Nephrology Flashcards
what cast you will see after strenous exercise?
Hyaline
Indication of renal replacement therapy
Hint : mostly refractory
Patient with
Dark tea color urine with dipstick +ve for blood but no erythrocyte on UA
And high CK
Ttt?
Rhabdomyolysis
IV fluid💦
Increased BUN: creatinine ratio occurs in ?
Renal ? Post rena?
Isolated high BUN with normal creatinine occurs in ?
Upper GI bleeding 🩸
MCC of renal AKI
ATN
Prolonged pre-renal injury leads to?
ATN (renal)
Patient eating a lunch composed of 5 NSAID pill + 15 PII
Then came to hospital complaining of
Fever, rash, hematuria and proteinuria, and esonophillouria
Dx?
Patient after PCI development
Hematuria + rash + levido reticularis + esonophilluria
Dx?
Hint : it is Ameera fault
Ameera moved the cholesterol plaque when she did PCI 😝
Dx: cholesterol emboli
Patient lab
High, K, PO4, uric
Low Ca
Ddx?
TLS (+ Hx of cancer ttt)
Rhabdomyolysis ( + high CK )
A
MCC of death in ESRD ?
Hint : same as RA and SLE
CVS disease
Always choose
AV fistula
When to screen DM patient for diabetic nephropathy?
Remember we sceen by microalbuminuria level
Do not be tricked 🤣
Answer: A
EXCLUDE IRON FIRST !!!!
Surprise ☠️Nobody in practice order EPO level for dx of CKD anemia
The rule says if not iron it is due to CKD
What is the cutoff point of protien in urine for nephritic and nephrotic syndrome?
All nephritic and nephrotic disease are confirmed by 🤔 except 🤔 is confirmed clinically
Which of the nephrotic syndrome disease has the best response to steroid?
Minimal change disease
Which of the nephrotic syndrome disease has the best response to steroid?
Minimal change disease
Patient with protein in urine >3.5gm
And renal vein thrombosis
Dx?😣
Membranous nephropathy
A
A
D
all nephrotic give ACEI
except minimal change choose steroid
D
all nephrotic give ACEI
except minimal change choose steroid
A
in any case of fever there is normally a transient protein leak
So repeat if normal no further workup
FIRST 3 days after URTI > IgA (Burger)
After 7 -10 days of URTI > post-streptococcal GN
FIRST 3 days after URTI > IgA (Burger)
After 7 -10 days of URTI > post-streptococcal GN
Low complement in PSCGN
BUT NOTMAL IN IgA
GN + low complement
DDX???
very important
Patient with hematuria + family hx of ESRD ??
Dx
Also called hereditary nephritis
Patient with hypertension
Developed increase in creatinine >30% of baseline after taking ACEI
US showed asymmetric kidney
DX?
Next step DOPPEL US ( 🙅🏻♀️not renal US)
best CTA
Which on of the following cause hyperkalemia?
ACEI
BB
NSAID
spironolactone
All of them 😂😂😂😂😂😂😂😂
NEXT STEP
First stabilize the heart ❤️
Ca gluconate
Patient with
- hypocalcemia and hypokalemia
Next step in ttt? Think of one thing treat both !
-And you need to check what in case of refractory case?
Ca gluconate
Check Mg
C
Dx?
Refeeding syndrome
Tha body is starving so it will absord glucose largely and then high insulin spike lead to shif of all electrolyte
To avoid give smaller meals
Dx?
Refeeding syndrome
Tha body is starving so it will absord glucose largely and then high insulin spike lead to shif of all electrolyte
To avoid give smaller meals
Flat T wave
And U wave appear in what condition?
Hypokalemia
What is the ttt and prophylaxis of tumor lysis syndrome?
Hyponatriemia approach?
😎
C
If there is severe hyponatriemia <120 + neuro symptoms ( confused, obtunded, …) = 3% saline
Rapid correction of
Hyponatremia
And
Hypernatremia
What will cause
If you did it in real life areej will kill you peacefully 😘😘
Rapid correction of
Hyponatremia
And
Hypernatremia
What will cause
If you did it in real life areej will kill you peacefully 😘😘
A
Remeber aspirin activate the central resp center so forst is will cause resp alkalosis then the body try to compansate
Best to diagnose renal stone
CT with or without contrast? 🤣
B
RadiolUcent stone in xray?
Uric
Family hx of stone + hexagonal stone , and is the pathology of this disease
Cystiene stone , amino acid defect
A
A best for pyelonephritis
D
👍🏻
D
👍🏻
B
66 y/o patient did CT angio. 4 days ago, he came today complaining
of oliguria and abnormal renal function dx?
What cast you will see?
Contrast induced nephropathy = ATN
Mudd brown or epithelial or granular cast
What cast you will see in cholesteric emobli causing AKI
esonophilic
old male k/c of HTN came with BP 160/90 , you suspected
some kidney abnormality , what you will find on workup ? •
A-Decrease sclerosis •
B-increase sclerosis
C-Increase hyalinization of arterioles
C
A 63 y/o Patient diagnosed with major depression complaining of excessive thirst and urination +
she has cancer with lung mets. investigations shows hyponatremia and low urine osmolality .
what’s the dx?
A. DI
B. SIADH
C. Psychogenic polydipsia
D. None
C
DI present with hypernatremia
Polydypsia present with hyponatremia and increase urination
SIADH hyponatremia without frequent urination
Old patient known case of gastric antral cancer with hepatic metastasis, presented with vomiting
for 10 days. On PE he was found to have jaundice . • Which of the following mostly will be found in urinalysis?
A. High K B. Aciduria C. Alkaline Urine D. High Na
B
Early = alkalotic urine
Late = aciduria
A48 y/o Patient came with history of pin prick sensation, loss of
vibration sensation with loss of ankle reflex. Found to have K 6 and
high creatinine. Initial step in management?
A. IV bicarbonate
B. insulin and dextrose infusion
C. hemodialysis
D. Vitamin B complex
C
Symptoms of uremic polyneuropathy are an indication for kidney
replacement therapy, including either dialysis or transplantation.
Old patient had URTI and treated 2w ago, now come with hematuria, hypertension, periorbital and ankle edema
Ttt?
Supportive
Frusemide
Old patient had URTI and treated 2w ago, now come with hematuria, hypertension, periorbital and ankle edema
Ttt?
Supportive
Frusemide
Patient came with severe vomiting ECG show flat T wave what u
expect in urine as the cause of presentation?
A. high K.
B. high Na
C. alkaline urine
D. Aciduria
A
A 24 year old UTI patient came k/c of CKD , which antibiotic is
contraindicated for treatment ?
B. TMP-SMZ
C. Fluro
D. Nitrofurantoin
E. Amoxicillin.
D
A52 year old female came with suspected UTI , which of the following
fast indication infection rather than other diagnoses ?
A. Nitrate B. Leukocyte C. Specific gravity D. RBC
A
A 53 year old male patient k/c of CKD, his labs showed low calcium. • What is the treatment of choice in such patient ?
Calcitriol
The most active form of vit D✅
Refractory hypokalemia not response of KCl what is your
management ?
A. IV magnesium sulfate
