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JD RENAL > Other Clin Med_hematuria, nephrotic syndrome, etc > Flashcards

Other Clin Med_hematuria, nephrotic syndrome, etc Flashcards

1
Q

for hematuria - when do we refer to UROLOGY?

A

kidney stones, mass cysts

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2
Q

for hematuria - when do we refer to NEPHROLOGY?

A

glomerular bleeding
elevated Creatinine
new or worsening HTN or edema

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3
Q

CASTS

muddy brown casts

A

acute tubular necrosis

(PPP)

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4
Q

CASTS

white blood cell casts

A

pyelonephritis

acute interstitial nephritis
PPP

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5
Q

CASTS

red blood cell casts

A

acute glomerulonephritis

vasculitis
PPP

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6
Q

four disorders classified as Critical Intrinsic Renal Disorders

A

vascular disorders
glomerular disorders
tubular disease
interstitial disorders

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7
Q

name one Intrinsic Renal Disorder / Vascular Disorder

A

renal atheroembolism

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8
Q

name two Intrinsic Renal Disorder / Glomerular Disorders

A

RPGN = Rapidly Progressive Glomerulonephritis

Thrombotic Microangiopathy

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9
Q

name two Intrinsic Renal Disorder / Tubular Diseases

A

ATN = Acute Tubular Necrosis

Pigment Nephropathy/Rhabdomyolysis

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10
Q

name one Intrinsic Renal Disorder / Interstitial Disorders

A

acute allergic interstitial nephritis

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11
Q

iatrogenic damage from catheterization - usually free plaque/cholesterol crystals

A

renal atheroembolism

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12
Q

blue toes

A

renal atheroembolism

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13
Q

loss of 50% of GFR w/in 3 months

A

Rapidly Progressive Glomerulonephritis (RPGN)

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14
Q

“crescent formation” in glomeruli

A

Rapidly Progressive Glomerulonephritis (RPGN)

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15
Q

diagnosis of Rapidly Progressive Glomerulonephritis (RPGN)

A

biopsy

serological workup

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16
Q

associated with Rapidly Progressive Glomerulonephritis (RPGN)

A

lupus (SLE)

Goodpasture syndrome

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17
Q

treatment of Rapidly Progressive Glomerulonephritis (RPGN)

A

immunosuppressants, corticosteroids

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18
Q

schistocytes

A

Thrombotic Microangiopathy

19
Q

inner surface of endothelial cells injured

or

prothrombotic agents disrupt smooth inner layer

A

Thrombotic Microangiopathy

20
Q

name six common causes for Acute Tubular Necrosis

A 
aminoglycosides
vancomycin
acyclovir
HIV drugs
iodine contrast
rhabdo
21
Q

muddy brown casts

A

Acute Tubular Necrosis

22
Q

two main causes of Acute Tubular Necrosis

A

50% - ischemic

50% = toxic

23
Q

treatment of Pigment Nephropathy/Rhabdo

A

very aggressive ISOTONIC fluid for forced diuresis

24
Q

leukocyturia

A

Acute Allergic Interstitial Nephritis

25
Q

WBC casts in urine

A

Acute Allergic Interstitial Nephritis

26
Q

definitive imaging for post-renal acute kidney injury

A

bladder u/s

27
Q

two distinct findings for diagnosis of pre-renal acute kidney injury

A

BUN/Cr ratio >20/1 (nml ~15/1)

FENa (Fractional Excretion of Na) <1%

28
Q

edema/hypoalbuminemia
hyperlipidemia
proteinuria

A

Nephrotic Syndrome

29
Q

three main findings/presentations for nephrotic syndrome

A

edema/hypoalbuminemia
hyperlipidemia
proteinuria

30
Q

blood clots in urine/easy bruising

A

nephrotic syndrome

31
Q

three main etiologies for nephrotic syndrome

A

minimal change disease
focal segmental glomerular sclerosis
membranous nephropathy

32
Q

three important indicators of kidney disease that should not be overlooked

A

hematuria
proteinuria
Cr

33
Q

Can renal tubules heal?

Can nephrons regenerate?

A

Renal tubules can heal but NEPHRONS DO NOT REGENERATE.

34
Q

what is most common cause of CKD?

second most common cause?

A

DM

2nd - HTN

35
Q

S/S of CKD (four)

A

proteinuria (best predictor of disease progression)

urine: albumin/Cr ratio or protein/Cr ratio

U/A: metabolic acidosis

renal US: get one early to establish baseline
(have at least one US)

36
Q

Trtmt of CKD

A

lifestyle: reduce salt, eat nml amts of protein
get bp <140/90, ACE-Is or ARBs (renal protective) for the HTN/Proteinuria
A1C < 7.0% for the DM
met acidosis - fix it w/ diet

37
Q

stages of CKD

A

Stage 1 - nml GFR (120-130) but other signs are present)

Stage 2 - GFR 60-90
Stage 3 - GFR 30-60
Stage 4 - GFR 15-30
Stage 5 GFR <15

38
Q

when is dialysis considered for CKD?

A

hyperkalemia
fluid overload
uremia (Cr/urea in blood)

39
Q

PKD presentation

A

dilute urine/nocturnal/polyipsia (100%)
hematuria
proteinuria (mild, might have frothy urine)
nephrolithiasis/UTIs

HTN

large palpable kidney

40
Q

two types of PKD

A

type 1 -

  • most common (75%)
  • younger/earlier onset
    • more severe
      • larger cysts

type 2 -

 - less common
 - older onset
 - less severe
41
Q

life-threatening concerns for PKD pts

A

aneurysms
subarachnoid hemorrhages
mitral valve prolapses

42
Q

common comorbidities for PKD

A

hepatic cysts

colonic diverticula

43
Q

PKD U/A presentation

A

hematuria
proteinuria
low osmolarity
low specific gravity

44
Q

PKD management (6 things)

A

U/S: get at least one renal US

suppress ADH with high fluid consumption (ADH drives cyst growth)

Tolvaptan (ADH V2 receptor antagonist)

HTN management (target bp is lower than usual)
   - maybe add ACE-I or ARBs

manage pain

watch for aneurysms

JD RENAL (3 decks)

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