Nephrology Flashcards
EPO can cause XXXXX in CKD patients
EPO can cause new-onset HTN in CKD patients
Cause?
Bleeding in patient with CKD
Uremic platelet dysfunction. Abnormal platelet adhesion and platelet aggregation in individuals with uremia and CKD
Presentation
Poststreptococcal glomerulonephritis
- flank pain
- elevated creatinine levels
- nephritic sediment
- facial edema
- hypertension
- gross hematuria.
1–6 weeks after acute tonsilliti
Poststreptococcal glomerulonephritis caused by the **deposition of immune complexes **
Pyelonephritis + Macroscopic hematuria
vs
Pyelonephritis + Microscopic hematuria
Pyelonephritis + Macroscopic hematuria: Complicated! –> Renal papillary necrosis (RPN)
* May also have proteinuria
Pyelonephritis + Microscopic hematuria: Uncomplicated
Leading cause of death in patients with advanced CKD
Cardiovascular disease
BUN: Cr ratio
- < 15:1 intrinsic renal damage (e.g., glomerulonephritis)
- Between 10:1 and 20:1 urinary tract obstruction
- > 20:1 Prerenal AKI
Renal secondary effects of acyclovir
Risk of crystal inducted AKI
Particularly in patients with volume depletion or preexisting renal conditions (e.g., diabetic nephropathy)
Management of hypernatremia with severe hypovolemia
0.9% saline first (to correct dehydratation)
Then, D5%W if hyperNa persists
Hyponatremia that develops after massive hemorrhage is likely xxxxx.
Hyponatremia that develops after massive hemorrhage is likely dilutional.
The compensatory secretion of antidiuretic hormone (ADH), increases renal reabsorption of free water, thereby diluting serum sodium levels and causing hyponatremia
Patient post head trauma with hypoNa+, low serum osmolarity and high urine osmolarity
SIADH
Fluid restriction is the first-line treatment for nonsevere, nonacute hyponatremia associated with SIADH.
Hexagonal crystals on urinalysis
Cystinuria
Caused by an autosomal recessive defect in the cystine-reabsorbing proximal convoluted tubule transporter in the kidneys. Cystine stones are weakly radiopaque (i.e., visible on CT scan but not necessarily on x-ray).
A positive urine sodium nitroprusside test is pathognomic for cystinuria.
Rhomboid crystals on urinalysis
Uric acid stones
Radiolucent
Low pH urine
Envelope-shaped crystals on urinalysis indicate
calcium oxalate crystals.
Why?
Crohn disease increases de risk of neprholitiasis
Malabsorption of fatty acids
Patients with Crohn disease often have pathologically increased luminal oxalate and increased oxalate absorption. After entering the serum, oxalate is excreted in the urine (hyperoxaluria), where it binds calcium and forms calcium oxalate stones.
The characteristic finding associated with persistent vomiting or excessive nasogastric (NG) suctioning is
Hypokalemic, hypochloremic metabolic alkalosis.
Severe diarrhea typically causes
hyperchloremic metabolic acidosis through a loss of HCO3- ions with the stool
Acid-base abnormality after tonic-clonic seizure
Postictal lactic acidosis, an anion gap metabolic acidosis that manifests with a reduced serum bicarbonate concentration.
The primary acid-base disturbance in DKA is
Anion gap metabolic acidosis
Dx>
Resistant HTN
HTN at night
Decreased appetite
Nausea
Nephrolitiasis
Fatigue
Weakness
High Ca++
HyperPTH
Individuals with cystic fibrosis are at increased risk of developing XXXX due to impaired absorption of vitamin D.
Individuals with cystic fibrosis are at increased risk of developing rickets due to impaired absorption of vitamin D.
