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Surgery > Kidney > Flashcards

Kidney Flashcards

1
Q

What is the effect of TMP on K levels?

A

Hyperkalemia, blocks ENaC

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2
Q

What is the test of choice to detect diabetic nephropathy?

A

Random urine for microalbumin/creatinine ratio

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3
Q

What injury does blood at the beginning of urination indicate?

A

Urethral injury or urethritis

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4
Q

What injury does blood at the end of urination indicate?

A

Prostatic or bladder injury

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5
Q

What injury does blood throughout urination indicate?

A

Ureters of kidney injury–will not pass clots

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6
Q

Renal vein thrombosis (RVT) occurs because of loss of…

A

Antithrombin III (an inhibitor of the coag cascade)

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7
Q

RVT is most associated with what nephrotic syndrome?

A

Membranous glomerulopathy

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8
Q

What are indications of rhabdo?

A

Red urine and increased Cr

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9
Q

Symptoms of periorbital swelling, hematuria, and oliguria indicate what glomerulonephritis?

A

Post-strep glomerulonephritis

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10
Q

What does urine show in PSGN?

A

Hematuria with RBC casts and proteinuria

- C3 levels are also low

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11
Q

What is the first sign of renal abnormality in pts with DM?

A

Glomerular hyperfiltration

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12
Q

What is the first change to the kidney in pts wtih DM that can be quantitated?

A

Glomerular basement membrane thickening

  • followed by mesangial expansion
  • followed by nodular sclerosis (specific for diabetic nephropathy)
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13
Q

What part of the kidney is injured in analgesic nephropathy?

A

Causes tubulointerstitial nephritis

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14
Q

A non-anion gap metabolic acidosis with preserved kidney fx indicates…

A

Renal tubular acidosis

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15
Q

Metformin should not be given to acutely ill patients with kidney failure. liver failure, or sepsis, because…

A

…it causes lactic acidosis

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16
Q

What is the most common type of glomerulonephropathy associated with malignancies?

A

Membranous glomerulonephropathy, generally associated with solid tumors (lung, colon, prostate, breast)

17
Q

What is the most common type of glomerulonephropathy associated with Hodgkin’s lymphoma?

A

Minimal change disease

18
Q

What is the first step in normalizing a pt with hyperkalemia?

A

Administration of insulin and glucose, to drive to K intracellularly (and prevent hypoglycemia)

19
Q

Loop diuretics act on what channel in the kidney?

A

Na-K-Cl channel in the loop of Henle

  • Cause Na wasting
  • Therefore also increase K secretion
20
Q

What is a common vascular complication of ADPCKD?

A

Berry aneurysm

21
Q

What’s the preferred imaging for renal stones?

A

US

22
Q

How do thiazide diuretics prophylax against kidney stones?

A

Reabsorb Na and water, and Ca is passively reabsorbed with them

23
Q

What’s the most common COD in renal tx and dialysis pts?

A

Cardiovascular death

24
Q

In painless hematuria, must rule out…

A

…bladder ca!

25
Q

Amitryptiline is a tricyclic anti-depressant with anticholinergic properties that cause…

A

urinary retention, by inhibiting detrusor muscle contraction and internal urethral sphincter relaxation.

Rx = urinary catheter and dc med

26
Q

What two lab values are the best indicators for acid-base status?

A

pH and PaCO2

27
Q

What is the most common HIV-related glomerulonephropathy ?

A

FSGS

  • Nephrotic range proteinuria (3+)
  • Azotemia
  • Normal sized kidneys
28
Q

What is the rx for severe hypernatremic hypovolemia?

A

Normal saline

  • Corrects the hyperosmolarity and fluid status
  • Normal saline is actually hypo-osmolar in comparison to hypernatremic serum

Less severe: use 1/2 NS + 5% dextrose

29
Q

What are the dietary recommendations for patients with nephrolithiasis?

A
  1. Decreased dietary protein and oxalate
  2. Decreased Na intake
  3. Increased fluid intake
  4. Increased dietary Ca
30
Q

How does Tamulosin aid the excretion of renal stones?

A

Tamulosin is an a1-adrenergic antagonist that relaxes ureteral muscle and decreases intra-ureteral pressure, facilitating passage of urinary stone

31
Q

What kind of stones does ethylene glycol poisoning produce?

A

Calcium oxalate stones

- Rectangular, envelope-shaped crystals

32
Q

How does nephrotic syndrome result in increased risk of atherosclerosis?

A

Altered lipid metabolism

Surgery (3 decks)

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