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NEPHROLOGY > NEPHROLOGY > Flashcards

NEPHROLOGY Flashcards

MASTER STEP-2 USMLE CONCEPTS

1
Q

Diagnostic Test for cystinuria?

A

Urinary cyanide-nitroprusside test (detects einc cystine levels)

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2
Q

Complications of Familial hypocalciuric hypercalcemia?
Renal function is often normal.

A
  1. Pancreatitis
  2. Chondrocalcinosis
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3
Q

Lab findings in Familial Hyocalciuric hypercalcemia?

A

1.Urine ca/cr clearance <0.01
2. Primary hyperparathyroidism > 0.02

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4
Q

MOA of Cinacalcet?

A

Increases sensitivity to Calcium

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5
Q

How does Obstructive uropathy (renal calculi) cause weakness?

A

Potassium wasting and dehydration due to excessive diuresis after the stone is overcome large volume of retained urine.

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6
Q

What I expect to find in the U/A of a pt with interstitial nephritis caused by one of the offensive drugs?

A

Eosinophiluria with WBC casts.

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7
Q

The MOA of antimuscarinic drugs like Oxybutynin used to treat urge incontinence?

A
  1. Increase bladder capacity and decrease detrusor contractions by reducing acetylcholine activity.
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8
Q

Type of incontinence?
Constant involuntary dribbling and incomplete emptying?

A

Overflow Incontinence

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9
Q

If my patient with neurogenic bladder cannot be put on Betannechol (a cholinergic agonist) what can I do to solve the problem?

A

Intermittent Catheterization

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10
Q

What does vaginal estrogen do for women with vaginal atrophy accompanied by stress or urge incontinence?

A

Increases uretheral resistance, raises sensory threshold of bladder fullness and promotes relaxation of detrusor muscle.

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11
Q

What is the first thing I will do when working up a Psych patient who had a seizure and is hyponatremic?

A

Check urine osmolality, if it is <100 mosm then this is very dilute urine - patient likely has primary polydipsia.

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12
Q

2 things that cause dilute urine with osmolality < 100mOsm?

A
  1. Primary polydipsia and Malnutrition (beer potomania)
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13
Q

Treatment for Uric Acid stones?

A
  1. Oral Potassium Citrate
  2. Alkalinization of the urine with potassium citrate to 6.0 - 6.5 since stone is soluble then
  3. Low purine diet
  4. Hydration
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14
Q

Acute Nephritic syndrome is primary glomerular damage d.t what?

A
  1. Post-strep glomerulonephritis
  2. IgA nepropathy
  3. Lupus nephritis
  4. membrano proliferative glomeruloneprtis
  5. RPGN
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15
Q

Pathology seen in Analgesic Nephropathy? What are the early manifestations? (women mostly, combination of large doses of NSAIDS & ASA)

A
  1. Papillary Necrosis
  2. Tubulointerstitial nephritis
    Polyuria and sterile pyuria (WBC casts) can be seen
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16
Q

Granulomatous diseases that cause Adrenal Insufficiency.

A
  1. Sarcoidosis
  2. TB
  3. Histoplasmosis
  4. Cocidiodomycosis
  5. Cryptococcocosis
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17
Q

Treatment for Iatrogenic Hyponatremia

A
  1. Hypertonic 3% Saline
  2. Serial measurement of electrolytes
  3. Increase serum sodium 6-8 in first 24hrs
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18
Q

What are the settings where sodium bicarbonate is used for treatment?

A
  1. Salicylate toxicity
  2. TCA overdose
  3. Severe metabolic acidosis (Renal failure)
  4. Hyperkalemia
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19
Q

Pre-renal acute Kidney injury leads to what type of renal disturbance.

A

Anion Gap metabolic acidosis, hyperkalemia

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20
Q

Primary clinical feature of Renal artery stenosis?

A

HTN

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21
Q

Drugs that cause Acute Interstitial Nephritis

A
  1. PCN
  2. TMP/SMX
  3. Cephalosporins
  4. NSAIDS
  5. Ciprofloxacin
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22
Q

Treatment for Acute Interstitial Nephritis besides discontinuation of offending drug.

A

Systemic Glucocorticoids

23
Q

Lab findings in Acute interstitial nephritis?

A
  1. Pyuria
  2. Eosinophilia
  3. Urinary Eosinophils
  4. WBC casts
24
Q

Renal biopsy results in Acute Interstitial Nephritis?

A

Inflammatory Infiltrate, Edema

25
Q

What is the osmotic stimuli for secretion of antidiuretic hormone?

A

Serum osmolality > 285

26
Q

What are the non-osmotic stimuli for secretion of anti-diuretic hormone?

A

Nausea, pain, physical or emotional stress, hypotension, hypovolemia, hypoxia, and hypoglyemia

27
Q

2 conditions that cause hypoalbuminemia?

A
  1. protein loss
  2. Decreased Albumin synthesis like in cirrhosis and malnutrition
28
Q

What is the cause of recurrent cystitis in toddlers?

A

Constipation - rectal distension prevents complete voiding and bacteria breeds.

29
Q

Most common glomerular cause of ESRD?

A

FSGS

30
Q

Microscopy findings in FSGS?

A

Localized regions of mesangial sclerosis and BM collapse

31
Q

Difference btw SIADH and central diabetes insipidus

A

In SIADH: ADH is high and urine NA is high
In Central diabetes insipidus: ADH is low and urine Na is low

32
Q

Metformin will cause lactic acidosis in patients with the following two conditions?

A

Acute Kidney Injury & Sepsis

33
Q

Why is it important to place a foley catheter in patients who have suffered traumatic spinal cord injuries.

A

Allows one to assess for urinary retention and prevent acute bladder distension and damage.

34
Q

What is the difference on CT/MRI of simple renal cysts vs malignant renal cysts?

A

Simple renal cysts: Absence of contrast enhancement
Malignant renal cysts: presence of contrast enhancement

35
Q

When would I expect to place a ureteral stent in a patient?

A

Urinary obstruction at the ureter or renal pelvis

36
Q

What do all these medications have in common:
ACEI
ARBS
K+Sparing diuretics
Cardiac Glycosides
NSAIDS
Digitalis
Cyclosporine
Heparin
Succinylcholine

A

They all cause hyperkalemia

37
Q

Non-drug related causes of hyperkalemia?

A
  1. Uncontrolled hyperglycemia
  2. Metabolic Acidosis
  3. Increased tissue catabolism like in trauma or tumor lysis syndrome
  4. Pseudohyperkalemia
38
Q

What is pseudohyperkalemia?

A

Hemolyzed blood sample

39
Q

The infectious agent that is one of the causes of membranous nephropathy - a nephritic condition

A

Hepatitis B

40
Q

2 adenocarcinomas that cause the neritis syndrome called membranous nephropathy?

A

Breast and lung cancer

41
Q

Hepatitis b/c and lipodystrophy are responsible for which nephritic disorder?

A

Membranoproliferative glomerulonephritis

42
Q

How does low dose dopamine work on the kidneys?

A

Works as a dopamine 1 receptor agonist, leading to renal arteriole dilation and increased renal blood flow.

43
Q

Risk factor for the second most common urologic cancer ?

A

Bladder cancer
smoking & exposure to industrial chemical

44
Q

Mom used ACEI during pregnancy and now we have this?

A

POTTER SYNDROME

45
Q

1 yo kid with: alkalosis, hypokalemia, hypercalcinuria

A

Barter’s syndrome/like a loop diuretic

46
Q

acts like a thiazide

A

Gittleman/PCT

47
Q

Affects the reabsorption of everything/proximal convoluted syndrome

A

Fanconi

48
Q

affects sodium channel by stimulating the activity, AD, Acts like aldosterone

A

Little
treat with Amiloride or Triamtrene to block the sodium channel of the collecting duct

49
Q

Give Iv ammonium chloride to check the levels of bicarbonate later in what disease?

A

RTA type 1

50
Q

treatment for RTA type 1/PCT

A

Sodium bicarb

51
Q

Test for RTA type 2

A

Test by giving them bicarb

52
Q

RTA TYPE 4 TREATMENT

A

Give fludrocortisone - acts like aldosterone

53
Q
A

NEPHROLOGY (1 decks)

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