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UWorld step 2 > nephrology UWorld > Flashcards

nephrology UWorld Flashcards

1
Q

Diabetic nephropathy changes

A

GBM changes — glomerular basement membrane
Micro-angiopathy

1) glomerular hyperfiltration
2) Glomerular basement membrane fibrosis and thickening
3) interstitial fibrosis, mesangial thickening and nodules (kimmelstiel Wilson lesion)

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2
Q
A
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3
Q

<50% foot process effacement and severely obese

A

FSGS

lose weight

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4
Q

complications of nephrotic syndrome

A

hypercoagulability: increased risk of thromboembolism d/t urinary loss of antithrombin III and hepatic synthesis of fibrinogen

hyperlipidemia: increase risk of atherosclerosis d/t hepatic synthesis of lipoproteins

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5
Q

iga nephropathy vs post strep gn

A
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6
Q

serum complement

A
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7
Q

low C3, childbearing woman age, pancytopenia, can have joint pains, hx of sinusitis, no prior infection

A

lupus nephritis

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8
Q

pt takes acyclovir, BUN:Cr 38:2.8 (13:1)

A

renal tubular obstruction

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9
Q

pt has septic shock, gets antibiotics, then few days later gets FeNa>2%

A

ATN: drug induced Aki

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10
Q

dialysis related amyloidosis

A

beta-2- microglobulin, can cause osteoarticular structural problems:
scapulohumeral periarthritis (deposits on imaging)
carpal tunnel: weakness of thenar eminence and atrophy
bone cysts

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11
Q

pt with Rheumatoid arthritis, now has 4+ proteinuria

A

glomerular deposits seen after special (congo red) staining
amyloidosis

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12
Q

pt with Rheumatoid arthritis, now has 4+ proteinuria

A

glomerular deposits seen after special (congo red) staining
amyloidosis

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13
Q

CKD + excessive bruising and normal coagulation studies

A

platelet dysfunction

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14
Q

advanced cirrhosis kidney injury

A

renal hypoperfusion
NO –> splanchnic dilation –> systemic vasodilation –> decreased peripheral vascular resistance and BP –> renal hypoperfusion

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15
Q

chronic hypertension and kidneys

A

u/s: small atrophic kidneys, hyaline arteriosclerosis, glomerulosceloriss, bland UA with mild proteinuria <1g/day

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16
Q

tall, peaked t waves with shortened qt interval, widened QRS

A

hyperkalemia
calcium gluconate + insulin/glucose

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17
Q

management of hypercalcemia

A

normal saline

18
Q

rapid correction of hypo-natremia

rapid correction of hyper-natremia

A

osmotic demyelination

cerebral edema

19
Q
A
20
Q

chronic alcohol use with diffuse weakness and hyporeflexia hours after receiving IV fluids

A

refeeding syndrome
LOW PHOSPHOROUS, POTASSIUM, MAGNESIUM

21
Q

normal anion gap metabolic acidosis

A
22
Q

seizure activity (tonic clonic) now has metabolic acidosis

A

observe and repeat labs 2 hours later
post-ictal lactic acidosis d/t skeletal muscle hypoxia

23
Q

chronic alcoholism with constant low Potassium even though attempted to replenish K

A

hypomagnesemia

24
Q

Patient just started sertraline now has hyponatremia, serum osmolality 260, urine osmolality 500, urine Na 56

A

SIADH 2/2 SSRI

25
Q

hypernatremia

A
26
Q

causes of hyperkalemia

A
27
Q

hypovolemic hyponatremia in pt with diarrhea d/t c-diff, poor oral intake
ADH
Renin
Aldosterone

A

ADH: HIGH
renin: high
aldosterone: high

28
Q

pt with pH>7.45 and serum bicarb > 24, with urine chloride<20

A

self-induced vomitting – loss of Cl- and H+ (alkalosis)

vs loop diuretic or thiazide diuretic overuse: loss of Cl- and retention of bicarb (alkalosis) – will see lots of salt wasting so high sodium in urine

serum chloride differentiates metabolic alkalosis from vomitting, barter/gitlemen(since Cl- can not be reabsorbed)

29
Q

hyponatremia

A
30
Q

metabolic acidosis with normal anion gap w/ patient who has Sjorgen syndrome

A

Renal tubular acidosis type 1
impaired H+ excretion by alpha-cells in distal tubule
Hypo-K
urine pH > 5.5

31
Q

RTA 1

A

Renal tubular acidosis type 1
impaired H+ excretion by alpha-cells in distal tubule
Hypo-K
urine pH> 5.5

32
Q

RTA 2

A

impaired Bicarb reabsorption in proximal tubule
Hypo-K ***
urine pH < 5.5

33
Q

RTA 4

A

reduced aldosterone
impaired H+ and K+ excretion in collecting duct
hyper-K**
urine pH<5.5

34
Q

DKA
pH
Bicarb
PaCo2

A

ph: low
bicarb: low
paco2: low

35
Q

asymptomatic hypercalcemia and normal renal function

A

familial hypocalciuric hypercalcemia – AD calcium sensing receptor

36
Q

mixed acid base

A
37
Q

chronic lithium use – nocturne + dilute urine (urine osmolality < 200)

A

Nephrogenic DI
collecting ducts**

38
Q

how to prevent calcium oxalate stones

A

decrease sodium

increase potassium

decrease animal protein

chlorthalidone – thiazides decrease calcium

39
Q

uric acid stone management

A

alkalinize urine – potassium citrate

40
Q

diphenhdryamine (anti-histamine) and the cant pee

A

detrusor hypo contractility

UWorld step 2 (16 decks)

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