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CLINICAL YR: Int Med > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

(from didactic lecture, Ahmad)

list five serum lab findings for assessing kidney function

A 
elevated Cr
increased BUN
acidosis (decreased serum bicarb)
hyperkalemia
hypO or hypERnatremia
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2
Q

(from didactic lecture, Ahmad)
what are some urinary lab findings on URINALYSIS that are NOT DIAGNOSTIC of AKI but provide clues in diagnosing etiology of kidney injury?

A

hematuria
proteinuria
crystals
cellular or tubular casts (different types)

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3
Q

(from didactic lecture, Ahmad)
what are some urinary lab findings in RBCs that are NOT DIAGNOSTIC of AKI but provide clues in diagnosing etiology of kidney injury?

A

dysmorphic RBCs
(or RBC casts)
proteinuria — glomerulopathy

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4
Q

(from didactic lecture, Ahmad)
what are some urinary lab findings on BLOOD DIPSTICK that are NOT DIAGNOSTIC of AKI but provide clues in diagnosing etiology of kidney injury?

A

positive dipstick for blood but absence of RBCs is suggestive of rhabdomyolysis

(the dipstick is detecting the globin parts, but there aren’t whole RBCs in the urine)

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5
Q

(from didactic lecture, Ahmad)
epi of AKI:
where in the renal system do most AKI injuries occur?

A

70% prerenal (in the community)

(hospital) HA-AKI were Pre-renal(42%)

[hospital continued: Post-Op (18%), Iodinated Contrast (12%), Medications( 7%)]

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6
Q

(from didactic lecture, Ahmad)
etiologies of pre renal AKI:
give two TRUE VOLUME DEPLETION reasons for pre renal AKI

A

extra renal losses
renal losses

extra renal = n/v/d
renal = overdiuresis, renal salt wasting, DI

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7
Q

(from didactic lecture, Ahmad)
etiologies of pre renal AKI:
give four EFFECTIVE VOLUME DEPLETION reasons for pre renal AKI

A

sepsis
cardiomyopathy
cirrhosis/hepatic insufficiency
nephrotic syndrome

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8
Q

(from didactic lecture, Ahmad)
etiologies of pre renal AKI:
give two reasons for pre renal AKI not related to volume depletion

A

structural renal artery/arteriolar disease (renal artery stenosis, arteriolonephrosclerosis)
altered intrarenal hemodynamics
(NSAIDs, calcineurin inhibitors, ACE inhibitors, ARBs)

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9
Q

(from didactic lecture, Ahmad)
etiologies of pre renal AKI:
whats the deal with ACE’s and ARBs?

A

ACE’s and ARBs have a reputation in ERs for causing kidney disease – but they do not lead to kidney injury, they have a kidney protective factor, but if there are other injuries (HTN, dehydration), they may add to kidney problems

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10
Q

(from didactic lecture, Ahmed)

prostaglandins

A

vasodilators

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11
Q

(from didactic lecture, Ahmed)

how do NSAIDs lead to pre renal AKI?

A

NSAID’s –> inhibits Prostaglandins (vasodilators) –> afferent vasoconstriction
(afferent = the arteriole entering the nephron)

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12
Q

(from didactic lecture, Ahmed)

what BUN creatinine ratio leads to diagnosis of pre renal AKI?

A

BUN Creatinine Ratio >20

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13
Q

(RoshReview)

What positive finding of salivary gland biopsy indicates Sjogren’s syndrome?

A

mononuclear cell infiltration

A salivary gland biopsy that shows mononuclear cell infiltration is diagnostic.

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14
Q

(RoshReview)

what is first and most important treatment of hyperkalemia?

A

calcium gluconate or calcium chloride

immediately administer calcium gluconate or calcium chloride to stabilize the myocardium and increase the cardiac threshold.

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15
Q

(RoshReview)

what is the second step of correcting hyperkalemia, after administering calcium gluconate or calcium chloride?

A

decrease serum potassium by redistributing potassium into the cells via
INSULIN
ALBUTEROL
SODIUM BICARBONATE

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16
Q

(PPP 444)

First step in treatment of hypercalcemia (>12 mg/dL)

A

IV fluids

17
Q

(PPP 444)

second step of correcting hypercalcemia (>12 mg/dL)

A

calcitonin and bisphosphonates

18
Q

(RR)

fun phrase for remembering problems associated with hypercalcemia

A

bones stones groans and psychiatric overtones

19
Q

(RR)

ECG findings of hypercalcemia

A

shortened QT interval

20
Q

(RR)

most common inpatient cause of hypercalcemia

A

malignancy

21
Q

(RR)

most common out patient cause of hypercalcemia

A

primary hyperparathyroidism

CLINICAL YR: Int Med (4 decks)

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