Lecture 3

Question 1

Long-term autoimmune disorder that may affect the skin, joints, kidneys, brain, and other organs.
Body’s immune system mistakenly attacks healthy tissue, leading to long-term (chronic) inflammation.
MC in AA and asians

Answer 1

SLE, malar rash

Question 2

how to dx lupus nephritis

Answer 2

bx

Question 3

pheo triad

Answer 3

Headache, palpitations, and diaphoresis

Question 4

best imaging to detect a pheo

Answer 4

CT

Question 5

suspect in pts with HTN, hypokalemia, alkalosis

Answer 5

hyperaldosteronism

Question 6

aldosterone > 20 ug indicates

Answer 6

hyperaldosteronism

Question 7

hypertensive emergency

Answer 7

SBP > 180, DBP > 120, resulting in end organ damage

reduce by no more than 25%

Question 8

hypertensive urgency

Answer 8

AKA Hypertensive crisis

SBP > 180, DBP > 120 without acute organ dysfunction

Question 9

Seen in Pts with Prolonged HTN >150/90 but not in the malignant phase
Usually older Pts

Answer 9

benign arteriolar nephrosclerosis

Question 10

2 MC forms of RAS

Answer 10

Artherosclerotic ischemic renal disease
Fibromuscular dysplasia (young women)

Question 11

“Horse-shoe kidney”

Kidneys fuse across the midline usually at the lower poles

Answer 11

renal fusion

Question 12

Presents early in life
Associated with Oligohydraminos
Can be seen with Potter’s facies

Answer 12

autosomal recessive PCKD

Seen with abnormality of the short arm of chromosome 16 and 4

Question 13

“Hereditary nephritis”
Familial disease
Associated with Hearing Loss before age 30
Male X linked dominant trait

Answer 13

Alport’s syndrome

Question 14

M/C cancer of the kidneys
M/C tumor type
M/C bladder cancer

Answer 14

RCC
clear cell
transitional cell

Question 15

nrl PSA

Answer 15

<4

increse of >0.75 per year indicates aggressive

Question 16

issues with PSA

Answer 16

PSA increases with time
Cannot differentiate between slow and aggressive cancers
Snow ball effect. Often leads to more invasive and expensive work-ups / treatments

Question 17

androgen deprivation tx for prostate cancer

Answer 17

lupron

Question 18

kidney cancer of kids

Missing iris, urinary tract problems and hemihypertrophy are congenital anomolies associated

Answer 18

Wilm’s tumor

Question 19

fluid retention
serum hypoosmolality
dilutional hyponatremia
concentrated urine in the presence of normal or increased intravascular volume
normal renal function

Answer 19

SIADH

Question 20

what is happening with SIADH

Answer 20

ECF volume expands, plasma osmolality declines and GFR increases
Sodium levels decline(dilutional hyponatremia)

Question 21

how to dx SIADH

Answer 21

Diagnosis of SIADH is made by simultaneous measurement of urine and serum osmolality
serum osm is lower than urine osm

Question 22

how to tx SIADH

chronic SIADH

Answer 22

fluid restriction, hypertonic saline

declomycin

Question 23

central DI

Answer 23

ADH deficiency

low urine osm, high serum osm

Question 24

how to determine central vs nephrogenic DI

Answer 24

Administering ADH is diagnostic (if kidneys respond and urine output drops= central DI. If no decrease in UO= nephrogenic DI)

Question 25

how to tx DI

Answer 25

fluids/electrolytes
vasopressin
DDAVP long term

Question 26

indications for dialysis

Answer 26

Volume expansion that cannot be controlled by diuretics
Hyperkalemia refractory to medication
Severe acid-base imbalances refractory to medication
Severe azotemia (BUN > 80-100), uremia,
Seizure/coma
CC <10 and serum Cr >9

Question 27

Short term treatment used in ICU patients with acute or chronicrenal failure, more frequently used for Acute

Answer 27

CVVH

Question 28

Vascular Insufficiency resulting from AVF (fistula) or AVG

Answer 28

steal syndrome

decreased wrist-brachial index