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ECOS III Final > Nephrolithiasis, Pyelonephritis, AKI > Flashcards

Nephrolithiasis, Pyelonephritis, AKI Flashcards

1
Q

What is the presenting chief complaint for nephrolithiasis?

A

flank pain/groin pain, N/V, inheritable/recurrent

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2
Q

What is the presenting chief complaint for pyelonephritis?

A

flank pain/abd pain, fever/chills, N/V

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3
Q

What is the presenting chief complaint for AKI?

A

asx, decreased urine output, fatigue, SOB/CP, N/V

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4
Q

What are the sympathetics for the GU tract (includes bladder)?

A

T10-L2

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5
Q

What are the sympathetics for the upper ureter?

A

T10-11

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6
Q

What are the sympathetics for the lower ureter?

A

T12-L2

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7
Q

What are the parasympathetics for the upper ureter?

A

OA, AA - vagus N

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8
Q

What are the parasympathetics for the bladder and lower ureter?

A

S2-4

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9
Q

What is the chapmans point for the kidney?

A

1 in lateral and superior to the umbilicus

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10
Q

What is the chapman point for the ureters?

A

none

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11
Q

what is the chapman point for the bladder?

A

umbilicus

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12
Q

AIN is inflammation between the tubules and often a reaction to what?

A

Drugs such as NSAIDs, Abx, PPIs, diuretics

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13
Q

What BUN Cr ratio suggests pre-renal azotemia?

A

20:1

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14
Q

What is FeNa?

A

determines if the nephrons retain the ability to concentrate urine; can differentiate between ATN and pre-renal azotema

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15
Q

FeNA of <1% suggests what?

A

tubules are intact; pre-renal azotemia

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16
Q

FeNa >2% suggests what?

A

damaged tubules; ATN

17
Q

What is the gold standard for kidney imaging?

A

non constrast CT abd and pelvis

18
Q

What are the Ddx to rule out for nephrolithiasis?

A

pyelonephritis, abd organ pathology, ectopic pregnancy

19
Q

What initial labs/imaging should be performed for nephrolithiasis?

A

BMP or CMP, UA, beta-hCG (if female) –> non contrast CT if negative but if positive order US

20
Q

What are the expected lab/imaging results for nephrolithiasis?

A

Negative BMP +/- elevated BUN/Cr, UA + microscopic blood, - nitrites/leukocyte esterase, non contrast CT + for stone

21
Q

What DDx need to be ruled out for pyelonephritis?

A

nephrolithiasis, abd organ pathology, ectopic pregnancy, STIs

22
Q

What is the initial labs/imaging for pyelonephritis?

A

BMP or CMP, CBC, UA with culture, beta hCG if female, STI panel

23
Q

What are the expected lab results for pyelonephritis?

A

BMP negative +/- elevated BUN/Cr, CBC + leukocytosis, UA + nitrites and leukocyte esterase, culture + likely E coli, abx sensitivities, STI panel negative

24
Q

What Ddx need to be ruled out for pre-renal AKI?

A

intrinsic, post renal, CKD

25
Q

What initial labs/imaging should be performed for pre-renal AKI?

A

BMP or CMP, CBC, UA with microscopy w/ or w/o FeNa, +/- US

26
Q

What are the expected lab results for pre-renal AKI?

A

BMP + 20:1 BUN Cr, CBC -, UA specific gravity >1.030, FeNa <1%, microscopy hyaline casts, US no hydronephrosis or atrophy

27
Q

What are the Ddx to rule out for intrinsic tubular AKI (ATN)?

A

pre-renal, post renal, CKD

28
Q

What are the initial labs/imaging that should be done intrinsic tubular AKI (ATN)?

A

BMP or CMP, CBC, UA with microscopy with or wo FeNa, +/- US

29
Q

What are the expected lab results intrinsic tubular AKI (ATN)?

A

BMP + elevated BUN/Cr, UA microscopy shows tubular epithelial cells (granular casts), FeNa >2%

30
Q

What Ddx need to be ruled out for intrinsic interstitial AKI (AIN)?

A

pre-renal, post renal, CKD

31
Q

What labs/imaging should be done for intrinsic interstitial AKI (AIN)?

A

BMP or CMP, CBC, Ua with microscopy w or wo FeNa, +/- US

32
Q

What are the expected lab results for intrinsic interstitial AKI (AIN)?

A

BMP + elevated BUN/Cr, CBC showing eosinophilia, UA leukocytosis, microscopy WBC casts

33
Q

What Ddx need to be ruled out for glomerulonephritis?

A

pre-renal, intrinsic, post renal, CKD

34
Q

What labs/imaging should be done for glomerulonephritis?

A

BMP or CMP, CBC, UA with micropscy w or wo FeNA, +/- US

35
Q

What are the expected lab results for glomerulonephritis?

A

BMP + elevated BUN Cr, UA hematuria and proteinuria, microscopy RBC casts

36
Q

What Ddx need to be ruled for post-renal AKI?

A

pre-renal, intrinsic, CKD

37
Q

What labs/imaging should be performed for post-renal AKI?

A

BMP or CMP, CBC, Ua with microscopy w or wo FeNa, +/- US

38
Q

What are the expected results for post-renal AKI?

A

BMP + elevated BUN/Cr, US shows hydronephrosis

ECOS III Final (14 decks)

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