Nephro Flashcards
Anion gap calculation:
Na - (Cl + HCO3)
How do you calculate a FENa? What does a FENa of > 1 indicate?
=[(uNa x PCr)/(pNa x uCr)] x 100
>intrinsic causes of renal failure
Osmolality calculation:
=2(Na) + (BUN/2.8) + (glucose/18)
How do you calculate a urine anion gap?
=Na + K - Cl
What is nephrotic range proteinuria?
3.5g/day
What are the causes of normal AG metabolic acidosis?
Rta Diarrhea Adrenal insufficiency Meds (acetazolamide) Normal saline, TPN GI- fistulas, ileostomy
- UAG > 0 indicates RTA
AG metabolic acidosis causes:
Methanol Uremia DKA Paraldehyde, formaldehyde Iron, ischemia, infection Lactic acidosis Ethylene glycol Salicylates, starvation
What metabolic changes occur with ethylene glycol ingestion?
High gap acidosis. Calcium oxalate crystals in urine.
Causes of metabolic alkalosis:
GI losses: NG, vomiting, antacids Renal losses: loop/HCTZ, 1 mineralcorticoid (cushings, hyperaldosteronism) Alkali administration: citrate, acetate Volume contraction: diuresis, laxative Intra cellular H+ shift 2/2 hypokalemia
4 causes of persistent asymptomatic hematuria:
Idiopathic hypercalciuria
IgA nephropathy
Thin basement membrane disease
Alport syndrome
How are complement levels affected in APSGN?
C3 low, C4 normal. C3 normalizes in 6-8 weeks
For MPGN what will happen to C3?
It will be persistently decreased. This, presence of nephrotic syndrome, and lack of strep findings will distinguish it from PSGN.
What is the main treatment for MPGN?
Prolonged course of steroids
What lab test is positive is wegners granulomatosis?
C-ANCA
What lab test is positive in microscopic polyarteritis?
P-ANCA
What is churg Strauss syndrome?
Autoimmune vascular is characterized by allergic asthma, eosinophilia with GN and st other organ damage
What vaccine is recommended for children with nephrotic syndrome?
Strep pneumococcus vaccine
Where are the most common sites for thrombotic event in a child with nephrotic syndrome?
Renal vein and Sagittal sinus
What are the findings of Alport syndrome?
Hematuria -> proteinuria, HTN, renal failure. Sensorineural deafness, lenticonus, perimacular pigment
How is benign familial hematuria transmitted?
AD
What classic findings are associated with ARPKD and ADPKD?
ARPKD- hepatic fibrosis
ADPKD- berry aneurysm of circle of Willis
What is Laurence-moon-bardet-biedl syndrome?
Obesity, retinitis pigmentosa, hypogenitalism, polydactyly, MR, cystic dysphasia of kidneys
Xray findings in medullary sponge kidney? Pyelo gram?
Xray- calcifications
Pyelo gram- linear striations
Lab findings and causes of type 1 RTA:
Hypokalemic, non acidic urine > 6, hypercalciuria-> renal stones. Amphotericin B, SLE, lithium, glue sniffing, chronic hepatitis
