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PGY-4 Board Prep > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Liddle syndrome

A

pseudoaldosteronism
AD
hypertension, hypokalemia, and metabolic alkalosis (with high urinary chloride).

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2
Q

Gordon Syndrome

A

pseudohypoaldosteronism

hypertension, hyperkalemia, metabolic acidosis, and normal renal function

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3
Q

Treatment of Scleroderma Renal Crisis

A

ACEI

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4
Q

CKD G1

A

90

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5
Q

CKD G2

A

60-89

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6
Q

CKD G3a and b

A

3a 45-59

3b 30-44

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7
Q

CKD G4

A

15-29

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8
Q

CKD G5

A

<15

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9
Q

Alb/Crt Ratio

A

A1 <30
A2 30-300
A3 >300

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10
Q

Prot/Cr Ratio

A

<200 (or 150?)

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11
Q

24 Urine Protein

A

<150

>3.5 Nephrotic

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12
Q

Value for potential treatment of anemia in CKD

A

<10

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13
Q

CKD: When to Add Sodium Bicarb

A

Bicarb <22

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14
Q

Kidney Disease and Vitamin D

A

inability to convert to active form of Vit D
Decreased Calcium
Due to CKD, increased phos (normally decreased)
Increase in PTH

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15
Q

Primary Hyperparathyroidism Values

A

High PTH –> High Ca and High Phos

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16
Q

Secondary Hyperparathyroidism due to CKD

A

Low Calcium, High Phos –> High PTH (due to Vit D + inability of kidneys to filter phos)

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17
Q

Secondary Hyperparathyroidism due to Vit D Def

A

Low Ca and Low Phos

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18
Q

Tertiary Hyperparathyroidism due to CKD

A

HIgh Ca, Phos, PTH

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19
Q

Agents that reduce proteinuria

A

ACEI
ARB
Non-dihydropine CCBS: Verapamil and Dilt

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20
Q

Nephrogenic Systemic Fibrosis - GFR to worry about

A

<30 and gadolinium (MRI)

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21
Q

ADH - mechanism

A

stimulate reabsorption of water in the collecting duct

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22
Q

AIN Triad

A

fever, rash and peripheral eosinophilia

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23
Q

Anion Gap

A

Na-Cl+HCO3

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24
Q

Albumin Correction of AG

A

Ag + 2.5 x (normal/measured)

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25
Q

Delta/Delta Ratio

A

AG- 12 / Bicarb -24

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26
Q

Delta Delta Ratio Values

A

<1 - NAGMA

>2 - metabolic alkalosis

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27
Q

Type A Lactic Acidosis

A

Tissue Hypoperfusion = MUDPILES

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28
Q

Type B Lactic Acidosis

A
  • Propofol
  • metformin
  • HIV NRVT
  • Heme/Malignancy
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29
Q

D-lactic Acidosis

A

short bowel syndrome

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30
Q

MUD (of MUDpiles)

A

Methanol
Uremia
DKA, Drugs

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31
Q

PILES (of MudPILES)

A 
Phosphate or Paraldehyde
Ischemia
Lactate
Ethylene Glycol
Starvation or Salicylates
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32
Q

NGMA - DURHAM

A 
Diarrhea
Urteral Diversion
RTA
Hyperalimentation
Addison Disease, Acetazolamide
Misc (chloride, amph B, toluene)
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33
Q

Winter’s Formula for HAGMA compensation

A

1.5 x Bicarb + 8 +/- 2

34
Q

Metabolic Alkalosis - Low Urine Cl/Saline Responsive

A

Diuretic Use
Vomiting
NG Suction
Post-hypercapnia alkalosis

35
Q

Metabolic Alkalosis - High Urine Cl w/o HTN

A

Decreased Mg or K
Barter or Gietlman
Laxative Abuse

36
Q

Metabolic Alkalosis - High Urine Cl w/ HTN

A

Cushing Syndrome
Conn
RAS/RVH
Liddle Syndrome

37
Q

Urine Anion Gap

A

Na+K-Cl
negative = presence of ammonium (base, means acid secretion is happening)
positive = lack of ammonium

38
Q

Proximal Tubule Function (for RTA)

A

bicarb reabsorption

39
Q

Distal Tubule Function (for RTA)

A

acid excretion/clearing daily acid load

H + NH3 = NH4+ (ammonium)

40
Q

Type II RTA

A

proximal tubule defect, lack of bicarb reabsporption

41
Q

Causes of Type II RTA

A

Drugs - Topiramate, Acetazolamide
Multiple Myeloma
Fanconi Syndrome

42
Q

HTN Secondary Causes “A”

A

Apnea

Alcohol

43
Q

HTN Secondary Causes “B”

A

bad kidneys - CKD, RAS, FMD, PCKD

44
Q

HTN Secondary Causes “C”

A

coarctation of aorta, cocaine

45
Q

HTN Secondary Causes “D”

A

drugs + diet

46
Q

HTN Secondary Causes “E”

A

Endocrine: hyper/hypothyroid, pheochromocytoma, increasing aldosterone/Conn, Cushing

47
Q

Most Common Types of Kidney Stones

A

Calcium Oxalate > Calcium Phos

48
Q

Calcium Oxalate Stones associated with

A

hypercaliuria/hypercalcemia
hyperoxaluria
hypocitraturia

49
Q

What stones can be seen on KUB?

A

Radiopaque = Ca ox + Ca phos

50
Q

Treatment of Calcium Stones

A

Thiazide diuretics
Limit Sodium
K citrate or K bicarb
Limit oxalate intake

51
Q

Type I RTA

A

distal, hypokalemic, can’t excrete hydrogen!

52
Q

Type I RTA common causes

A

Autoimmune = Sjogrens, SLE
Sickle Cell Anemia
Reflex/Obstructive Uropathy

53
Q

Type IV RTA

A

distal, hypoaldosteronism

hyperkalemic

54
Q

Type IV RTA common causes

A

DM
Obstructive Uropathy
Drugs = Heparin, ACE, ARB, NSAIDs

55
Q

Treatment Anemia in CKD - goals

A

transferritin sat >30

ferritin >500

56
Q

ADPCKD associations

A

hepatic cysts
MVP
intracranial aneurysms

57
Q

Tuberous Sclerosis renal manifestations

A

renal angiomylolipomas
renal cell carcinoma
renal cysts

58
Q

Hereditary Nephritis =

A

Alport Syndrome
X linked
sensioneural hearing loss, eye abnormalities

59
Q

Thin Glomerular Basement Membrane Disease

A

Benign Familial Hematuria

type IV collagen defects

60
Q

Fabry Disease

A

X-linked Recessive
defieincy of alpha-glactosiadase A
CKD of unknown etiology in young adults!

61
Q

Pyroglutamic Acidosis

A

5-oxoproloine, HAGMA
mental status changes in older/frail person on chronic Tylenol at low dose
can measure urine levels of pyroglutamic acid

62
Q

Treatment of Alcohol KetoAcidosis

A

D5-NS

stimulate insulin secretion to correct ketoacidosis

63
Q

Hyperaldosteronism classic triad

A

resistant HTN
metabolic alkalosis
hypokalemia

64
Q

Hypermagnesemia treatment

A

Saline Diuresis for magnesium excretion

IV Calcium

65
Q

Nephrotic Syndrome - 4 things

A

nephrotic range proteinuria
edema
hyperlipidemia
hypoalbuminemia

66
Q

APOL1 gene

A

FSGS, African americans

67
Q

Causes of Membranous Nephropathy

A

SLE, hepatitis, solid tumors

68
Q

spikes of immune deposits, dx?

69
Q

podocyte effacement or fusion, dx?

70
Q

Nephritis Syndrome/GN/RPGN Charactersitis

A

HTN
hematuria
proteinuria
azotemia

71
Q

Definition of RPGN

A

50 % decline in GFR

extensive glomerular creseents

72
Q

ANCA GN with worse progrnosis

A

C ANCA/anti-PR3

73
Q

“Full House” appearance on IF, dx?

A

Lupus Nephritis

74
Q

Pauci-Immune GN?

A

ANCA associated

75
Q

Linear GN?

A

Ant-GBM antibody disease

76
Q

Infection Related GN latency period

A

1-2w URI

2-4 skin infections

77
Q

Infection Related GN common infections in adults

A

S aureus, GN bacteria

78
Q

PTH Mediated Hypercalcemia

A

Primary and Tertiary Hyper PTH
Familial Hypocalciuric Hypercalcemia
Ectopic PTH Secretions

79
Q

Non-PTH Mediated Vitamin D-Dependent Hypercalcemia

A

excess vitamin d intake
granulomatous disease
lymphomas

80
Q

Non-PTH Non-Vitamin D Dependent Hypercalcemia

A

PTHrp

Bone Mets/infiltration (MM)

81
Q

Clue for Light Chain/MM/Cast Nephropathy

A

elevated Ur/Prot Cr ration with minimal prot on dipstick

PGY-4 Board Prep (18 decks)

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