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PANRE > Nephrology > Flashcards

Nephrology Flashcards

1
Q

how do you calculate the anion gap?

A

NA - (HCO3 + CL) 4-12 nl range

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2
Q

Causes of Respiratory acidosis?

A

COPD, myesthenia gravis, hypercapnia

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3
Q

In the blood gas- what signifies respiratory acidosis?

A

decreased pH, Increased PCO2

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4
Q

In the blood gas, what signifies Respiratory alkalosis?

A

increased pH, decreased PCO2

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5
Q

Causes of respiratory alkalosis?

A

hyperventilation/ anxiety, pregnancy, Salicyclate overdose

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6
Q

in the blood gas what signifies Metabolic acidosis?

A

decreased pH and decreased HCO3 (bicarb)

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7
Q

Causes of metabolic acidosis?

A

starvation, lactic acidosis, renal failure, methanol overdose, salicylate intoxication

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8
Q

In a blood gas, what results indicate metabolic alkalosis?

A

increase pH and increase HCO3(bicarb)

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9
Q

What causes metabolic acidosis?

A

vomiting and diarrhea, NG suctioning

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10
Q

causes of hypokalemia?

A

diuretics, renal tubular acidosis, GI loss

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11
Q

What are the EKG changes found in severe hypokalemia?

A

flattened T waves ad U waves.

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12
Q

Treatment for hypokalemia?

A

K+ >2.5 - po supplementation

K+ < 2.5 IV supplementation followed by PO

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13
Q

Causes of hyperkalemia?

A

renal failure, ACE inhibitors, hypoalsotreonism, metabolic acidosis

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14
Q

Neurosymptoms of hyperkalemia?

A

numbness/tingling/weakness/flaccid paralysis

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15
Q

What cardia symptoms can be found with hyperlakemia?

A

dysrthymias, cardia arrest

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16
Q

What are EKG findings in hyperkalemia?

A

Peaked T waves(K+ > 6.5)

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17
Q

Treatment of hyperkalemia

A

discontinue K+ sparing diurectics, dc K supplementation/vitamins, give sodium bicarb(D50) and Kayexelate.

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18
Q

What is diabetes insipidius?

A

hypernatriumia but with decrease urinary sodium ad polyuria. Usually due to a posterior pituitary issue causing decrease secretion of ADH

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19
Q

What can happen if you attempt to correct hypernatremia too quickly?

A

pulomonary/cerebra edema - chances are increased in a diabetic patient.

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20
Q

What is SIADH?

A

hypotonic hypernatriemia in a patient with normal cardiac/liver/adrenal/renal function
Check a CT scan to rule out a CNS disorder

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21
Q

How do you treat SIADH

A

free water restriction, give isotonic saline.

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22
Q

What can happen if you correct a hyponatriemia too quickly?

A

Central Pontine mylenolysis - permanent neurologic damage.

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23
Q

Define Nephrotic syndrome

A

> 3.5 gm of protein/24 hour urine.

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24
Q

Causes of Nephrotic syndrome.

A

Primary renal - IgA nephropathy, congential, focal GN

Secondary renal- post strep GN, SLE, malignancy, toxemia of pregnancy

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25
Q

Discuss auto somal dominant polycystic kidney disease

A

Most common, found males onset 4th decade of life. present in bilateral kidneys. no treatment - just supportive until it gets bad enough for kidney transplan

26
Q

What is the most common type of stone in nephroliathiasis?

A

calcium - 75-85% present - they are radiopague - can be seen on plain film

27
Q

What type of stone has Psuedomonas/Proteus as a causative agent?

A

Struvite.

28
Q

treamtent for a kidney stone <5mm

A

will pass on its own. Hydrate/ pain management. Alpha blockers and CCBs can help it to pass.

29
Q

you have a patient with a kidney stone at 8mm - how would you treat/ counsel?

A

stone 5-10 mm may pass on own. Hydrate and manage pain. Consider early elective lithotripsy / ureteroscoic basket retrieval if signs of obstruction.

30
Q

Treatment of a kidney stone > 10mm?

A

Ureteral stent or percutaneous nephorstomy (gold standard or treatment) there is increase risk of complications with stones of this size.

31
Q

who is more common to have glomerulonephritis, kids or adults?

A

most common in ages 2-12, if adult onset - worse prognosis

32
Q

Describe the urine found in glomerular nephritis.

A

hematuria that is tea or cola in color.

33
Q

what type of casts are found in the urine of a patient diagnosed with glomerular nephritis?

A

red blood cell casts

34
Q

what significance is the finding of broad waxy casts in a urinalysis?

A

chronic kidney failure.

35
Q

what should you think of if a UA microscopic shows granular or muddy brown casts?

A

acute tubular necrosis

36
Q

urine microscopy has maltese crosses in it. what should you think of?

A

nephrotic syndrome

37
Q

What is the most common cause of glomerular nephritis?

A

post streptococcal infection. should had a + ASO titer

38
Q

how would you treat glomerular nephritis?

A

prednisone and dietary managment

39
Q

what are causes of glomerular nephritis?

A

post infectious, henoch-schlein purport, IgA nephropathy, SLE, vasculitis

40
Q

What are common causes of acute renal failure?

A

pre renal (60-70% of cases)- and acute tubular necrosis (intrinsic renal)

41
Q

List pre-renal causes of ARF .

A

hypovolemia, hypotension, CHF/cirrhosis/early sepsis, abdominal aortic aneurysm, renal artery stenosis (RAS)

42
Q

What are intrinsic renal causes of acute kidney failure?

A

ATN, nephrotoxins, acute interstitial nephritis, SLE, glomerular nephritis, vascular disease

43
Q

What are post renal causes of ARF?

A

tubular obstruction, obstructive uropathy (nephrolithiasis, BPH, etc)

44
Q

What is nephrotic syndrome?

A

nephorisis is a histopathologic term for renal disease without inflammation.

45
Q

Causes of nephrotic sydrome

A

Primary renal disease, SLE, post infection, DM, NSAIDS, lithium, toxins, pregnancy

46
Q

what are the labs found in nephrotic syndrome

A

Proteinuria> 3.5 gm / day
hypercholesterolemia/yperlipidemia
ascitis/edema
UA has oval fat bodies/maltese crosses and fatty casts

47
Q

Treatment for nephritic syndrome

A

diet - elevate protein to match protein loss, slat restriction, diuretics, ACEI/ARB, steroids

48
Q

What are reasons to consider short term dialysis in an ARF patient?

A

creatinine >5-10, unresponsive acidosis, fluid overload, uremic complications

49
Q

what is the normal range of PCO2

A

35-45 mmHg

50
Q

What is the normal range of bicarb (HCO3)

A

22-26mEq/l

51
Q

what is the most predictive factor for loss of kidney function?

A

albumenuria ( followed by tubular proteinuria and renal tubular cell constuituents

52
Q

acuteglomerular nephritis will demonstrate what on UA?

A

hematuria, microsopy will reveal red blood cell casts

53
Q

how do ACE inhibitors work to control blood pressure?

A

It blocks conversion of angiotensin I to angiotensin 2 which results in greater dilation of the efferent renal arteriole and reduces intraglomerular pressure by lowering resistance.

54
Q

what is the level of album first noted in the first stage of diabetic nephropathy?

A

Albumenuria > 30 mg/24hours

55
Q

what level does a serum glucose need to reach to be excreted in the urine?

A

180-200 is the renal glucose threshold

56
Q

what are screening tests for chronic kidney disease?

A

Blood pressure, serum creat level, spot urine albumen

57
Q

describe the most frequent presentation of IgA nephroplathy in kids (< 21 yo)

A

An episode of gross hematuria during or immediately after (1-3 days ) after URI

58
Q

describe the blood flow through the glomerulus

A

Renal artery, afferent arterioles, glomerulus, efferent arterioles

59
Q

What does the acronym RIFLE criteria stand for in AKI

A

risk, injury, failure, loss and end stage.

60
Q

What is the most common cause of nephrotic syndrome in children? in

A

Minimal change disease

PANRE (12 decks)

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