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From Flashcardlet > MKSAP: Nephrology > Flashcards

MKSAP: Nephrology Flashcards

0
Q

What are dysmorphic erythrocytes associated with when they are found in urine sediments?

A

-glomerular hematuria

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1
Q

What are monomorphic or intact erythrocytes characteristic of when found in urine sediments?

A

-nonglomerular hematuria

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2
Q

What classifies as ACEi-induced prerenal acute renal failure? Tx?

A
  • increase of creatinine >30% after the initiation of an ACEi or ARB (less than 30% is tolerable, an increase in creatinine is expected with these drugs)
  • tx: stop the ACEi or ARB
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3
Q

In what kidney disease are ACEi contraindicated? Why?

A
  • bilateral renal artery stenosis bc in these pts the GFR is maintained by an angII-induced vasoconstriction at the efferent arterioles
  • *switching to an ARB will NOT solve this problem!
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4
Q

What rash is characteristic of atheroembolic acute renal failure?

A
  • fine reticular rash, livedo reticularis

- red, lacy rash

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5
Q

How long after an arterial catheter can atheroembolic acute renal failure occur?

A

-1-4 weeks afterwards

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6
Q

Tx and prognosis of atheroembolic acute renal failure?

A

-no tx and the renal function does not usually return

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7
Q

Mechanism for how NSAIDs can cause prerenal acute renal failure?

A

-inhibition of prostaglandin synthesis causes vasoconstriction –> decreased glomerular capillary pressure –> acute renal failure

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8
Q

Abdominal pain and an increasing creatinine level in an elderly man?

A

-consider acute renal failure caused by urinary tract obstruction

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9
Q

4 Characteristics of hypertensive nephrosclerosis?

A
  1. HTN
  2. Non-nephrotic proteinuria
  3. Bland urine sediments
  4. Slowly progressive loss of kidney function
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10
Q

Classic triad of sx for acute interstitial nephritis?

A
  1. Fever
  2. Rash
  3. Arthralgias
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11
Q

Dipstick-positive hematuria, but no intact eyrthrocytes on microscopic analysis of urine sediments?

A

-think: rhabdomyolysis-associated acute renal failure

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12
Q

Muddy brown casts?

A

-acute tubular necrosis

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13
Q

5 Characteristics of acute glomerulonephritis?

A
  1. HTN
  2. Edema
  3. Proteinuria
  4. Glomerular hematuria
  5. Erythrocyte casts in urine
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14
Q

What type of casts are seen in acute interstitial nephritis?

A

-leukocyte casts

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15
Q

4 Characteristics of nephrotic syndrome?

A
  1. Urine protein excretion > 3.5 g/day
  2. Hyperlipidemia
  3. Hypoalbuminemia
  4. Edema
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16
Q

Which comes first diabetic retinopathy or nephropathy?

A

-retinopathy!

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17
Q

C3 and C4 levels in postinfectious glomerulonephritis?

A
  • low C3

- normal C4

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18
Q

C3 and C4 levels in SLE nephritis?

A

-C3 and C4 will be really low!

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19
Q

Glomerular nephritis + alveolar hemorrhage?

A

-Goodpasture’s syndrome

20
Q

Which pathogen is associated with HUS?

A

-E. Coli O157:H7 shiga toxin

21
Q

4 Characteristics of multiple myelomma?

A
  1. Calcium is elevated
  2. Anemia
  3. Renal failure
  4. Bone lesions
    * *“CRAB”
22
Q

Common cause of nephrotic syndrome in children and adults?

A

-minimal change disease

23
Q

5 Characteristics of minimal change disease?

A
  1. Edema
  2. Hypoalbuminemia
  3. Hyoercholesterolemia
  4. Urine protein excretion of >3.5 g/24hrs
  5. Numerous oval fat bodies in urine –> “ maltese cross”
24
Q

Oval fat bodies in urine?

A

-hallmark of proteinuria

25
Q

4 Characteristics if Wegener’s granulomatosis?

A
  1. Upper respiratory dz
  2. Lower respiratory dz
  3. Glomerulonephritis
  4. C-ANCA
26
Q

Best screening test for diabetic nephropathy?

A

-measurement of microalbumin

27
Q

Winter’s formula?

A

-Expected PCO2 = 1.5*[HCO3-]+ 8

+/-2

28
Q

Anion Gap formula?

A

= [Na+] - ([Cl-] + [HCO3-])

29
Q

Normal anion gap

A
  • = 6-11
30
Q

Low anion gap? Common cause?

A
  • less than 6

- hypoalbuminemia

31
Q

Decreased pH and bicarb?

A

-metabolic acidosis!

32
Q

Primary metabolic acidosis plus a PCO2 higher than expected?

A

-mixed metabolic and respiratory acidosis

33
Q

Formula to calculate osmolality?

A

2*[Na]+[glucose]/18+[BUN]/2.8

-normal gap < 10

34
Q

Osmolar gap?

A
  • difference btwn the calculated and measured osmolality

- normal < 10

35
Q

What does an elevated osmolar gal mean? Common causes?

A
  • means there is a presence of an unmeasured osmole

- causes: ethylene glycol or methanol

36
Q

3 features of ethylene glycol poisoning?

A
  1. Elevated Anion gap metabolic acidosis
  2. Elevated osmolar gap
  3. Calcium oxalate crystals in urine
37
Q

Acetazolamide: what is it? What acid/base disturbance can it cause? Why?

A
  • carbonic anhydrase inhibitor

- can cause a non-ion gap metabolic acidosis –> prevents the reabsorption of bicarb in the proximal tubule

38
Q

What acid/base disturbance often develops in a pt with ESLD? Why?

A
  • respiratory alkalosis
  • the liver normally metabolizes steroid hormones, the elevated prostaglandin levels in ESLD cause a stimulation of the respiratory drive –> primary resp alkalosis
39
Q

Common cause of mixed anion gap metabolic acidosis and respiratory alkalosis?

A

-salicylate toxicity

40
Q

What is the normal response to a fluid deprivation test?

A

-increasing urine osmolarity

41
Q

What electrolyte abnormality can be caused by ACEi? What drug should be used instead in these pts?

A
  • hyperkalemia

- instead use: hydralazine/nitrate combo to control the BP

42
Q

What electrolyte imbalance can occur in a pt taking hydrochlorothiazide

A

-hyponatremia

43
Q

General characteristic of SIADH?

A

-patient is unable to make dilute urine

44
Q

What electrolyte imbalance does sarcoidosis cause? Why?

A
  • hypercalciuria and hypercalcemia
  • the granulomatous tissue can produce 1-alpha-hydroxylase –> converts 25-hydroxyvitamin D to the active form, 1-25-dihydroxyvitamin D3 –> more absorption of calcium via vit D toxicity
45
Q

Electrolytes in primary hyperparathyroidism?

A
  • elevated serum calcium
  • low phosphorus
  • elevated hypercalcemia
46
Q

What can hypomagnesium in pts with alcoholism mimic? Why?

A
  • can mimic hypoparathyroidism with hypocalcemia
  • hypomagnesium can cause suppression of parathyroid hormone secretion and resistance to PTH action
  • so magnesium needs to be corrected in order to correct the calcium
47
Q

Why does hypomagensium occur in alcoholics?

A

-acute alcohol ingestion induces magnesium loss via urine

From Flashcardlet (79 decks)

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