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Nephro > MTB 1 > Flashcards

MTB 1 Flashcards

1
Q

Ethylene Glycol Toxicity effect on kidney

A

Acute kidney injury
Oxalic acid and oxalate precipitate in tubule to cause ATN
Envelope shaped crystals
LOW Calcium (calcium oxalate)

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2
Q

NSAIDs and Ibuprofen cause what kidney damage

A

Acute interstitial nephritis

Papillary necrosis

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3
Q

Presentation of Papillary necrosis

A

Sudden flank pain

Fever

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4
Q

Opiates ass’d with what kidney damage

A

Focal Segmental Glomerulonephritis

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5
Q

What electrolyte disturbance increases risk of aminoglycoside or cisplatin toxicity

A

Low Magnesium

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6
Q

Bence Jones protein effect on kidney

A

Directly toxic to renal tubules

Death by RF and Infxn in Myeloma

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7
Q

What kind of crystals do we see in Crohn’s?

Why?

A

Oxalate

Fat malabsorption - fat stays in gut, binds to calcium, so oxalate can’t bind to calcium and we get oxalate crystals

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8
Q

Best initial test for rhabdomyolysis

A

UA

Positive on dipstick for large amts of blood, but no cells seen on microscope

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9
Q

Causes of rhabdomyolysis

A 
Crush Injury
Immobilization 
Snake bite
Trauma
SEizures
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10
Q

Labs in rhabdomyolysis

A

Markedly elevated CPK
Hyperkalemia
Hyperuricemia
Hypocalcemia

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11
Q

Most specific test for rhabdomyolysis

A

Urine test for myoglobin

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12
Q

TX for rhabdomyolysis

A

Saline hydration
Mannitol
Bicarbonate = drives K+ back into cells

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13
Q

Wrong answers for TX for ATN

A

Low dose dopamine
Diuretics
Mannitol
Steroids

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14
Q

Dialysis is answer when

A 
Fluid Overload
Encephalopathy 
Pericarditis
Metabolic Acidosis
Hyperkalemia
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15
Q

TX for hypocalcemia

A

Vitamin D + Calcium

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16
Q

Drugs that cause ototoxicity

Pathophys of ototoxicity

A

Furesomide, Gentamicin
Damages hair cells of cochlea - sensorineural hearing loss, burns inner ear
Aminoglycosides decrease trough for free period to prevent damage

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17
Q

Signs of hepatorenal syndrome

A 
Cirrhosis
New onset renal failure w no explanation 
Very LOW Urine Sodium < 10-15
FeNa < 1%
Elevated BUN/Cr > 20:1
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18
Q

TX for hepatorenal syndrome

A

Albumin
Midodrine - increase mean arterial pressure
Octreotide

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19
Q

What is Midodrine
MOA
Use

A

Pressor/Inotrope
Stimulates alpha 1 receptors
Constricts arterioles and veins = Increases peripheral resistance
Significant improvement of Supine BP

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20
Q

Atheroemboli - Cholesterol emboli in kidney presentation

A

Blue/purplish skin lesions in fingers and toes
Livedo reticularis
Ocular lesions

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21
Q

What is Livedo reticularis

A

Venule swelling caused by capillary obstruction by thrombi

“Blue fish net stocking”

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22
Q

What are peripheral pulses in Atheroemboli

A

Normal

Too small to occlude vessels

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23
Q

Labs in Atheroemboli

A

Eosinophilia
Low complement
Eosinophiluria
High ESR

24
Q

Most accurate diagnostic test for atheroemboli

A

BX of purplish skin lesions

25
Q

Acute/Allergic Interstitial Nephritis Definition

A

ARF damaging tubules

Abs and eosinophils attack cells lining tubules as rxn to drugs, infxn, AI dz

26
Q

Drugs that cause AIN

A 
PCNs
Cephalosporins
Sulfas
Phenytoin
Rifampin
Quinolones
Allopurinol
PPIs
27
Q

Presentation of AIN

A

Fever
Rash
Arthralgias
Eosinophilia + Eosinophiluria

28
Q

Most accurate test for AIN

A

Hansel or Wright stain - detects eosinophils

29
Q

TX for AIN

A

Resolves spontaneously - treat underlying cause

If Creatinine keeps rising after, admin glucocorticoids

30
Q

Best initial test for AIN

A

UA for eosinophils

31
Q

Pathophys of analgesic nephropathy

A

PG Inhibition (constriction at afferent arteriole) causes vascular insufficiency = decreased renal perfusion
ATN - directly toxic to tubules
Papillary necrosis

32
Q

Papillary Necrosis seen in

A

Underlying renal disease + NSAIDs

  • Sickle Cell
  • Diabetes
  • Urinary obstruction
  • Chronic Pyelonephritis
33
Q

Papillary Necrosis Presentation

A

Sudden onset flank pain
Fever
Hematuria

34
Q

Best diagnostic test for Papillary Necrosis

A

UA shows red and white cells

35
Q

Most accurate test for Papillary Necrosis

A

CT scan shows abnormal internal structures

36
Q

Chronic Pyelonephritis on IVP

A

Blunting of calices

Calyceal clubbing focal, parenchymal scarring

37
Q

CT scan of Papillary Necrosis

A

Bumpy contour (lost papillae)

38
Q

TX for Pyelonephritis

A

Abx

  • Amp/Gent
  • FQ’s
39
Q

Tests for Glomerular DZ

A 
UA w hematuria
UNa and FeNa= Low
Red cell casts
Proteinuria
Dysmorphic red cells
40
Q

Goodpasture Dz Presentation

A

Lungs and kidney
No = URT, skin, joint, GI, eye, or neuro
Anemia often present

41
Q

Goodpasture v Wegener

A

Goodpasture = No Upper respiratory tract involvement

Wegener =URT involvement

42
Q

Best initial test for Goodpasture

A

Antiglomerular BM Abs

43
Q

Most accurate test for Goodpasture

A

Lung or Kidney BX

- Kidney Bx = linear deposits

44
Q

TX for Goodpasture

A

Plasmapheresis + Steroids

45
Q

IgA Nephropathy
Aka?
Presentation?
Complement levels

A 
Berger Dz
Young, adult men
Asians
Recurrent gross hematuria 1-2 days post URI 
Normal Complement levels
46
Q

MCC of acute glomerulonephritis

A

IgA Nephropathy

47
Q

Post URI glomerulonephritis

A
  1. IgA Nephropathy = 1-2 days

2. Poststrep GN = post pharyngitis by 1-2 weeks

48
Q

Post strep GN Presentation
Test results
Labs

A

MC in children
High ASO +/-DNAase Abs for GAS
Subepithelial humps of C3
Low complement C3 levels

49
Q

Most accurate test for IgA Nephropathy

A

Kidney BX

IgA only elevated in 50%

50
Q

TX for IgA Nephropathy

A

No Tx to reverse

Severe proteinuria w ACE-I + Steroids

51
Q

Postinfectious GN Presentation

A

Dark urine (cola-colored)
Edema = periorbital
HTN
Oliguria

52
Q

Management of Postinfectious GN

A

Supportive

  • Abx
  • Diuretics
53
Q

Pathophys of Hepatorenal syndrome

A

Arterial Vasodilation of splanchnic circulation

Results in under filling of arterial circulation

54
Q

Pathophys of Atheroemboli

A

Cholesterol plaques near aorta/coronary arteries broken off during manipulation of vessels with catheterization
Lodge in kidney
Cause AKI

55
Q

Infxn that cause AIN

A 
Leptospira
Legionella
CMV
Rickettsia
Streptococcus
Hantavirus

Nephro (6 decks)

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