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CDP > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Evaluation of the kidneys for masses, scarring, and hydronephrosis is best done with this imaging type

A

Ultrasound

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2
Q

Acute kidney injury severity is classified by ..

A

Increased serum creatinine and decreased GFR

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3
Q

What would be seen on an ultrasound in chronic kidney disease?

A

Decreased kidney size

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4
Q

Bun-to-creatinine ration increases with these two things

A

Renal failure

CHF

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5
Q

Symptom that is shared by SIADH and diabetes insipidus

A

Excessive thirst

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6
Q

Bun-to-creatinine ration decreases with these two things

A

Starvation

Liver failure

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7
Q

Urinary sediment findings in these acute renal failures:
1.) Prerenal
2.) Intrarenal
3.) Postrenal

A

1.) Prerenal = Normal
2.) Intrarenal = Abnormal casts and debris
3.) Postrenal = Normal

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8
Q

Vitamin D deficiency is significant in identifying these three conditions

A

Osteoporosis/penia

Rickets

Liver disease

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9
Q

BUN normal range

A

8-18 mg/dL

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10
Q

Nephrolithiasis should be evaluated with this type of imaging

A

CT-KUB without contrast

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11
Q

In the diagnosis of CKD, what four things would be seen in a urinalysis?

A

Proteinuria
Casts
Microalbuminuria
Electrolytes

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12
Q

Reasons (2) for decreased eGFR levels

A

Impaired kidney function

Conditions causing decreased GFR (e.g. CHF, cirrhosis with ascites, shock, dehydration)

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13
Q

Reasons (3) for ADH to be increased

A

SIADH

Nephrogenic diabetes insipidus caused by primary renal diseases

Dehydration

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14
Q

Three functions of ADH

A

Decrease urine output

Decrease sweating

Increase BP by retaining fluid

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15
Q

BUN-to-creatinine ration >20:1 suggests …

A

Dehydration

(but also increases with CHF and renal failure)

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16
Q

The key to SIADH is that the hyponatremia is a result of …

A

Excess of water (rather than a sodium deficiency)

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17
Q

Reason for ADH to be decreased

A

Neurogenic (central) diabetes insipidus

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18
Q

Urine specific gravity findings in these acute renal failures:
1.) Prerenal
2.) Intrarenal
3.) Postrenal

A

1.) Prerenal = Increased
2.) Intrarenal = Normal
3.) Postrenal = Varies

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19
Q

In ultrasound of chronic kidney disease you would see this change in size

A

Reduced size

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20
Q

Leading cause of cancer death in males in US (2nd worldwide)

A

Prostate cancer

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21
Q

Which, pre, intrinsic, or post renal azotemia is most common?

A

Pre-renal

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22
Q

True or false. Ultrasounds are nonspecific for solid renal masses and moderate sensitivity for stones.

A

True

Further imaging with CT usually required

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23
Q

Reason for decreased serum osmolality

A

SIADH

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24
Q

Microalbuminuria is an early indicator of …

A

Renal disease

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25
Q

How is a creatinine clearance test performed

A

24 hour urine collection

Serum creatinine level

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26
Q

Lab test for cause of glomerulonephritis

A

ANA - antinuclear antibodies

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27
Q

Causes of intrinsic renal azotemia

A

Acute tubular necrosis

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28
Q

In diagnosis of CKD, what would be seen on a CMP?

A

Azotemia
Increased ammonia
Increased uric acid
Decreased active vitamin D

Hyperkalemia
Hyperphosphatemia
Hypermagnesemia

Hyponatremia
Hypocalcemia

Decreased GFR
Increased creatinine
Increased BUN

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29
Q

Is serum osmolality directly or inversely related to serum water levels?

A

Inversely

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30
Q

GFR normal values for men and women

A

MEN: 115-125 mL/min

WOMEN: 90-100 mL/min

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31
Q

Serum creatinine normal ranges for men and women

A

MEN: 0.6-1.2 mg/dL

WOMEN: 0.5-1.1 mg/dL

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32
Q

Reason for increased urine osmolality

A

SIADH

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33
Q

Nephritic syndrome is also known as …

A

Glomerulonephritis

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34
Q

Four signs of CKD

A

CHF
HTN
Edema
Weight gain

(chew!)

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35
Q

This test is helpful when the urine output is low and you suspect acute kidney disease

A

Urine sodium

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36
Q

Acute tubular necrosis is associated with what finding in the urine?

A

Muddy brown casts

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37
Q

For most people, transient microscopic hematuria is of little concern. What is the exception and why?

A

Old people

Blood in urine = risk of malignancy

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38
Q

Renal stones greater than this size warrant referral to urology

A

10mm (if hasn’t been passed in four weeks)

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39
Q

BUN/Cr >20:1 is suggestive of …

A

Pre-renal azotemia

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40
Q

Renin is an enzyme (and a hormone) that is released by the …

A

Kidney

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41
Q

Most common test for ADH levels

A

Serum ADH (blood draw)

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42
Q

Cystoscopy is contraindicated in these two kinds of patients

A

Febrile patients with UTIs

Patients with severe coagulopathy

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43
Q

Nephrotic syndrome is characterized by …

A

Large protein losses in the urine

44
Q

True or false. GFR changes with age, sex, race, and body size.

A

True

45
Q

This hormone is made in the kidney and stimulates bone marrow to increase RBC production

A

Erythropoietin (EPO)

46
Q

Reasons (2) for increased serum osmolality

A

Dehydration

Diabetes insipidus

47
Q

Contraindications (5) for CT angiography

A

Pregnancy

Unstable vitals

Kidney problems

Allergies

Severe diabetes

48
Q

This view is useful in visualizing calcifications anywhere along the renal tract

A

KUB - kidneys, ureters/urethra, bladders

49
Q

Nuclear testing measures this

A

Function!

50
Q

BUN-to-creatinine ration

A

10:1 - 20:1

51
Q

eGFR evaluates the degree of …

A

Kidney function/impairment

52
Q

CKD severity is classified by …

A

eGFR

53
Q

In ultrasound of acute kidney injury you would see this change in size

A

None! (not for acute anyway)

54
Q
A
55
Q

Normal value for eGFR

A

> 60 mL/min/1.73m2

56
Q

The most important noninvasive test in the initial workup of acute kidney injury

A

Urinalysis

57
Q

Is ADH more likely to be released from the pituitary in a state of overhydration or dehydration?

A

Dehyrdration

58
Q

BUN:Cr ratio in postrenal azotemia

A

Initially >20:1 then switches to <20:1

59
Q

Hyperuricemia is an independent risk factor for …

A

Gout

60
Q

What might be seen on ultrasound in postrenal azotemia?

A

Hydronephrosis/Dilated bladder/Urinary retention

61
Q

Uric acid in the urine is called …

A

Uricosuria

62
Q

Is it preferable to have a high or low GFR?

A

High GFR is better

63
Q

Most common cause of postrenal azotemia

A

Any obstruction of urinary tract

64
Q

Erythropoietin testing is used in the differential diagnosis of these two conditions

A

Anemia

Polycythemia

65
Q

Define azotemia

A

Build up of urea, uric acid, creatinine, and ammonia in the blood

66
Q

Plasma renin assay blood test measures …

A

Enzyme ability to convert angiotensinogen to angiotensin 1 and is limited by the availability of the angiotensinogen.

67
Q

Reason for decreased urine osmolality

A

Diabetes insipidus

68
Q

Nephrotic syndrome is most commonly caused by …

A

Diabetes

69
Q

Definition of chronic kidney disease

A

Urinary albumin excretion of 30+ mg/day

OR

eGFR <60 for three or more months (that’s how you know it’s not acute)

70
Q

Does GFR increase or decrease with age?

A

Decrease

71
Q

The examination of choice for urinary tract imaging is …

A

CT

72
Q

Kidney appearance on ultrasound in acute kidney injury

A

Normal renal size

73
Q

Glucosuria in the absence of hyperglycemia is called …

A

Renal glucosuria

74
Q

At the first sign of microalbuminuria in a diabetic they must be placed on this medication

A

ACE inhibitor

75
Q

Definition of acute kidney injury

A

Abrupt (within 48 hours) reduction in kidney function based on an elevation in serum creatinine levels

76
Q

All patients with kidney disease (acute or chronic) should have their …. from the serum creatinine evaluated.

A

Glomerular filtration rate

77
Q

True or false. Biopsy is contraindicated in pregnancy and advanced age

A

False

78
Q

Normal vitamin D (D2 + D3) levels

A

25-80 ng/mL

79
Q

BUN levels are directly related to …

A

Metabolic function of the liver

Excretory function of the kidney

80
Q

In the diagnosis of CKD, what three things would be seen in a CBC?

A

Normochromic, normocytic anemia

Thrombocytopenia

Increased bleeding time

81
Q

True or false. All patients with prostate cancer have increased PSA levels.

A

False.

1 in 4 have normal PSA levels

82
Q

Acute kidney injury laboratory findings

A

Hyponatremia
Hypocalcemia
Metabolic acidosis

Hyperkalemia
Elevated BUN levels
Elevated plasma creatinine

83
Q

The best measure of renal function is …

A

GFR

84
Q

Proteinuria is suggestive of this type of kidney condition

A

Nephrotic syndrome

85
Q

Biopsy is contraindicated in these two conditions

A

Severe hypertension (>170 systolic, uncontrolled)

Active renal or perineal infection

86
Q

Cause of pre-renal azotemia

A

Any cause of reduced renal blood flow

(CHF, dehydration, shock, sepsis)

87
Q
A
88
Q

Reason for presence of albumin in urine

A

Diabetes mellitus

89
Q

How to be sure proteinuria is transient rather than persistent?

A

Two protein free urinalyses

90
Q

Is serum creatinine directly or inversely related to GFR?

A

Inversely

91
Q

In SIADH will serum Na/osmolality be increased or decreased? And will urine osmolality be increased or decreased?

A

Serum Na/osmolality = DECREASED

Urine osmolality = INCREASED

92
Q

Grading system used in evaluating the prognosis of men with prostate cancer

A

Gleason grading scale

93
Q

Labs for glucosuria

A

Complete UA (with microscopy)
Serum glucose
Serum urea nitrogen
Creatinine

94
Q

USPSTF recommendations for prostate cancer screening

A

Age 55-69 only if patient wants it (shared decision making)

Category C

95
Q

The most important indicator of renal disease in urine is

A

Proteinuria

96
Q

In the diagnosis of CKD, what would be seen on a lipid profile?

A

Hyperlipidemia

97
Q

Compare and contrast neurogenic and nephrogenic diabetes insipidus

A

Neurogenic results from inadequate ADH secretion

Nephrogenic results from the kidney being unresponsive to ADH stimulation

98
Q

In DIABETES INSIPIDUS will serum Na/osmolality be increased or decreased? And will urine osmolality be increased or decreased?

A

Serum Na/osmolality = INCREASED

Urine osmolality = DECREASED

99
Q

The most common way to measure a person’s GFR is …

A

Creatinine clearance

100
Q

BUN:Cr ratio in intrinsic renal azotemia

A

Less than 20:1

101
Q

Nuclear medicine is used to evaluate for this type of disease

A

Metastatic

102
Q

In DEHYDRATION will serum Na/osmolality be increased or decreased? And will urine osmolality be increased or decreased?

A

Serum Na/osmolality = INCREASED

Urine osmolality = INCREASED

103
Q

Persistent hematuria is mostly caused by these three cancers

A

Bladder
Renal
Prostate (least common)

104
Q

All diabetics older than 12 should be screened annually for this …

A

Microalbuminuria

105
Q

The gold standard for imaging vascular malformations is

A

CTA (CT + angiography)

106
Q

Nephritic syndrome is characterized by …

A

Inflammation (of the capillary loops)

CDP (12 decks)

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