Nephro/Urology

Question 1

what is acute renal failure

Answer 1

is a syndrome of rapidly deteriorating GFR with accumulation of (Urea,Creatinine) referred to azotemia
serum creatinine rises .5mg/dl or more than 50% over baseline

Question 2

what two disease cause ARF or AKI

Answer 2

reduced renal perfusion or actue tubular necrosis

Question 3

what are clinical features of ARF

Answer 3

nausea, vomiting, diarrhea, pruritus, drowsiness, dizziness, SOB
distended bladder, CVA tenderness, enlarged prostate

Question 4

what is GFR

Answer 4

is a key parameter to measure renal function, serum creatinine or blood urea nitrogen is less reliable

Question 5

BUN

Answer 5

provides an estimate of renal function but is more sensitive to dehydration, catabolism, diet, renal perfusion and liver disease

Question 6

what are prerenal causes for ARF

Answer 6

hypovolemia
hypotension (systolic BP less than 90mmHg
CHF,Cirrhosis, nephrotic syndrome, early sepsis
Aortic aneursym
Renal Artery stenosis
decreased renal perfusion from NSAID, ACE

Question 7

intrinsic causes of ARF

Answer 7

ATN, Nephrotoxins (NSAID, Aminoglycosides

SLE, Polyarteritis nodosa

Question 8

post renal causes

Answer 8

tubular obstruction

urolithiasis, BPH, bladder outlet obstruction

Question 9

what does a prerenal 
UA, BUN/CR
FENa
Urine Osmolality 
urine sodium

Answer 9

Hyaline casts
BUN/CR >20:1
FENa500mOsm
Urine Sodium

Question 10

what does a intrinsic 
UA, BUN/CR
FENa
Urine Osmolality 
urine sodium

Answer 10

abnormal casts
BUN/CR 2-3%
250-300mOsm
urine sodium>40

Question 11

what do RBC indicate

Answer 11

glomerular disease

Question 12

what do WBC cast indicate

Answer 12

renal parenchymal inflammation

Question 13

what do muddy brown casts indicate

Answer 13

ATN

Question 14

what is the most common cause of CKD

Answer 14

diabetes

Question 15

what is CKD

Answer 15

loss of kidney function (GFR)

Question 16

CKD1 GFR

Answer 16

kidney damage with normal or increased GFR>90

Question 17

CKD2 GFR

Answer 17

kidney damage with 60-89 GFR

Question 18

CKD3 GRF

Answer 18

30-59

Question 19

ckd4

Answer 19

15-29

Question 20

ckd 5

Answer 20

GFR

Question 21

lab findings with CKD

Answer 21

Elevated BUN
Elevated Cr
Hyperkalemia
Hyperphosphatemia
Hypocalcemia
Metabolic acidosis

Question 22

what are the most common causes of CKD

Answer 22

DM, HTN, hlomerulonephritis and PKD

Question 23

treatment of CKD

Answer 23

ACE and ARBs slow progression of disease
managing co-morbid condition like DM or HTN
Erythropoetin and iron to maintain Hgb
Dietary management( restrict protein intake, calcium and Vit D supplements

Question 24

what is glomerularnephritis

Answer 24

refers to damage of the renal glomeruli by deposition of inflammatory protein in the glomerular membranes as the result of an immunologic response

Question 25

when is glomerular nephritis most common

Answer 25

2-12yrs

Question 26

what are clinical features of glomerularnephritis

Answer 26

hematuria and tea colored urin
oligouria or anuria is present
edema of the face and eyes is present in the morning and edema of the feet and ankles

Question 27

lab findings

Answer 27

ASO titer is increased in 60-80% should be considered of a recent streptococcal infection
UA shows >3RBC/HPF
red blood cells will be misshaped acanthocytes
Renal biopsy to determine exact diagnosis or severity of the disease

Question 28

what is the treatment for glomerularnephritis

Answer 28

steriods and immunosuppressive drugs for PSGN
Salt and fluid intake should be decreased
dialysis for symptomatic azootemia
ACE