OME - Day 5

Question 1

Asterixis, pericardial friction rub, nausea, altered mental status, diagnosis?

Answer 1

Uremia

Question 2

Cr 1.5; gets IV contrast. Creatinine goes up. What’s the diagnosis?

Answer 2

Contrast induced nephropathy (functionally ATN)

Question 3

Eosinophils in the urine, diagnosis?

Answer 3

AIN

Question 4

Labs for Pre-renal failure?

Answer 4

BUN/Cr > 20, FeNa < 1%

Question 5

Muddy-Brown Casts?

Answer 5

ATN

Question 6

Nephrotic syndrome, define it?

Answer 6

> 3.5g /day proteinuria, Edema, Elevated Cholesterol

Question 7

Red Blood Cell casts in the urine, diagnosis?

Answer 7

Glomerulonephritis

Question 8

Renal failure in the setting of penicillin antibiotic, diagnosis?

Answer 8

AIN

Question 9

What are the indications for Dialysis?

Answer 9

Acidosis, E-lytes, Ingestion, Overload, Uremia

Question 10

How do you diagnose a prerenal AKI if the patient is on a natriuretic medication?

Answer 10

FeUrea <35% (instead of FeNa < 1%)

Question 11

What test do you get to look for obstructive uropathy?

Answer 11

Ultrasound (or non Con CT)

Question 12

White blood cell casts, diagnosis?

Answer 12

Pyelonephritis

Question 13

Differential for hypervolemic hyponatremia?

Answer 13

Cirrhosis, Nephrosis (nephrotic syndrome), cardosis (CHF)

Question 14

How do you treat hypernatremia?

Answer 14

Give free water D5W or oral water

Question 15

If the patient has a hypovolemic hyponatremia, what do you do?

Answer 15

IVF

Question 16

If you correct Hypo Na too fast (>0.5mEq / hour) what do you do?

Answer 16

Give free water (D5W)

Question 17

The Sodium is 123 and the glucose is 600. What is the corrected sodium?

Answer 17

131 (600-100 = 500, 5 x 1.6 = 8, 123 +8 = 131)

Question 18

There is a euvolemic hyponatremia, what is the first test?

Answer 18

TSH

Question 19

When do you give 3% Saline (Hypertonic)?

Answer 19

Seizure, Coma and Hyponatremia

Question 20

36 year old black woman with hypercalcemia and bilateral hilar lymphadenopathy, diagnosis and next step?

Answer 20

Sarcoid, get a 1,25 Vit Level, biopsy the sarcoid

Question 21

Altered mental status, abdominal pain, and bone pain, diagnosis?

Answer 21

Hypercalcemia

Question 22

Asymptomatic patient with a mildly elevated calcium, next step?

Answer 22

Check a urine (familial hypocalciuric hypercalcemia)

Question 23

Biochemical levels of hypercalcemia of malignancy, PTH-rp

Answer 23

High calcium Low PTH, low Phos, high PTH-rp

Question 24

Biochemical levels of Hypercalcemia of malignancy, mets?

Answer 24

High Calcium, Low PTH, high Phos

Question 25

Chvostek Sign, Trousseau Sign, diagnosis?

Answer 25

Hypocalcemia

Question 26

Most common cause of hypercalcemia?

Answer 26

Malignancy and Hyperparathyroidism

Question 27

Perioral tingling and paresthesias after a thyroidectomy, diagnosis and next step?

Answer 27

Hypocalcemia, check iCa

Question 28

What is the treatment for Symptomatic Hypercalcemia?

Answer 28

Fluid Fluid Fluid (NOT LASIX)

Question 29

What is the treatment of hypercalcemia of malignancy?

Answer 29

Fluid fluid fluid, and bisphosphonates (not lasix)

Question 30

What lab should you look at first with disorders of calcium?

Answer 30

Albumin

Question 31

You diagnose hyperparathyroidism, what do you do?

Answer 31

Sestamibi scan

Question 32

How do you reduce total body K in a normal person?

Answer 32

Diuretics, Kayexalate

Question 33

How do you reduce total body K in ESRD?

Answer 33

Kayexalate, HD

Question 34

If you see an elevated K, what should you do?

Answer 34

Recheck the K, get an EKG (you should have to pick)

Question 35

T-wave flattening and U waves, diagnosis?

Answer 35

Hypokalemia

Question 36

T-wave peaking, QRS widening, diagnosis?

Answer 36

Hyperkalemia

Question 37

T-wave peaking, QRS widening, next step?

Answer 37

IV Calcium

Question 38

What do you do about a low K?

Answer 38

Give K