Nephrology Flashcards
acute pyelonephritis outpatient summary
SS: fever rigors HAN/V malaise flank pain CVA tender ab pain
Eval: UA - > 100,000 bacteria - > 10 WBC - LE + - Nitrate +
Cause:
E coli
Enterococcus
Txt:
Cipro 500 mg bid po x 7 days
AM/CL 875/125 mg bid 14 days
hospitalized - Cipro 500 mg bid po x 14 days (IV until no fever 48 then oral)
What can cause renal insufficiency
disease
drugs
age
What is cockloft-gault equation with creatinine clearance
Male:
(140-age) x (50 + (2.3 x ht over 5 ft))
—————————————————-
72 x SCr
Female:
(140 - age) x (45.5 + (2.3 * ht over 5 ft))
——————————————————
72 x .85 x SCr
What is normal creatinine clearance
100 - 125 ml/min
nephrolithiasis
Def: general term for renal calculi (kidney stones)
SS: CVA tenderness pain migrating to upper/lower ab painful testicles tachycardia HTN hematuria
Eval:
US
Txt: IV hydration antiemetics pain control CCB alpha-blockers
What types of kidney stones require surgery
> 7 mm
place stent to try and get it to pass
Glomerular hematuria (color, clots, proetinuria, RBC morhphology, and RBC casts)
color: red, smoky brown, cola-colored
clots: absent
proteinuria: sometimes
may be >500mg/day
RBC morph: dysmorphic
RBC casts: likely present
Extraglomerular (color, clots, proetinuria, RBC morhphology, and RBC casts)
color: red or pink
clots: may be present
proteinuria:
initial labs to order with hematuria
urinalysis with microscopyurine cytology CBC with diff serum creatinine BUN urine culture
*What does it mean if your Creatinine doubles
You have lost half of your kidney function
As body mass ______ the amount of Creatinine ______
increases and increases
Arnold Schwarzennager has a high Cr
Stages of renal disease
Based on CrCl Stage 1: nothing wrong; GFR >90ml/min Stage 2: mild; GFR >60ml/min Stage 3 (where most people are): GFR >30 Stage 4: Severe; GFR 15-29ml/min Stage 5: need dialysis;
