Nephrology - random topics

Question 1

non anion gap metabolic acidosis, positive urine anion gap

Answer 1

renal tubular acidosis

Question 2

non anion gap metabolic acidosis, negative urine anion gap

Answer 2

gut cause (diarrhea, laxative abuse, etc.)

Question 3

Anion gap calculation

Answer 3

Serum Na - serum Cl - serum bicarb

Question 4

Anion gap corrected for albumin calculation

Answer 4

Anion gap + 2.5 x (Normal albumin - measured albumin)

Question 5

Urine anion gap calculation

Answer 5

(Urine Na + urine K) - urine Cl

Question 6

Non anion gap metabolic acidosis, positive urine anion gap, low K, urine pH >5.5

Answer 6

Type 1 (distal hypokalemia) RTA

Question 7

Non anion gap metabolic acidosis, positive urine anion gap, high K, urine pH <5.5

Answer 7

Type 4 (distal hyperkalemia) RTA

Question 8

Non anion gap metabolic acidosis, positive or negative urine anion gap, low K, variable urine pH

Answer 8

Type 2 (proximal) RTA

Question 9

Medications that can cause type 2 proximal RTA

Answer 9

topiramate, acetazolamide, ifosfamide, tenofovir fumarate

Question 10

Causes of type 2 proximal RTA

Answer 10

Fanconi syndrome, myeloma light chains, medications (topiramate, acetazolamide, ifosfamide, tenofovir fumarate)

Question 11

Medications that can cause type 1 distal hypokalemia RTA

Answer 11

amphotericin B, lithium

Question 12

Causes of type 1 distal hypokalemia RTA

Answer 12

Sjogrens, obstructive uropathy, reflux uropathy, sickle cell disease, Wilson disease, medications (amphotericin B, lithium)

Question 13

Medications that can cause type 4 distal hyperkalemia RTA

Answer 13

ACE/ARB, heparin, COX-2 inhibitors

Question 14

Causes of type 4 distal hyperkalemia RTA

Answer 14

Addison disease (primary adrenal insufficiency), urinary obstruction, sickle cell disease, kidney transplant rejection, medullary cystic kidney disease, medications (ACE/ARB, heparin, COX-2 inhibitors)

Question 15

RTA that is associated with kidney stones and nephrocalcinosis

Answer 15

type 1 distal hypokalemia RTA

Question 16

treatment of type 2 proximal RTA

Answer 16

alkali replacement, thiazides

Question 17

treatment of type 1 distal hypokalemia RTA

Answer 17

potassium citrate

Question 18

treatment of type 4 distal hyperkalemia RTA

Answer 18

thiazides, loop diuretics, fludrocortisone

Question 19

causes of anion gap metabolic acidosis with elevated plasma osmolar gap

Answer 19

Ethylene glycol
Methanol
Propylene glycol
Isopropanol, isopropyl alcohol

Question 20

Drug toxicity that can cause a mixed acid-base disorder characterized by respiratory alkalosis, increased anion gap metabolic acidosis, and metabolic alkalosis

Answer 20

Salicylates (aspirin)

Question 21

treatment of ethylene glycol poisoning

Answer 21

fomepizole
IV hydration
hemodialysis (for severe acidosis, CNS depression, AKI, systemic collapse)
sodium bicarb

Question 22

treatment of methanol poisoning

Answer 22

fomepizole
hemodialysis (for severe acidosis, CNS depression, visual impairments)
sodium bicarb

Question 23

treatment of salicylate poisoning

Answer 23

sodium bicarb
hemodialysis (for AKI, CNS depression, cerebral edema, serum salicylate levels >100 in acute ingestion and >60 in chronic ingestion, pulmonary edema)

Question 24

Delta-delta calculation

Answer 24

(anion gap -12)/(25 - bicarb)

Question 25

Delta-delta <0.5 -1

Answer 25

concurrent NAGMA

Question 26

Delta-delta >2

Answer 26

concurrent metabolic alkalosis