Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Foundations II Exam 5 (Jess) > Nephrology > Flashcards

Nephrology Flashcards

(76 cards)

Start Studying
1
Q

What are the MC ways to get imaging on kidneys?

A

US and CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the benefit of US?

what is is not good at identifying?

A
  • safe/easy to use
  • initial test MCly used
  • choice for obstructive dz

less sensitive to renal masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

US with doppler is used for what?

A

assess vascular flow

MR/CT more sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are benefits of CT?

A

Gold standard for renal stones

  • locate ureteral obstruction
  • higher sensitivity for PKD
  • Evaluate tumor
  • dx RVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who can you not give gadolinium to? why

A

in moderate to advanced kidney disease (GFR < 30)

leads to nephrogenic systemic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are ateriorgraphy and venography used for?

A

arterial and venous occlusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is intravenous pyelogram (IVP)?

A

used for caliceal anatomy, size of kidney, shape of kidney

high sensitivity and specificity for stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indications for renal biopsy?

Not indicated?

A

Indicated:
Nephrotic syndrom
acute nephrotic syndrome
unexplained ARF

NOT:
Isolated glomerular hematuria
low grade proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hydronephrosis?

how does it present?

A

Unilateral or bilateral edema of the collecting system

almost always asymptomatic
possible pain or change in UOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are causes of obstructive hydrogenphrosis? What do you do for dx?
Tx?

A

-bladder outlet obstruction consider GI and GYN masses, stones, BPH

US

stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are causes of non obstructive hydrogenphrosis? What do you do for dx?
Tx?

A

Large diuresis can distend intrarental collecting system (EX. Diabetes insipidus)

-CT if US is not indicative

stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is AKI? Is it reversible/not?

A

abrupt (w/in 48 hrs) decline in renal filtration function

usually reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are lab values for acute renal failure?

A
  • decrease in GFR
  • UOP less than 0.5 ml/kg/hr for > 6 hrs
  • increase in Urea and creatinine (azotemia)
  • serum creatinine increases abruptly by more than 50% of baseline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the levels of kidney failure? (RIFLE)

A

R- risk of renal dysfunction
GFR decrease more than 25% and UOP less than .5 mL x6 hrs

I- injury to kidney
GFR decrease more than 50% and UOP less than .5 x 12 hrs

F-failure of kidney function
GFR decrease more than 75% and UOP less than .5 x24 hrs

L- loss of kidney function
for more than 4 weeks

E- end stage Renal dz
more than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of pre-renal AKI?

A

Anything before the kidneys

renal hypo perfusion, hypovolemia, shock, GI fluid loss, poor fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of intrinsic AKI?

A

damage to the glomeruli, tubular or interstitial, glomerularnephritis, acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of post-renal AKI?

A

Obstruction nephrology: prostatic hyperplasia, neoplasia, nephrolithiasis, tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MC type of AKI?

A

Prerenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of Prerenal AKI

A

hypo perfusion leading to decrease in renal perfusion:

  • decrease in intravascular volume (hemorrhage, gI losses, burns, dehydration)
  • change in vascular resistance (cirrhosis, sepsis, anaphylaxis)
  • low CO (CHF, PE, tamponade)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What will the BUN/Cr ratio be in prerenal AKI?

A

upper limit of nl 20:1

increase ratio in prerenal dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx for prerenal AKI? Avoid?

A

Tx: maintain envolemia

Avoid: nephrotoxic drugs (NSAIDS, ACEI, Digoxin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Intrinsic causes of AKI? (types)

A
  • acute tubular necrosis (ATN)
  • interstitial (AIN)
  • glomerular (GN)
  • vascular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acute tubular necrosis is causes by?

characteristic KEY WORDS?

A

muddy brown casts;
ischemia, nephrotoxin, sepsis

  • tubular damage due to ischemia or nephrotoxins (ahminoglycosides, vancomycin, contrast)
  • prolonged hypotension/hypoxemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx of Acute tubular necrosis?

Avoid?

A

avoid volume overload
avoid hyperK
protein restrict
+/- diuretics

-Give N-acetylcystine/IVF w/ bicarb to renal protect from radiographic contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is AIN? causes of AIN?
Inflammatory response leading to edema and possible tubular cell damage 70% caused by nephrotoxic drugs (others= strep infections)
26
What will UA show in AIN? how do you treat?
Eosinophiluria steroids +/- dialysis
27
What is GN caused by?
Immune complex deposition/etiology: - IgA nephropathy (Berger dz) - postinfectious strep GN - MPGN, Goodpastures, Wegeners
28
What does UA in GN show? Tx?
UA: RBC casts (bleeding from kidneys) Tx: steroids, plasma exchange
29
What type of Intrinsic AKI is MC?
ATN- 85%
30
What are causes of post renal AKI?
Obstruction: | BPH, urolithiasis, bladder dysfunction, bladder CA
31
What is a common sx of pt w/ postrenal AKI? | DX? Tx?
Lower abd pain Dx: bladder US, elevated BUN/Cr ration Tx: catheter, stent, surgery depending on etiology (key point= fix whatever is causing obstruction)
32
``` Again, What is tx: Prerenal intrarenal Postrenal ``` Tx for all?
prerenal: IVF w/ goal to nl hemodynamics intrarenal: avoid nephrotoxic agents Postrenal: removal of obstruction For all: consider short-term dialysis
33
What should be considered when debating to dialyze or not? (Who should have dialysis)
- weight - Physical exam/ fluid overload - UOP/uremic complications - unresponsive acidosis pH < 7.1
34
What are the stages of Chronic Kidney Disease?
1-5 1, 2, 3a, 3b, 4, 5 5= ESRD
35
What does GFR tell you?
Degree of impairment varies by age, gender, body size
36
What is creatinine? | What is it dependent on?
Waste product of creatinine phosphate from muscle which passes in the blood through kidneys *Dependent on muscle mass
37
What is Azotemia? What is it measured by?
Nitrogen in the blood Measured by BUN and Cr (markers of nitrogen accumulation)
38
Why does Azotemia occur? What does it lead to?
Occurs when renal fxn can no longer efficiently clear metabolites results from renal parenchymal damage Leads to uremia
39
Uremia is monitored by what? What stages is it in?
Monitored w/ blood urea nitrogen (BUN), urea produced by liver excreted by urine stages 3-5
40
Sx of Uremia
lotssssss some are: ``` malaise N/V insomnia cardiac arrest weight loss HTN ecchymosis Kussmaul respirations ```
41
Dx studies for CKD?
GFR= gold standard! BUN and Cr elevated, proteinuria, microalbuminuria may be present in early stages, Abnormal hgb, hct, lytes, UA
42
Tx for CKD?
- slows progression: ACE/ARB - Epo, Fe, antiplatelet therapy (goal hgb 11-12) - low protein diet, fluid restriction, Ca/VitD supplementation - dialysis/transplant
43
Hypervolemia causes what and is seen in what?
Causes hyponatremia w/ hypervolemia seen in CHF, nephrotic syndrome, ESRD
44
In Hypervolemia, what happens to HgB and Hct? | Tx?
Decreased fluid restrict consider diuretic therapy or dialysis
45
Hypovolemia is caused by? what happens to HgB and Hct?
lost from extracellular compartment > intake -usually GI tract, kidneys Hgb and Hct increase, urine Na down, Urea increases
46
Tx of hypovolemia
Give isotonic IVFs rapid correction can lead to central pontine myelinoysis
47
What is polycystic kidney disease? Signs/sx?
multiple b/l cysts, (autosomal dominant MC 75%) hematuria, infection, pain from rupture, nephrolithiasis, nocturia weight loss, early satiety, N/V
48
Dx tool for Polycystic kidney dz? Tx
US is choice method Tx: pain management, ACE/ARB, aggressive abx if symptomatic, transplantation
49
Diabetes Mellitus causes...
1/2 of ESRD cases!
50
What should be avoided in pts w/ Cr greater than 1.4 in women and 1.5 in men? how many days after scan do you hold it?
Metformin 2 days
51
MC cause of renal artery stenosis?
atherosclerosis
52
Dx and tx of renal artery stenosis
Dx: renal angiogram is gold standard however, Doppler US is good start Tx: angioplasty, +/- stenting
53
DX and Tx of renal htn?
Dx: 2 episodes of SBP > 140 or DBP > 90 Lifestyle modifications then medications -thiazide diuretic, ACE/ARB, Ca chan blockers
54
MC sx of HTN?
Trick- | usually asymptomatic
55
SLE is MC in? What does it cause
young female 9x more likely than males Nephritis w/ proteinuria
56
Types of stones in Nephrolithiasis? | are they radiopaque or radiolucent
1. Calcium 75-85%- - radiopaque 2. Uric acid- radiolucent 3. Cystine- radiolucent 4. Stuvite- radiopaque. Pts w/ UTIs and recurrent caths
57
Most of Glomerulonephropathies are seen in?
kids ages 2-12 60%
58
Signs of Nephritic syndrome? | Tx?
hematuria, RBC casts, mild proteinuria, hTN RBC casts present! Tx: diuretics, salt/water restrict, dialysis
59
Sx of nephrotic syndrome?
Hypoalbumunemia heavy proteinuria hyperlipidemia edema
60
Major causes of death for dialysis pts?
CV disease, infection, withdrawal from dialysis
61
What is KDRI? Explain
Kidney Donor risk Index summarizes risk of graft failure KDPI 80% has higher expected risk of graft failure t
62
Antibodies in recipient blood can cause reaction resulting in a positive crossmatch
previous tip pregnancy blood transfusions
63
What do you need to watch for post transplant?
- new meds and drug-drug interactions - hyper/hypoglycemia - HTN/hypotension - N/V/D - wound complications - anemia - watch for hyper/hypovolemia
64
Hyperkalemia: sign on ekg tx
Sx: peaked T waves hemodialysis, sodium bicarbonate, D50 + insulin, Kayexalate
65
Hypercalcemia: | sx
sx: bones, stones, and groans common in hyperparathyroid and malignancies
66
Hypocalcemia: | sx
Trousseau sign (carpal tunnel spasm) Chevostek sign (spasm of facial muscles)
67
hyperphosphatemia cause? | hypophosphatemia?
Hyper: MC 2/2 CKD hypo: EtOH
68
Hypomagnesemia sign on EKG?
widening of QRS
69
HbA1C is ___ or great to dx DM?
6.5%
70
Type 1 DM characteristics, sx
autoimmune, early onset, risk of DKA sx: polydipsia, polyuria, nocturia, gastroparesis
71
Type 2 DM characteristics
later onset, +FH, obesity, hyperinsulinemia
72
What dz is a risk factor in pts who have kidney/pancreas tx?
Gastroparesis tx: metoclopramide, domperidone, erythromycin
73
What is key in preventing rejection after transplant?
Always steroids
74
What is Cytomegalovirus? sx? tx?
CMV MC viral infection found in immunocompromised pts most prominent 1st 3 months fevers, malaise, arthralgias, lymphocytes, thrombocytopenia gastroenteritis, myocarditis, pneumonitis, fatality tx= antivirals
75
EBV and BK virus causes what?
mononucleosis 45-50% reactivation after kidney transplant
76
What is the 2nd leading cause of death in liver transplant recipients?
Malignancy

Foundations II Exam 5 (Jess) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions