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ABR > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Respiratory compensation for metabolic acidosis

A

1.5 (HCO3) + 8

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2
Q

Respiratory compensation for metabolic alkalosis

A

40 + 0.7 (change in HCO3)

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3
Q

Metabolic compensation for respiratory acidosis

A

Acute: 1 for 10

Chronic: 4 for 10

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4
Q

Metabolic compensation for respiratory alkalosis

A

Acute: 2 for 10

Chronic: 5 for 10

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5
Q

Delta/delta

A

Change in AG / change in HCO3

> 2 = HAGMA + Met alk
< 1 = HAGMA + NAGMA
1-2 = HAGMA

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6
Q

Ketoacidosis with hyperkalemia

A

Euglycemic OR Diabetic

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7
Q

Ketoacidosis with low or normal K

A

Alcohol

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8
Q

NAGMA + low Ur Cl

A

RTA (+UAG)

Early kidney disease

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9
Q

NAGMA + high Ur Cl

A

Diarrhea (-UAG)

Ureterosigmoidostomy

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10
Q

Metabolic alkalosis with Ur Cl < 15

A 
Diuretics (remote)
Volume depletion 
Vomiting
NGT aspiration
Exogenous alkali
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11
Q

Metabolic alkalosis with Ur Cl > 15

A 
Diuretics
Recent high BP
Hyperaldosteronism
Cushing Syndrome
Licorice ingestion
Liddle’s syndrome

HypoMg
HypoK
Bartter syndrome
GItelman syndrome

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12
Q

Decreased transport defect in ascending LoH.
Similar to furosemide.
Metabolic alkalosis. HypoK. Low BP. UrCl > 15.

A

Barter syndrome

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13
Q

Decreased transport defect in distal tubule.
Similar to thiazides.
Metabolic alkalosis. HypoK. Low BP. UrCl > 15. Decreased Ur Uric Acid and Calcium

A

GItelman syndrome

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14
Q

Increased (aldosterone) transport defect in distal tubule.
Similar to hyperaldosteronism and licorice ingestion.
Metabolic alkalosis. HypoK. High BP. UrCl > 15.

A

Liddle syndrome

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15
Q

HAGMA + rectangular shaped Ca oxylate crystals

A

Ethylene glycol

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16
Q

Elevated OG w/o metabolic acidosis

A

Isopropyl alcohol

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17
Q

Respiratory alkalosis followed by metabolic acidosis

A

ASA toxicity

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18
Q

Urine anion gap

A

UrNa + UrK - UrCl

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19
Q

Acid-base disturbance in cirrhosis

A

Respiratory alkalosis

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20
Q

Defect in reabsorption of HCO3.
HypoK. +/- stones.
Ur pH <5.5 (steady state). > 5.5 (not steady state)
Fanconi, MM, acetazolamide, osteomalacia

A

Proximal Type II RTA

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21
Q

Defect in H & K excretion.
HyperK. Ur pH < 5.5. No stones
Hypoaldosteronism. DM.

A

Hypoaldosterone Type IV RTA

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22
Q

Defect in H excretion.
HypoK. Ur pH > 5.5. + Stones (CaPO4).
Sjogrens. SLE. Amphotericin B.

A

Classic Distal Type I RTA

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23
Q 
HyperNa
Low Ur Na
Low Ur Osm
No change post-H20 deprivation 
Inc in post-DDAVP Ur Osm
A

Central DI

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24
Q 
HyperNa
Low Ur Na
Low Ur Osm
No change post-H20 deprivation 
No change in post-DDAVP Ur Osm
A

Nephrogenic DI

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25
HypoNa Low Ur Na Low Ur Osm Inc in post-H20 deprivation and post-DDAVP Ur Osm
Psychogenic polydipsia | Beer potomania
26
HypoNa High Ur Na (**specific**) High Ur Osm
SIADH | Addison’s
27
HypoNa High Ur Na High Ur Osm Inc in post-DDAVP Ur Osm
Cerebral salt wasting
28
Management for acute symptomatic hyponatremia (mental status changes or seizures)
3% saline
29
Rate at which not to correct chronic hyponatremia
> 0.5 mEq/h Can lead to pontine myelinolysis
30
Management for volume depleted hyponatremia
0.9% NaCl
31
Best test to measure micoalbuminuria
Spot urine alb/urine Cr > 30
32
Management for extreme exercise-induced hematuria
Repeat UA in 6 weeks
33
Dysuria Painful intercourse Post-void dribbling
Urethral diverticulum
34
Cola-colored urine UA + RBCs, RBC casts Sore throat < 7 days ago
IgA nephropathy
35
Best management to preserve renal function in ADPKD
BP control Na < 2g Protein restriction
36
Collagen IV abnormality Renal failure Hearing loss
Alport syndrome
37
Fatty, oval body casts
Nephrotic syndrome
38
RBC casts | Dysmorphic RBCs
Nephritis
39
Muddy/brown casts | Pigmented granular casts
Acute tubular necrosis
40
WBC casts Granular casts Eosinophils
Interstitial nephritis
41
Effacement of epithelial foot processes Hodgkins, Leukemia, NSAIDs, Lithium, pamidronate
Minimal change disease
42
Effacement if epithelial foot processes African American, HIV, Heroin
Focal segmental glomerulosclerosis
43
Subepithelial deposits Thickened capillary loops Hep B/C, solid tumors
Membranous glomerulopathy
44
Ribbon/sausaging of membrane in type II Low complement Mesangial deposits with tramtrack SLE, cryoglobulinemia, SBE, Hep B/C
Membranoproliferative nephritis
45
Strep infection 1-3 weeks ago OR skin infection 3-6 weeks ago Starry eye Subepithelial deposits Low C3, normal C4
Post-strep GN
46
Idiopathic abdominal pain Palpable purpura Arthritis
Henoch-Schonlein | IgA vasculitis
47
Goodpasture’s | Linear IgG
Rapidly proliferators GN
48
Low serum complement levels
``` PSGN MPGN SLE Cryoglobulinemia SBE Atheroembolism (+Eos) ```
49
When to continue and disco turn ACEi in setting of AKI.
Continue: if < 30% Inc in Cr Discontinue: if > 30% Inc in Cr
50
Prerenal azotemia with Ur Na < 10. | Precipitated with vigorous diuretic therapy, large volume paracentesis, or SBP
Hepatorenal syndrome
51
Livedo reticularis Eosinophilia Decreased complement
Atheroembolism
52
Inc CK, K, Phos Low Ca + Dipstick for blood
Rhabdomyolysis
53
Inc UA, K, Phos Low Ca - Dipstick for blood
Tumor Lysis Syndrome
54
TLS pretreatment management with UA < 8 UA > 8
UA < 8: allopurinol | UA > 8: rasburicase
55
TLS pretreatment management with WBC > 100k WBC < 100k
WBC > 100k: Rasburicase WBC < 100k: allopurinol
56
TLS management with AKI
Febuxostat
57
Causes of papillary necrosis
``` Pyelonephritis Obstruction Sickle cell TB Chronic EtOH Analgesic abuse RV Thrombosis Diabetes Mellitus ```
58
Increased use of Ca containing phosphate binders, high Ca dialysate and active Vit D analogues (calcitriol) >> markedly suppressed PTH (<100) and ALP (< 7) >> decreased bone turnover >> high risk for fractures, HyperCa, vascular calcification
Adynamic bone disease
59
Antacids to avoid in ESRD
No aluminum or Magnesium
60
Ischemic skin lesions | ESRD. High PTH. Inc Ca. Inc Phos
Calciphylaxis
61
Thickening of skin in legs and arms (peau d’orange). ESRD.
Nephrogenic fibrosing dermopathy
62
Management for first asymptomatic nephrolithiasis
Hydration and observation
63
Management for first symptomatic or recurrent nephrolithiasis
Further w/u
64
Best diagnostic step for nephrolithiasis
Spiral CT
65
Predisposing factor for hyoeroxaluria and hypocitraturia
IBD | Short bowel syndrome
66
Staghorn calculus | Coffin lid crystals
Mg aluminum Phos (struvite) stones
67
Most common cause of recurrent nephrolithiasis
Idiopathic hypercalciuria

ABR (12 decks)

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