onlinemeded-nephrology

Question 1

RBC casts

Answer 1

glomerulonephritis

Question 2

WBC casts

Answer 2

pyelonephritis

Question 3

AIN etiologies

Answer 3

• pyelo

- drugs: TMP-SMX, pens, cephs

Question 4

muddy brown casts

Answer 4

ATN?

Question 5

ATN etiologies

Answer 5

• ischemia

- toxins: myoglobin, IV contrast

Question 6

pre-renal AKI: BUN:Cr, UNa, FeNa, FeUr

Answer 6

BUN:Cr >20
UNa < 10
FeNa <1%
FeUr <30%

Question 7

acute HD indications

Answer 7

Acidosis
E-lytes (K, Ca)
Intox
Overload
Uremia

Question 8

stage I CKD

Answer 8

GFR >90

-prevent progression

Question 9

stage II CKD

Answer 9

GFR 60-89

Question 10

stage III CKD

Answer 10

GFR 30-59

-complication management

Question 11

stage IV CKD

Answer 11

GFR 15-29

-prepare for HD

Question 12

stage V CKD

Answer 12

GFR <15

-HD

Question 13

preventing progression in CKD

Answer 13

• HTN <130/80 (ACE/ARB)

- DM A1C<7, glu 80-120 (orals (not metformin), or insulin)

Question 14

bone involvement in CKD

Answer 14

high phos, low Ca -> inc PTH -> resorbs bones

Question 15

tx for hyponatremia

Answer 15

mild: dz spec
mod: NS
severe: 3% NaCl

Question 16

isotonic hyponatremia

Answer 16

pseudohyponatremia - caused by lab error

Question 17

hypertonic hyponatremia tx

Answer 17

-remove extra compound

Question 18

hypotonic hyponatremia tx

Answer 18

• vol up: diuresis
• vol down: IVF
• euvolemic: dx spec

Question 19

euvolemic hyponatremia

Answer 19

RTA
Addisons
Thyroid
SIADH

Question 20

PTH action on kidney

Answer 20

• reabsorb Ca
• excrete phos
• 25,VitD -> 1,25VitD

Question 21

most Ca is bound to ___

Answer 21

albumin, only 1% ionized Ca

Question 22

cancer mets: Ca, phos, PTH

Answer 22

high Ca + phos, low PTH

Question 23

PTHrP: Ca, phos, PTH

Answer 23

high Ca, low phos + PTH

Question 24

HyperK etiologies

Answer 24

iatrogenic, low aldo (ACE/ARB), ESRD, artifact (hemolysis)

Question 25

HyperK EKG

Answer 25

• peaked T waves

- wide QRS

Question 26

HyperK emergent tx

Answer 26

• stabilize: CaCl
• temporize: insulin + D50, NaBicarb, B-agonist
• get rid: loop diuretics, kayexalate

Question 27

hypoK etiology

Answer 27

• renal loss: hyperaldo, diuretics (TZDs, loops)

- GI loss: V/D

Question 28

Urine Cl in dehydration

Answer 28

low (<10)

Question 29

diarrhea leads to what acid base disturbance?

Answer 29

metabolic acidosis

Question 30

resp acid/alk: change in 10CO2 -> change in __pH

Answer 30

.08pH = acute 
.04pH = chronic

Question 31

winters formula

Answer 31

1.5(bicarb)+8+/-2