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Foundations of Clinical Practice II > Nephrology (Stearns) > Flashcards

Nephrology (Stearns) Flashcards

1
Q

Which test is safe, easy to use and most commonly used?

A

Renal Ultrasonography

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2
Q

Downside to Renal ultrasonography?

A

less sensitive for renal masses

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3
Q

Which test is the gold standard for renal stones?

A

CT

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4
Q

Which image studies are preferred in children due to reduced radiation compared to CT?

A

Radionuclide studies

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5
Q

At what eGFR is gadolinium contraindicated?

A

eGFR < 30mL/min

  • in moderate to advanced kidney disease gadolinium can lead to severe syndrome of nephrogenic systemic fibrosis
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6
Q

Nephrogenic systemic fibrosis (NSF)

A
  1. Thickening of skin on trunk and extremities, and fibrosis of dermis, muscle, fascia, lungs and heart
  2. Chronic, unremitting - wheelchair bound in weeks
  3. Exclusive to patients with renal failure
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7
Q

What is Hydronephrosis

A

Unilateral or bilateral edema of the collecting system

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8
Q

Hydronephrosis: treatment

A

stent

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9
Q

Acute Kidney Injury

A
  • abrupt (within 48 hours) decline in renal filtration/function
  • reversible
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10
Q

Acute renal failure: What two things decrease?

A
  1. GFR

2. Urine output - less than 0.5mL/kg/hr for >6hrs

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11
Q

Acute renal failure: What will increase? (2)

A
  1. Urea

2. Creatinine (Azotemia)

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12
Q

What are the 3 causes of Acute Renal Failure/Acute Kidney Injury

A
  1. Pre-renal AKI
  2. Intrinsic AKI
  3. Post-renal AKI
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13
Q

Which of the 3 causes of acute kidney injury is most common?

A

Pre-renal

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14
Q

Name some causes for prerenal acute kidney injury

A

***hypoperfusion leading to decrease in renal perfusion

  1. Decrease in intravascular volume (bleed, diarrheas, burns, dehydration, nephrotic syndrome)
  2. Change in vascular resistance (cirrhosis, sepsis, anaphylaxis, anesthesia)
  3. Low cardiac output (CHF, PE, tamponade)
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15
Q

What happens to the BUN/Cr ratio in AKI

A

increases

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16
Q

What are the characteristic findings with Acute tubular necrosis?

A

UA: muddy brown casts

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17
Q

What is the most common form of intrinsic acute kidney injury?

A

Acute tubular necrosis

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18
Q

Name 3 causes of Acute tubular necrosis?

A
  1. Ischemia
  2. Nephrotoxins (aminoglycosides, amphotericin B, Vancomycin, contrast)
  3. Hypotension/hypoxemia
19
Q

Acute tubular necrosis: TX (4)

A
  • avoid volume overload
  • avoid hyper kalemia
  • protein restrict
  • +/-diuretics
20
Q

What do you give with bicarb to renally protect from radiographic contrast?

A

N-acetylcystine

21
Q

Acute interstitial nephritis: most common cause

A

nephrotoxic drugs

22
Q

What is the classic finding on UA for Acute interstitial nephritis?

A

eosinophiluria

23
Q

Acute interstitial nephritis: treatment

A

-Steroids

+/- dialysis

24
Q

AKI: Instrinsic causes

A
  1. Acute tubular necrosis
  2. Acute interstitial nephritis
  3. Glomerular nephritis
  4. Vascular
25
Q

What is the etiology of glomerulonephritis?

A

immune complex deposition

26
Q

What is the characteristic UA finding for Glomerulonephritis?

27
Q

Glomerulonephritis: treatment

A
  • steroids

- plasma exchange

28
Q

AKI: Post renal causes

A

Obstructive (BPH, stones, bladder dysfunction, anticholinergic drugs, bladder CA)

29
Q

What are the indications for kidney biopsy

A
  1. Nephrotic syndrome: SLE
  2. Nephritic syndrome
  3. Unexplained acute renal failure
30
Q

What is a page kidney? How is it treated?

A

bleeding into the capsule of the kidney from biopsy. Remove capsule surgically

31
Q

Azotemia

A

Nitrogen in the blood (BUN and Cr are markers of nitrogen accumulation)

32
Q

What is the gold standard for diagnosing CKD

33
Q

CKD: treatment

A
  1. ACE/ARBs slow progression
  2. Epogen (medication that works like erythropoietin)
  3. Low protein diet, fluid restriction, Calcium/Vitamin D supplements
34
Q

At which stages does uremia develop in kidney disease?

35
Q

What is the gold standard for diagnosing renal artery stenosis?

A

Renal angiogram

36
Q

What is the best initial test for a patient with suspected renal artery stenosis?

A

Doppler US

37
Q

In SLE what would you expect to see on UA?

A

nephritis with proteinuria

38
Q

What is the treatment for SLE affecting the kidneys?

39
Q

Which 2 kidney stones are radiopaque?

A

Calcium and struvite

40
Q

Which 2 kidney stones are radiolucent?

A

Uric acid and cystine

41
Q

Nephritic Syndrome (4) characteristics

A
  • Hematuria
  • RBC casts
  • Mild proteinuria
  • HTN
42
Q

Nephrotic Syndrome (4) key characteristics

A
  • Hypoalbuminemia
  • Heavy proteinuria (>3.5mg/day)
  • Hyperlipidemia
  • Edema
43
Q

Name 3 examples of reversible processes that can lead to a decrease in renal function, but are reversible if fixed early

A
  1. Hypovolemia
  2. Infection
  3. Drugs: NSAIDs, ACE

Foundations of Clinical Practice II (25 decks)

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