Nephro Flashcards
Urine dipstick technology only detects albumin excretion of this rate
> 300-500 mg/24 h
Definition of abnormal urine protein-creatinine ratio
> 0.2 mg/mg
Condition associated with broad, muddy brown casts in urine
Acute tubular necrosis
Formula for urine anion gap
(Na + K) - Cl
Normal: 30-50 meq/L
A large negative urine anion gap points to this origin of metabolic acidosis
Extrarenal
A delta-delta value <1 is suggestive that the anion gap acidosis is accompanied by this condition
Normal-anion gap acidosis
Expected ratio between the change in anion gap and change in plasma bicarbonate (delta-delta)
1-2
A delta-delta value >2 is suggestive that the anion gap acidosis is accompanied by this condition
Metabolic alkalosis
Normal plasma osmolal gap
10 mosm/kg H2O
Most common cause of alcohol poisoning
Ethanol
Osmolal gap in alcohol poisoning
High
Diagnosis: alcohol poisoning with somnolence or coma and normal acid-base homeostasis
Isopropyl alcohol
Tx: IV fluids and gastric lavage if mild; hemodialysis if with hypotension/shock
Diagnosis: alcohol poisoning with severe anion gap metabolic acidosis, acute visual symptoms, and severe abdominal pain
Methanol (pancreatitis and retinal toxicity)
Tx: fomepizole and hemodialysis
Diagnosis: alcohol poisoning with severe anion gap metabolic acidosis and acute kidney injury
Ethylene glycol
Tx: fomepizole and hemodialysis
Diagnosis: alcohol poisoning with anion gap metabolic acidosis and ketoacidosis
Ethanol
Tx: IV normal saline and glucose for alcoholic ketoacidosis
Cause of pseudohyponatremia
Severe hyperlipidemia or hyperproteinemia
Most common osmotically active substance that causes hypertonic hyponatremia
Glucose
Most common form of hyponatremia
Hypo-osmolar hyponatremia
Diagnosis: hypo-osmolar hyponatremia with hypovolemia, hypotension, and a neurosurgical procedure or subarachnoid hemorrhage within the previous 10 days
Cerebral salt wasting syndrome
Treatment for asymptomatic outpatients with SIADH who do not respond to fluid restriction
Demeclocycline
IV V1 and V2 receptor antagonist approved for treatment of euvolemic or hypervolemic hyponatremia
Conivaptan
Oral V2 receptor antagonist approved for treatment of euvolemic and hypervolemic hyponatremia
Tolvaptan
Most common cause of nephrogenic diabetes insipidus
Lithium
Treatment for neurogenic (central) diabetes insipidus
Desmopressin
Test to confirm pseudohyperkalemia
Plasma potassium concentration
Most common cause of medication-induced AKI
Aminoglycosides
Formula for FE(Na)
(Urine Na / Serum Na) x 100
Intravesical pressure in abdominal compartment syndrome
> 20 mmHg
Target hemoglobin levels with erythropoitein therapy for CKD
10-11 g/dL
A calcimimetic that is approved for treatment of secondary hyperparathyroidism in dialysis patients
Cinacalcet
Most steroid-sensitive glomerular disease
Minimal change disease
Most common cause of idiopathic nephrotic syndrome in white Americans
Membranous nephropathy
Most common cause of idiopathic nephrotic syndrome in black Americans
Focal segmental glomerulosclerosis
Most common condition associated with “Maltese cross” fat droplets in urine
Nephrotic syndrome
Treatment for progressive IgA nephropathy
Corticosteroids or mycophenolate mofetil
Most common causes of pulmonary-renal syndromes (3)
Wegener granulomatosis, Goodpasture syndrome, SLE
Metabolic finding that suggests type 1 (distal) RTA as opposed to types 2 and 4
Urine pH >5.5
Metabolic finding that suggests proximal (type 2) RTA as opposed to types 1 and 4
Normal urine anion gap
Metabolic finding that suggests type 4 RTA as opposed to types 1 and 2
Hyperkalemia
High-risk medical illnesses associated with nephrolithiasis (2)
Crohn disease, ileostomy
High-risk medications associated with nephrolithiasis (2)
Indinavir, acetazolamide
Gold standard for diagnosis of nephrolithiasis
Noncontrast helical CT
Drug that reduces ureteral edema to facilitate stone passage
Corticosteroids
Drugs (2) that induce ureteral dilation and relaxation to facilitate stone passage
Nifedipine and tamsulosin
ADPKD is caused by a mutation on the PKD1 gene on this chromosome
Chromosome 16
Diagnostic test of choice for ADPKD
Kidney ultrasonography
Empiric treatment for infected renal cysts
Fluoroquinolone or trimethoprim-sulfamethoxazole
