Nephrology Flashcards
Contrast-associated nephropathy prophylaxis for patients who have an estimated GFR < 30 or AKI
IV NS pre- and post-procedure
Initial step in the management of newly diagnosed membranous nephropathy
Evaluation for secondary forms of the disease, including cancer screening in patient’s > 65 years of age
Most appropriate treatment for myeloma cast nephropathy aimed at reducing the concentration of free light chains
Chemotherapy
Indications for kidney biopsy
1) glomerular hematuria
2) severely increase albuminuria
3) acute or chronic kidney disease
4) Kidney transplant dysfunction or monitoring
Initial therapy for severe preeclampsia
Magnesium, antihypertensive medication, immediate delivery of the fetus
Management for kidney stone > 10 mm
Removal, ie via lithotripsy
Indication for management of chronic hypertension in pregnant women
Persistent systolic > 160 mmHg or diastolic > 110 mmHg blood pressure in the absence of end-organ damage to avoid over treatment of hypertension and associated fetal risk
Management for symptomatic hypermagnesemia
Immediate treatment with IV calcium gluconate while awaiting HD
NAGMA + negative urine anion gap
GI loss (diarrhea)
Primary therapeutic intervention in most patients with renal artery stenosis
Medical management, including correction of modifiable cardiovascular risk factors
Initial management of hyperphosphatemia in CKD
Low phosphate diet
NAGMA, hypokalemia, glycosuria (without hyperglycemia), low-molecular-weight proteinuria, and renal phosphate wasting.
Type 2 (proximal) RTA
Most common form of nephrotic syndrome in black patients
Focal segmental glomerulosclerosis
likely mediated in large part by variants in the APOL1 gene
Bacteria associated with struvite crystals (coffin-lid appearance)
Urea-splitting organisms (Proteus, Klebsiella, Pseudomonas
Most appropriate management for lithium -induced nephrogenic DI
Amiloride
Blocks the epithelial sodium channel in the collecting tubule and prevents the uptake of lithium by these cells
Appropriate management for recurrent gross hematuria and URI in younger patients with IgA nephropathy in the absence of proteinuria
Clinical observation
Appropriate management for salicylate toxicity in an otherwise well-appearing patient
IV sodium bicarbonate
Definitive diagnostic test for lupus nephritis
Kidney biopsy
Calcifications in the dermal arterioles resulting in painful ischemic skin lesions and has an increasingly recognized complication of ESRD. Many patients have severe secondary hyperparathyroidism and elevated calcium-phosphorus product
Calciphylaxis (calcific uremic arteriolopathy)
Preferred initial agent for hypertension in black patients
Calcium channel blocker or thiazide diuretic
Appropriate management for adults with stage 1 hypertension (SBP 130-139 or DBP 80-89) who have an estimated 10-year ASCVD event risk of < 10%
Non-pharmacological therapy
Appropriate management for adults with stage 1 hypertension (SBP 130-139 or DBP 80-89) who have an estimated 10-year ASCVD event risk of > 10%
Nonpharmacological and antihypertensive drug therapy
Most effective treatment to facilitate the passage of uric acid stones
Urinary alkalinization with potassium citrate
Necrotizing and crescenteric glomerular nephritis with linear staining for IgG on immunoflorescence
Anti-glomerular basement membrane antibody disease
Chronic interstitial nephritis with fibrosis and dense lymphoplasmacytic infiltrates
IgG4-related kidney disease
Most appropriate management for acute tumor lysis syndrome
Isotonic fluids and rasburicase
Gold standard for diagnosis of kidney stones
Noncontrast helical CT of the abdomen and pelvis
Serum bicarbonate level in which metabolic acidosis should be treated with alkaline therapy in patients with CKD
< 22 mEq/L
Autosomal dominant type IV collagen abnormality that causes thinning of the GBM, resulting IN hematuria but usually without proteinuria or abnormal kidney function. Diagnosis can be made by kidney biopsy, although this is not usually required and the setting of a good clinical in family history
Thin glomerular basement membrane disease, a.k.a. benign familial hematuria
Serological testing which diagnosis primary membranous nephropathy
Anti-phospholipase A2 receptor (Anti-PLA2R)
Leading cause of death among patients with CKD
Cardiovascular disease
Electrolyte abnormality associated with ferric carboxymaltose, IV iron preparation
Hypophosphatemia caused by renal phosphate wasting
Appropriate management for primary hyperaldosteronism
Aldosterone receptor antagonist, such as eplerenone
Hepatitis virus associated with cryoglobulinemic glomerulonephritis
Hepatitis C virus
hypokalemic metabolic alkalosis and frequently hypomagnesemia and high-normal serum calcium levels
Gitelman syndrome
Most common etiology of immune complex MPGN
Hepatitis C virus infection
Management for infection-related glomerulonephritis
Supportive and aimed at the infectious etiology
Gold standard for pathologic diagnosis of amyloidosis
apple-green birefringence with congo red stain
Pharmaceutical management that can slow kidney function decline in adults at risk for progressive autosomal dominant polycystic kidney disease
Tolvaptan, blockade of the renin-aldosterone system
Resistant hypertension, metabolic alkalosis, hypokalemia
Primary hyperaldosteronism
Etiology of hypokalemia with PPI use
Hypomagnesemia
