nephro Flashcards
ATN
drugs vs contrast
- Constras its instant(PRERENAL lab valued on Na and osmolarity with ATN BUN:creatinite relation)
- —BUN:Cr(
ATN
asossiated drugs
vancomycin aminoglycosides cisplatin acyclovir cyclosporine amphotericin
hepatorenal labs
prerenal azoemia
- BUN/cre(>20:1)
- FeNA500 mOsm/kg
contrast induced Lab values
BUN/Cr
AIN drugs
Penicillins Sulfas phenytoin PPI Rifampin quinolones allopurinol
fever
hematuria
sudden onset of flank pain
NSAID use antecedent
papillary necrosis
TTP association
HIV cancer cyclosporine ticlopidine clopidogrel
TTP treatment
plasmapheresis
if not present give FFP
DO NOT GIVE STEROIDS OR PLATELETS
psychogenic polydipsia assiation
bipolar disorder
SIADH sx Treatment
asymptomatic
confusion:
normal saline + DIURETIC
hyperkalemia . best next step?
do EKG if EKG changes give -Ca gluconate -Ca chloride -insuline
persistent WBC on UA with negative culture…
can be TB
useful to detect eosinophils in urine
Wright and Hansel
-the answer for allergic interstitial nephritis
Hematuria DDX
- stones
- hematologic disorders
- infection
- cancer
- treatment(cyclophosphmide)
- trauma
- GLOMERULONEPHRITIS
dysmorphic red cells
GLOMERULONEPHRITIS
hematuria with out infection or trauma
DO a Cystoscopy ( for cancer exclusion)
retroperitonela fibrosis
bleomycin,methylsergide or radiation
POSTRENAL AZOEMIA
most common cause of intrinsic renal disease
ATN
- NSAID(MOST COMMON)
- aminoglycoside,amphotericin
- cisplatin, cyclosporine.
enlargement of the bladder and massive diuresis after foley
specific for urinary obstruction
best imagen test for AKI
Renal sonogram
Medication for renal failure prophilaxis PRIOR chemotherapy
- Allopurinol
- Rasburicase
- Hydratation
rhabdomyolysis
UA positive for blood cells,no cell will be seen on microscopic examination
hepatorenal syndrome treatment
midodrine
octreotide
albumin
most accurate test in papillary necrosis(pyelonephritis like but negative culture)
CT scan(abnormal internal structures)
most common cause of acute glomerulonephritis in USA
Berger Disease
nephrotic syndrome in cancer
membranous
nephrotic syndrome in injection and AIDS
focal-segmental
best initial test for DI
water deprivation test, the most accurate is ADH ADMINISTRATION TEST
hyponatremia(hypervolemia,euvolemia,hypovolemia)
with Hypervolemia
Cirrhosis
nephrosis
CHF
hyponaremia with hypovolemia
- pseudohyponatremia(hyperglycemia)
- psychogenic polydipsia(12-24 L/day)
- hypothyroidism
- SIADH
for every 100 of glucose above abnormal, there ir a …… decrease in sodium
1.6
mental disease associated with psychogenic polydiosia
bipolar disorder
if K does not correct …
check for hypoMg
nephrolithiasis
pass spontaneosly
stones7-7mm
nifedipine and tamsolusin
stones from 0.5cm to 3
lithotripsy
most effective lifestyle modification for hypertension
WEIGHT LOSS
best inital therapy for hypertensive crisis
Labetalol or nitroprusside
metabolic acidosis with hyperkalemia
RTA 4
dysmorphic or RBC cast
glomerular disease
alport syndrome most accurate test
SKIN biopsy
non anion gap hyperchloremic metabolic acidosis
look for a RTA
RTA type 1 cause
- amphotericina B
- analgesic nephropathy
- multiple myeloma
- obstruction of the urinary tract
RTA type 2 causes
-fanconi syndrome
