbonate in a pt that has metabolic acidosis?

Answer 22

PH < 7.1

Question 23

Which pts are at higher risk for developing type 4 RTA?

Describe type 4 RTA

Answer 23

Poorly controlled Diabetics

Hyperkalemia
Lower serum bicarbonate levels

Question 24

Loop diuretics are commonly give to cirrhosis pts w/volume overload, what are the common SEs?

Answer 24

Hypokalemia
Metabolic alkalosis
Pre-renal AKI

Question 25

Kidney biopsy that shows hyalinosis of walls of afferent and efferent arterioles indicates what?

Answer 25

Diabetic nephropathy

Question 26

What can high-dose IV acyclovir cause?

Answer 26

Crystalluria w/renal tubular obstruction

Question 27

What level of hyponatremia is considered severe?

What treatment is required?

Answer 27

< 120

3% hypertonic saline