Nephrology Flashcards
Interstitial nephritis vs glomerulonephritis
interstitial will have increased WBCs greater than RBCs in the urine, glomerulonephritis will have the opposite.
RCC
Flank pain, hematuria, palpable renal mass. May have L scrotal varicocele. Can present with thrombocytosis or anemia (more advanced disease).
Diabetic Nephropathy
BP should be regulated to below 130/80
IgA nephropathy vs Post Infectious Glomerulonephritis
IgA hematuria starts with 5 days, PIGN hematuria starts 10-21 days later and low levels of complement proteins.
Acute Poststreptococcal Glomerulonephritis
1-4 weeks after strep (throat or impetigo) immune complexes in the mesangium and basement membrane.
Hematuria, HTN, edema
Most patients recover with supportive measures.
Indications for Urgent Dialysis (AEIOU)
Metabolic Acidosis (pH <7.1 after medical therapy)
Electrolytes (Symptomatic hyperkalemia or refractory to treatment)
Ingestion (methanol, ethylene glycol, salicylate, lithium, valproate, carbamazepine)
Overload (volume overload refractory to diuretics)
Uremia (Symptomatic, pericarditis, bleeding)
Minimal Change Disease
Nephrotic syndrome in kids
Podocyte injury
Edema, fatigue, no hematuria
Tx: corticosteroids
Renal Tubular Obstruction
AKI within 7 days of starting a new drug. Usually asymptomatic.
-Acyclovir, sulfonylureas, methotrexate, ethylene glycol, protease inhibitors, uric acid.
Nephrogenic DI
ADH resistance in kidney
Chronic lithium use, hypercalcemia or hereditary
Normal Serum sodium
Amyloidosis presentation and causes
proteinuria, cardiomyopathy, hepatomegaly, peripheral neuropathy, macroglossia, waxy skin
Found in RA, recurrent infections, IBD, Malignancy, Vasculitis
Renal Vein thrombosis
sudden onset membranous glomerulopathy
RCC precursor
benign cysts
ADPCKD
Aneurysms and kidney cysts
ARPCKD
Early onset renal failure with hepatic fibrosis and liver cysts.
VUR complications
renal scarring, HTN, renal insufficiency
Uric Acid Kidney Stones
Tx: Potassium Citrate alkalizes the urine and increases the solubility of uric acid crystals.
Hypocalcemia in CKD
Decreased 1,25 VitD synthesis and increased phosphate retention
Conn Syndrome
Hypokalemia, mild hypernatremia, metabolic alkalosis (increased bicarb reabsorption and increased H+ secretion)
Hypocalcemia with calcium oxalate crystals in urine
Ethylene glycol poisoning
Fomepizole
May present with hematuria, AKI, anion gap metabolic acidosis
Hemodialysis may be required to correct the acidosis
Metabolic findings in OSA+OSH
Constant hypercapnia (not just at night) causes the kidneys to increase Bicarb retention and increase chloride excretion.
Electrolytes in Rhabdo
Hyperkalemia, Hyperphosphatemia
SIADH
Low NA, high urine osmolality, high urine sodium
