Nephro

Question 1

presents with hypovolemia and hyponatremia with high urine sodium, but always occurs due to neurologic insult (injury/sx)

Answer 1

Cerebral salt wasting

Question 2

in prevention of renal calcium stone recurrence, what is the mechanism of thiazide diuretics

Answer 2

inc renal calcium reabsorption

Question 3

in prevention of renal calcium stone recurrence, what is the mechanism of potassium citrate

Answer 3

inc urinary citrate concentration

Question 4

dietary interventions for all renal calcium stones

Answer 4

inc fluid
dec sodium (⬆️ renal calcium reabsorp)
inc citrate (binds urinary calcium)
inc potassium (⬆️ urinary citrate excretion
dec animal protein (⬇️ urinary calcium exc

Question 5

marker of skeletal muscle damage and its serum elevation (>1000U/L) confirms the diagnosis in the appropriate clinical setting

Answer 5

creatine phosphokinase

Question 6

types of diabetes insipidus and their responsiveness to exogenous ADH (DDAVP)

Answer 6

central DI: ✅ responsive
nephrogenic DI : ❎ ineffective

Question 7

Type of AKI with BUN:Crea ratio >20:1

Answer 7

Prerenal and postrenal azotemia

Note: for <20:1 : ATN

Question 8

initial diagnostic test for rhabdomyolysis

Answer 8

urinalysis (altho shows positive only on dipstick for large amts of bloood)

Note: most specific diagnostic test is URINE TEST FOR MYOGLOBIN

Question 9

treatment for rhabdomyolysis

Answer 9

saline hydration and mannitol

• increase urine flow rates, decreasing contact time between myoglobin and tubular cells

Question 10

lab finding u expect in contrast media induced ATN (rapid onset rise in crea - within the next day)

urine Na?
FENa?
urine spec gravity?

Answer 10

exactly opposite with other forms of ATN:

urine Na: VERY LOW (i.e. 5 meq/L)
FENa <1%
urine sp.gr. VERY HIGH

Note: pathophysio is due to spasm of afferent arteriole that leads to renal tubular dysfunction > tremendous resorption of Na and H2O