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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
Q

HypoNa
Low Ur Na
Low Ur Osm
Inc in post-H20 deprivation and post-DDAVP Ur Osm

A

Psychogenic polydipsia

Beer potomania

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26
Q

HypoNa
High Ur Na (specific)
High Ur Osm

A

SIADH

Addison’s

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27
Q

HypoNa
High Ur Na
High Ur Osm
Inc in post-DDAVP Ur Osm

A

Cerebral salt wasting

28
Q

Management for acute symptomatic hyponatremia (mental status changes or seizures)

A

3% saline

29
Q

Rate at which not to correct chronic hyponatremia

A

> 0.5 mEq/h

Can lead to pontine myelinolysis

30
Q

Management for volume depleted hyponatremia

A

0.9% NaCl

31
Q

Best test to measure micoalbuminuria

A

Spot urine alb/urine Cr > 30

32
Q

Management for extreme exercise-induced hematuria

A

Repeat UA in 6 weeks

33
Q

Dysuria
Painful intercourse
Post-void dribbling

A

Urethral diverticulum

34
Q

Cola-colored urine
UA + RBCs, RBC casts
Sore throat < 7 days ago

A

IgA nephropathy

35
Q

Best management to preserve renal function in ADPKD

A

BP control
Na < 2g
Protein restriction

36
Q

Collagen IV abnormality
Renal failure
Hearing loss

A

Alport syndrome

37
Q

Fatty, oval body casts

A

Nephrotic syndrome

38
Q

RBC casts

Dysmorphic RBCs

A

Nephritis

39
Q

Muddy/brown casts

Pigmented granular casts

A

Acute tubular necrosis

40
Q

WBC casts
Granular casts
Eosinophils

A

Interstitial nephritis

41
Q

Effacement of epithelial foot processes

Hodgkins, Leukemia, NSAIDs, Lithium, pamidronate

A

Minimal change disease

42
Q

Effacement if epithelial foot processes

African American, HIV, Heroin

A

Focal segmental glomerulosclerosis

43
Q

Subepithelial deposits
Thickened capillary loops

Hep B/C, solid tumors

A

Membranous glomerulopathy

44
Q

Ribbon/sausaging of membrane in type II
Low complement
Mesangial deposits with tramtrack

SLE, cryoglobulinemia, SBE, Hep B/C

A

Membranoproliferative nephritis

45
Q

Strep infection 1-3 weeks ago OR skin infection 3-6 weeks ago
Starry eye
Subepithelial deposits
Low C3, normal C4

A

Post-strep GN

46
Q

Idiopathic abdominal pain
Palpable purpura
Arthritis

A

Henoch-Schonlein

IgA vasculitis

47
Q

Goodpasture’s

Linear IgG

A

Rapidly proliferators GN

48
Q

Low serum complement levels

A 
PSGN
MPGN
SLE
Cryoglobulinemia
SBE
Atheroembolism (+Eos)
49
Q

When to continue and disco turn ACEi in setting of AKI.

A

Continue: if < 30% Inc in Cr

Discontinue: if > 30% Inc in Cr

50
Q

Prerenal azotemia with Ur Na < 10.

Precipitated with vigorous diuretic therapy, large volume paracentesis, or SBP

A

Hepatorenal syndrome

51
Q

Livedo reticularis
Eosinophilia
Decreased complement

A

Atheroembolism

52
Q

Inc CK, K, Phos
Low Ca
+ Dipstick for blood

A

Rhabdomyolysis

53
Q

Inc UA, K, Phos
Low Ca
- Dipstick for blood

A

Tumor Lysis Syndrome

54
Q

TLS pretreatment management with
UA < 8
UA > 8

A

UA < 8: allopurinol

UA > 8: rasburicase

55
Q

TLS pretreatment management with
WBC > 100k
WBC < 100k

A

WBC > 100k: Rasburicase

WBC < 100k: allopurinol

56
Q

TLS management with AKI

A

Febuxostat

57
Q

Causes of papillary necrosis

A 
Pyelonephritis 
Obstruction 
Sickle cell
TB
Chronic EtOH
Analgesic abuse
RV Thrombosis
Diabetes Mellitus
58
Q

Increased use of Ca containing phosphate binders, high Ca dialysate and active Vit D analogues (calcitriol)&raquo_space; markedly suppressed PTH (<100) and ALP (< 7)&raquo_space; decreased bone turnover&raquo_space; high risk for fractures, HyperCa, vascular calcification

A

Adynamic bone disease

59
Q

Antacids to avoid in ESRD

A

No aluminum or Magnesium

60
Q

Ischemic skin lesions

ESRD. High PTH. Inc Ca. Inc Phos

A

Calciphylaxis

61
Q

Thickening of skin in legs and arms (peau d’orange). ESRD.

A

Nephrogenic fibrosing dermopathy

62
Q

Management for first asymptomatic nephrolithiasis

A

Hydration and observation

63
Q

Management for first symptomatic or recurrent nephrolithiasis

A

Further w/u

64
Q

Best diagnostic step for nephrolithiasis

A

Spiral CT

65
Q

Predisposing factor for hyoeroxaluria and hypocitraturia

A

IBD

Short bowel syndrome

66
Q

Staghorn calculus

Coffin lid crystals

A

Mg aluminum Phos (struvite) stones

67
Q

Most common cause of recurrent nephrolithiasis

A

Idiopathic hypercalciuria

ABR (12 decks)

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