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IM MedEd > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Appearance of Simple Cysts

A

small, no loculations, no septations, asymptomatic & incidential findings on U/S or CT

*do nothing

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2
Q

Appearance of Complex Cysts

A

large, septations, loculatoins, symptomatic +/- flank pain, hematuria = needle guided biopsy

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3
Q

Renal Cell Carcinoma

rf? dx? tx?

A

RF: VHL, smoking, ESRD
DX: U/A, CT, U/S –> biopsy
TX: Resect

*watch out for Renal Vein Thrombosis, anemia & EPO paraneoplastic syn

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4
Q

AR PKD

A

children w/oligohydramous, bilateral flank pain, U/S

-kid usually dies

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5
Q

AD PKD

*where else u get cysts

A

adults, cause ESRD, hematuria, flak pain, stones, HTN
DX: U/S & CT
tx: managment + transplant
**cysts on liver, pancreas + brain

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6
Q

Hyperkalemia tx

A
  1. IV Ca-gluconate to stablize membranes
  2. Insulin + glucose
  3. decrease K w/diuretics or Kayexalate
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7
Q

Hypokalemia tx

A

give K <10mEg/hr IV

*also check Mg

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8
Q

Familial Hypocalcemic Hypercalcemia

A

mut CaSR = does detect elevated serum Ca causing cont. elevation in PTH.
*asymptomatic = no tx just watch for aortic stenosis

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9
Q

Hypercalcemia tx

A

IVF + calcitonin

Long term: bisphophanates + IVF & sometimes furosemide

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10
Q

Tx of Kidney stone <5mm

A

pass spontaneously, give fluid and pain managment

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11
Q

Tx of Kidney stone <7mm

A

medical explusive therapy = CCB + A-blocker

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12
Q

Tx of Kidney stone <1.5cm

A

Uteroscopy(distal) or Lithotripsy(proximal)

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13
Q

Tx of Kidney stone >1.5cm

A

Resect!

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14
Q

How fast do you correct sodium?

A

0.25 mmol/hr

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15
Q

Characteristics of NephrOtic Syn. Name the nephrotic syndromes

A 
>3.5g/protein/d, HTN, Edema, Anti-thrombin 3
"MMM FSD"
-Minimal Change Dz
-Membranous Nephropathy
-Membranoproliferative glom
-Focal Segmental Glomerulosclerosis
-Systemic Amyloidosis
-Diabetic Nephropathy
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16
Q

Minimal Change Dz

assoc? tx?

A

Nephroic syn, effacemnt of podocytes via cytokines. associaed w/hodgkin lymphoma, tx w/steroids

17
Q

Focal Segmental glomerulosclerosis

assoc? sx?

A

nephrotic syn, collagen depo, HTN, dec GFR, pink sclerosis

-assoc: HIV, Heroin, SS, Idiopathic

18
Q

Membranous Nephropathy

causes? assoc?

A

nephrotic syn, sub-epi IC depo causing “string of pearls”.

  • cause: DISC = drugs, infection, SLE, cancer/hepC
  • assoc: assoc w/ renal vein thrombosis which is often seen with RCC
19
Q

membranoproliferative glomerulonephritis

A

nephrotic syn, BM thickens due to IC depo causing MESANGIAL CELL PROLIF = HYPERCELLULARITY

  • T1: tram track: assoc w/ a1at def, HBV/C
  • T2: ribbin w/C3 nephritic factor
20
Q

NephrItic Syn sx? dz’s?

A

RBC casts, <3.5g/d, HTN

=> PSGN, Rapidly Progressive GN, Alport, IgA Nephrop, Henoch Schonlein Purpura

21
Q

Post-Streptococcal Glomerulonephritis(PSGN)

A

Nephritic Syndrome, IC depo = decrease C3&C4 in serum, look for child whose post-strep

22
Q

Rapidly Progressive GN

3 types? dz’s?

A

Nephritic Syndrome w/cresents of Fibrin + macrophages.

  1. Linear IF = GOODPASTURES = Ab to A3 of T4collagen = lungs and kidney
  2. Granular: PSGN, SLE GN
  3. Paui-Immune: Wegners, MPAN, Churg Strauss
23
Q

Alport Syndrome

A

Nephritic Syndrome, XL def in T4 collagen, ocular, hearing loss, basket weave BM

24
Q

IgA Nephropathy(Berger dz)

A

Nephritic Syndrome, IgA depo, episodic, usually follows URTI

25
Q

henoch Schonlein Purpura

A

Nephritic Syndrome, systemic IgA depo, w/rash, purpura, etc

26
Q

When would you see OXALATE CRYSTALS? how do you treat this?

A

seen in suicidal ppl who ingest antifreeze(ethylene glycol)

tx: FOMEPIZOLE + dialysis + NaHCO2(correct acidosis)

27
Q

Hepatorenal syndrome

dx? tx?

A

RF due to Liver failure = vasoconstriction of affarent arteriol causing decrease in perfusion.

dx: 1.5L colloid = no change
tx: octreotide, Midodrine, tx cause

28
Q

RTA T1

ph? assoc?

A

pH>5.5 , Stones, impaired H+ excretion in distal tubules, bicarb <10

29
Q

RTA T2

ph? assoc?

A

Impaired HCO3 resorb in prox tubule, pH<5.5, Bone probs/pains, bicarb 12-20

30
Q

RTA T4

ph? assoc?

A

decrease aldo or aldo resistance, pH <5.5, no bones, no stones, elevated K, >17 bicarb

31
Q

Acute Tubular Necrosis(ATN)

tx? sx?

A

tubular dmg due to decrease perfusion causing inflammation = PGI2 causes ischemia = cell apop = no NaK pump!

sx: muddy casts, increased K, decreased Na, eleved U-Na, Low osm
tx: hydration + support

32
Q

Acute/Allergic Interstitial Nephritis(AIN)

sx? tx?

A

allergy/irritation to somthing = wks of drug exposure, or infection

sx: 80% ppl have rash + fever, eosinophilia, WBC casts, Proteinuria, elevated IgE
tx: hydration + stop drug

IM MedEd (24 decks)

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