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Nephrology Flashcards

1
Q

AKI etiology after arterial cath

A
  1. CIN

2. atheroembolic emboli (if persistent 5 days after) + Eos

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2
Q

Renal injury after bowel prep

A

phosphate nephropathy - check phosphate level

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3
Q

avoid fleet enema

A

> 50 yo
CKD
DM

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4
Q

Abdominal compartment syndrome

A

IAP >20 w/ AKI (N 6-7)

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5
Q

Treatment of Abdominal compartment syndrome

A

decompressive laparotomy

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6
Q

Minimal change dz clues

A
  • sudden onset

- Hodgkins dz + NSAIDS

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7
Q

FSGS

A

AA patient with nephrotic syndrome
HIV
obesity

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8
Q

membranous nephropathy

A

malignancy associated (25% is from a secondary cause)

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9
Q

Ddx for nephrotic syndrome a/w AKI

A
  1. MCG w ATN or
    AIN
  2. membranous w. b/l renal vein thrombosis
  3. amyloid w cast nephropathy
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10
Q

definitive dx of nephrotic syndrome

A

renal bx

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11
Q

Role of prophylactic AC in nephrotic syndrome

A

none

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12
Q

Role of bicarb in CKD when bicarb is <22

A

slows progression of CKD (sodium bicarbonate or sodium citrate)

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13
Q

Consequences of untreated chronic metabolic acidosis

A

muscle loss

bone loss

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14
Q

Treatment for primary Minimal change

A

glucocorticoids
ace/arb
diuretics
cholesterol lowering meds if total >200

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15
Q

Monoclonal gammopathy of renal significance

A

MGUS + renal insufficiency –> renal bx

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16
Q

Treatment of IgA nephropath

A

ACE/ARB

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17
Q

Role of any immunosuppression in IgA

A

controversial - never will be the answer

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18
Q

Causes of calcium oxalate stones in malabsorption/diarrhea

A
  1. urne citrate is an inhibitor of crystallization that is reduced in metabolic acidosis
  2. enteric calcium binds to poorly absorbed fat allowing oxalate to be absorbed and excreted in the urine
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19
Q

clues to dysproteinema related kidney disease

A

older, hypercalcemia, anemia, evidence of proximal tubular dysfunction (hypoK, hypophos, metabolic acidosis,

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20
Q

diagnosis of diabetic nephropathy

A

clinical. doesn’t need bx if 8 years of dm + nephrotic

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21
Q

Constellation of symptoms a/w MM

A

Old, hypercalcemia, anemia, NAGMA, AKI

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22
Q

Treatment of ethylene glycol

A

fomepizole, fluids, HD

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23
Q

lab findings of ethylene glycol

A

NAGMA, osmlol gap

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24
Q

osmol gap

A

measured - calculated >10

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25
Q

MOA of renal damage of ethylene glycol

A

calcium oxalate crystal deposition

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26
Q

AutoAB in 75% of primary cases of membranous glomerulopatny

A

PLA2R

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27
Q

Treatment of nephrogenic DI

A

thiazides

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28
Q

Tolvaptaan

A

vasopressin antagonist use for SIAD

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29
Q

heparin does what to K

A

hyperK+ (2/2 hypoaldosteronism)

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30
Q

> 50% of RPGN etiology

A

ANCA associated vasculitis

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31
Q

SE of chronic Tylenol use in patients with CKD, liver dz or poor nutrition

A

pyroglutamic acidosis (AGMA)

32
Q

Pyroglutamic acidosis

A

too much Tylenol depleting glutathione

33
Q

Acid-base disturbance in patients with short gut

A

D lactic acidosis

34
Q

Acid base disturbance with salicylate

A

respiratory alkalosis

or RA with AGMA

35
Q

Hematuria

A

> 3 rbc/hpf

36
Q

AUA risk factors for lower urinary tract malignancy

A

> 35 w irritative voiding symptoms, smoking, aniline dyes or cyclophosphamide

37
Q

risk factors to vanc nephrotoxicity

A

CKD, troughs >15, and concomitant use of loop diuretics

38
Q

Correction of acute hyponatremia

A

can be rapid. 2-3mmol immediately

39
Q

Correction rate of chronic hyponatremia

A

<10 in 24 hours.

40
Q

imaging for new diagnosis of fibromuscular dysplasia

A

one time head to pelvic imaging to look for aneurysms.

41
Q

Serum Cr elevation of more than 30% after initiation of ACE

A

look for fibromuscular dysplasia

42
Q

When to test for primary aldosternonism

A
  1. resistant HTN, adrenal mass
  2. spontaneous hypokalemia
  3. diuretic induced hypokalemia
43
Q

Dialysis and statins

A

Recommends against, in patients with ESRD, unless they have residual function of kidneys

44
Q

Gold standard for nephrolithiasis

A

Non contrast, helical CT

45
Q

Management of primary membranous nephropathy

A

PLA2R highly specific
- high rates of remission in 6-12 months. statin (if applicable) plus ace/arb and monitor. if things change or persistent nephrotic protein start immunosuppressants

  1. After alternating months of steroids + alkylating agents (can use cyclosporine if can’t use alkylating ages)
46
Q

Distal type 1 RTA

A

hyperchlorema, hypoKalemia 2/2 inability to excrete acid

47
Q

type 4 RTA

A

distal hyperkalemic (2/2 aldosterone def or resistance), NAGMA

48
Q

type 2 (prox)

A

issue with bicarb reclaiming

49
Q

Needed in the Dx of HELLP

A

MAHA (peripheral smear and bili level)

50
Q

B2 micro globulin associated amyloid pts

A

seen in dialysis for at least 5 years, present with shoulder pain, carpal tunnel

51
Q

Triad of hyperaldosteronism

A

metabolic alkalosis
hypokalemia
resistant HTN

52
Q

How to evaluate metabolic alkalosis

53
Q

saline responsive metabolic alkalosis lab

A

urine cl <15

54
Q

management of hypermagnesemia

A

saline
lasix
IV calcium

55
Q

electrolyte issues 2/2 hypomag

A

hypoK

hypoCa (increased PTH increase)

56
Q

Primary bug of post infectious GN

A

s. aureas (more so co exists, rather than post strep - 7 day lag)

57
Q

Gout ppt element that causes a chronic tubulointerstitial disease

58
Q

Acidosis associated with crohns or short gut

A

D lactic acidosis

AGMA, non osmol

59
Q

AGMA, osmol gap

A

ethylene glycol, methanol

60
Q

OP meds for HTN and conception

A

labetolol, nifedipine, methyldopa

61
Q

Immunosuppresants ok in pregnancy

A

AZA, tacrolimus, cyclosporine

62
Q

urine dipstick detects what kind of protein

A

albumin (not light chains)

- useful if you have a high protein/cr ration but small protein on urine to detect things other than albuminuria

63
Q

GFR of when to start evaluating for kidney transplant

64
Q

TIPS indication

A
  1. variceal hemorrhage
  2. refractory ascites
    Risk: increased HE, renal injury 2/2 contrast
65
Q

Etiology of hyperNa with urine ism 300-600

A

urea osmotic diuresis or glucose diuresis

66
Q

HTN med for difficult to control blood pressure w CKD

A

add a Loop (esp with cKd, cirrhosis, heart failure)

thiazides have less use as a diuretic with GFR <30

67
Q

4 variables to predict CKD progression

A
  1. age
  2. sex
  3. GFR
  4. albumin - cr ratio
68
Q

presentation of renal amyloid

A

nephrotic
bland ua
inflammatory conditions
TX: toci (IL-6)

69
Q

NSAID nephropathy

A
  1. AIN
  2. Membranous (pyuria, abc casts, proteinuria)
  3. MC
70
Q

Concern in ESRD pt with macroscopic hematuria or flank pain

A

RCC!

they have increased risk

71
Q

When to initiate HD in CKD patients

A

don’t need to start until symptomatic (uremic, fluid overload, acidosis)

72
Q

Nephrotic syndromes

A
  1. minimal change
  2. membranous
  3. membranoproliferative (only has low complements -rest wnl)
  4. FSGS
73
Q

Membranous nephropathy

A

Solid Cancer!! age appropriate screening

74
Q

FSGS

A

think AA!
Obesity!
HIV

75
Q

Membranous nephropathy

A 
Caucasian!
higher risk of clots (renal vein thrombosis - LDH)
carcinoma 
SLE, RA
Tx: ACEI, immunomodulation
76
Q

membranoprolif

A

hep C (low complements)

ABIM (4 decks)

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