Nephrology Flashcards
Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV) include….. (Name 4)
(1) granulomatosis with polyangiitis (GPA)
(2) microscopic polyangiitis (MPA), including
(3) renal-limited vasculitis (RLV), and
(4) eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss)
https://www-uptodate-com.libproxy.usouthal.edu/contents/clinical-manifestations-and-diagnosis-of-granulomatosis-with-polyangiitis-and-microscopic-polyangiitis?source=search_result&search=granulomatosis%20with%20polyangiitis&selectedTitle=1~150#H15
What diuretic is best for a patient with a history of calcium oxalate kidney stones?
Thiazide diuretics are the only class that decreases urinary secretion of calcium. They are ideal for patients with a history of renal stones. Their mechanism of action is through inhibition of the Na/Cl transporter in the distal convoluted tubule. In the process, they promote Ca reabsorption from urine.
What is Gerota’s fascia?
A fibrous envelope of tissue that surrounds the kidney. Also called Gerota’s capsule, or renal fascia.
[Retrieved from https://www.ncbi.nlm.nih.gov/pubmedhealth/ PMHT0022156/]
The term “nephrotic syndrome” refers to a distinct constellation of clinical and laboratory features of renal disease. It is specifically defined by…
…the presence of heavy proteinuria (protein excretion greater than 3.5 g/24 hours), hypoalbuminemia (less than 3 g/dL), and peripheral edema.
[From UpToDate: Overview of heavy proteinuria and the nephrotic syndrome]
The dipstick is insensitive to non-albumin proteins, most notably ___________ ______________ _____ chains in the setting of ________ _______. A screen for the presence of such proteins may be performed with the ______________ ____ test.
nephrotoxic immunoglobulin light
multiple myeloma
sulfosalicylic acid
[From UpToDate: Urinalysis in the diagnosis of kidney disease]
The urine dipstick is thought of as a highly sensitive test for the presence of heme in the urine, with the ability to detect minimal hematuria (eg, one to two RBCs per high-powered field). False-negative results are said to be unusual and, as a result, a dipstick that is negative for heme theoretically excludes hematuria. However, urinary ________ ____ can interfere with the peroxidase reaction, thereby yielding false-negative results. As an example, one study showed that, in the presence of urinary ascorbic acid, the urine dipstick was negative for heme in ___ of patients with documented microscopic hematuria. Given the frequency of vitamin C ingestion, this may limit the value of the urine dipstick as a screening test for hematuria. Manufacturers have attempted to allay such concerns through the production of dipsticks that oxidize ascorbic acid, thereby minimizing the risk of false negatives.
ascorbic acid
70%
[From UpToDate: Urinalysis in the diagnosis of kidney disease]
When giving IV DDAVP, how long does it take to see the peak effect and what is the duration?
1.5 - 2 hrs to peak effect
Duration is 6 - 14 hours
The anticoagulant properties of citrate are due to the _________ __ _______ _______ (___), which causes hypocalcemia in the circuit. Calcium is a necessary cofactor in the formation of ________. Coagulation is inhibited as soon as iCa falls below ___ mmol/L and is maximal at an iCa concentration of 0.25 mmol/L.
chelation of ionized calcium (iCa)
thrombin
0.50
[From Clinical Key, Critical Care Nephrology: Anticoagulation Strategies for Continuous Renal Replacement Therapy. https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780323449427001680?scrollTo=%23hl0000430 ]
Oliguria is defined as….
<0.3 ml/kg/hr UOP
Or
<500 ml/day of UOP
Anuria is usually defined as….
…<50 ml/day
