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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
What is the osmotic stimuli for secretion of antidiuretic hormone?
Serum osmolality > 285
26
What are the non-osmotic stimuli for secretion of anti-diuretic hormone?
Nausea, pain, physical or emotional stress, hypotension, hypovolemia, hypoxia, and hypoglyemia
27
2 conditions that cause hypoalbuminemia?
1. protein loss 2. Decreased Albumin synthesis like in cirrhosis and malnutrition
28
What is the cause of recurrent cystitis in toddlers?
Constipation - rectal distension prevents complete voiding and bacteria breeds.
29
Most common glomerular cause of ESRD?
FSGS
30
Microscopy findings in FSGS?
Localized regions of mesangial sclerosis and BM collapse
31
Difference btw SIADH and central diabetes insipidus
In SIADH: ADH is high and urine NA is high In Central diabetes insipidus: ADH is low and urine Na is low
32
Metformin will cause lactic acidosis in patients with the following two conditions?
Acute Kidney Injury & Sepsis
33
Why is it important to place a foley catheter in patients who have suffered traumatic spinal cord injuries.
Allows one to assess for urinary retention and prevent acute bladder distension and damage.
34
What is the difference on CT/MRI of simple renal cysts vs malignant renal cysts?
Simple renal cysts: Absence of contrast enhancement Malignant renal cysts: presence of contrast enhancement
35
When would I expect to place a ureteral stent in a patient?
Urinary obstruction at the ureter or renal pelvis
36
What do all these medications have in common: ACEI ARBS K+Sparing diuretics Cardiac Glycosides NSAIDS Digitalis Cyclosporine Heparin Succinylcholine
They all cause hyperkalemia
37
Non-drug related causes of hyperkalemia?
1. Uncontrolled hyperglycemia 2. Metabolic Acidosis 3. Increased tissue catabolism like in trauma or tumor lysis syndrome 4. Pseudohyperkalemia
38
What is pseudohyperkalemia?
Hemolyzed blood sample
39
The infectious agent that is one of the causes of membranous nephropathy - a nephritic condition
Hepatitis B
40
2 adenocarcinomas that cause the neritis syndrome called membranous nephropathy?
Breast and lung cancer
41
Hepatitis b/c and lipodystrophy are responsible for which nephritic disorder?
Membranoproliferative glomerulonephritis
42
How does low dose dopamine work on the kidneys?
Works as a dopamine 1 receptor agonist, leading to renal arteriole dilation and increased renal blood flow.
43
Risk factor for the second most common urologic cancer ?
Bladder cancer smoking & exposure to industrial chemical
44
Mom used ACEI during pregnancy and now we have this?
POTTER SYNDROME
45
1 yo kid with: alkalosis, hypokalemia, hypercalcinuria
Barter's syndrome/like a loop diuretic
46
acts like a thiazide
Gittleman/PCT
47
Affects the reabsorption of everything/proximal convoluted syndrome
Fanconi
48
affects sodium channel by stimulating the activity, AD, Acts like aldosterone
Little treat with Amiloride or Triamtrene to block the sodium channel of the collecting duct
49
Give Iv ammonium chloride to check the levels of bicarbonate later in what disease?
RTA type 1
50
treatment for RTA type 1/PCT
Sodium bicarb
51
Test for RTA type 2
Test by giving them bicarb
52
RTA TYPE 4 TREATMENT
Give fludrocortisone - acts like aldosterone
53

NEPHROLOGY (1 decks)

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