Nephrology/Urology Flashcards
(114 cards)
What test can be done to evaluate urine dipstick + for blood with UA with no RBCs?
Urine ammonium sulfate test
Is FeNa > 1 or < 1 in prerenal azotemia and AGN?
<1
What does alkalemia do to calcium?
Increases bound calcium therefore decreases ionized calcium leading to hypocalcemia
What is normal osmolality?
285 +/- 10
What is the formula to calculate osmolality?
Osm = 2[Na+] + (glucose /18) + (BUN/2.8)
What are the two ways ADH levels are regulated?
1) Osmoreceptors in the hypothalamus
2) Volume (stretch) receptors in the LA and blood vessels
What are the three categories of hyponatremia?
Hypoosmolar
Hyperosmolar
Isoosmolar
What are the three categories of hypoosmolar hyponatremia?
Hypovolemic
Euvolemic
Hypervolemic
What is the common etiology of euvolemic hyponatremia?
SIADH or thiazide diuretics
If a patient is hyponatremic, what would a urine Osm of > 250 represent as an etiology?
SIADH
If a patient is hyponatremic, what would a urine Osm of <200 represent as an etiology?
Psychogenic polydipsia
How does hypothyroidism affect ADH release?
Decreased cardiac output –> carotid baroreceptors
What is the max rate of hyponatremia correction over 24 hours? What is the risk?
10meq/L over 24 hours maximum, 0.5meq/L per hour
Concern for osmotic demyelination syndrome
What electrolyte abnormalities may induce nephrogenic DI?
Hypercalcemia
Chronic Hypokalemia
What common medication can cause nephrogenic DI?
Lithium
What is the test to differentiate between central and nephrogenic DI?
Water restriction test
What is the treatment of mild cases of central DI?
Thiazides
Salt restriction
Can give desmopressin in resistant cases
What is the treatment of nephrogenic DI?
Thiazide diuretics or amiloride
Sodium restriction
What is the typical volume status of a patient with DI?
Euvolemic
What is the effect of renin on aldosterone release?
Increases aldosterone release
What is the effect of spironolactone on aldosterone release?
Blocks aldosterone receptor
Increase K+
What is the effect of Trimethoprim on K+ levels?
Causes hyperkalemia due to interference in distal tubule and collecting duct
Which type of RTA is associated with hyperkalemia?
Type 4
What impact do the syndromes Liddle’s, Barters and Gitelman’s have on potassium levels?
Cause hypokalemia