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Clin Med II - Exam 4 > Paulson - Kidneys 103 > Flashcards

Paulson - Kidneys 103 Flashcards

1
Q

renal cysts made of epithelial cells from renal tubules and collecting ducts

A

cystic kidney dz

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2
Q

2 types of cystic kidney dz

A

simple cysts

complex cysts

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3
Q

mc type of cystic kidney dz

A

simple cysts

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4
Q

w. cystic kidney dz, you must differentiate btw (4)

A

malignancy

abscess

pkd

benign

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5
Q

characteristics of simple cysts

A

think wall without septa, calcifications, or solid components

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6
Q

simple cysts are mc in __

and pt’s older than __,

and are usually

A

men

50 yo

asymptomatic

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7
Q

comorbidity possibly associated w. simple cysts

A

htn

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8
Q

sx of ruptured simple cyst (2)

A

hematuria

flank pain

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9
Q

complication of infected simple cyst

A

renal abscess

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10
Q

diagnostic test for simple cyst (2)

A

US

CT

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11
Q

characteristics of complex cysts

A

+/- septa, calcifications, or solid components

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12
Q

complex cysts are associated w. increased risk for

A

malignancy

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13
Q

what classification system is used for complex cysts

A

bosniak

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14
Q

imaging for complex cysts

A

CT w. contrast

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15
Q

inherited dz’s that cause renal cyst development and progressive renal faiure from continued enlargement of cysts

A

polycystic kidney dz (pkd)

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16
Q

2 genetic mutations associated w. pkd

A

pkd 1

pkd 2

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17
Q

50% of pkd pt’s get __ by age 60

A

esrd

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18
Q

when does renal fxn begin to decline

A

4th decade of life → continues to decline 4-6 ml/min/year

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19
Q

major sx of pkd

A

htn

20
Q

other possible sx of pkd (6)

A

hematuria

proteinuria

renal insufficiency on labs

flank pain

nephrolithiasis

renal cell carcinoma

21
Q

mc sx of pkd reported by pt’s

A

flank pain

22
Q

what causes flank pain in pkd (3)

A

renal hemorrhage

calculi

UTI

23
Q

2 mc types of renal stones associated w. pkd

A

uric acid

calcium oxalate

24
Q

extrarenal sx of pkd

A

cerebral aneurysms

hepatic cysts

pancreatic cysts

cardiac valve dz

colonic diverticula

abd wall and inguinal hernia

25
Q

most serious complication of pkd

A

SAH or ICH

26
Q

mc dx imaging for pkd

A

US

27
Q

most sensitive imaging for pkd (2)

A

CT

MRI

28
Q

US findings of pkd

A

large kidneys

extensive bilateral cysts

29
Q

indication for screening for pkd

A

positive fh

30
Q

screening for pkd recommended for younger pt’s

A

genetic testing

31
Q

genetic type of pkd

A

autosomal dominant polycystic kidney dz (adpkd)

32
Q

tx for adpkd (3)

A

rigorous control of bp

dietary Na restriction

statin

33
Q

which tx for adpkd prevents progression of renal dz and decreases risk of CV mortality

A

rigorous control of bp

34
Q

initial bp control med for adpkd

A

ACEI

35
Q

t/f: adpkd is considered coronary heart dz risk equivalent in terms of statin recs

A

T!

36
Q

what class of drug is tolvapatan (samsca)

A

vasopressor

37
Q

indications for tolvapatan (samsca) in pkd

A

18-55 yo

GFR >25

high risk for progression to esrd

38
Q

how are tolvapatan indications established (2)

A

total kidney volume (tkv)

CT or MRI

39
Q

what drug is dz modifying for pkd and slows progression

A

tolvapatan (samsca)

40
Q

pt ed for tolvapatan (samsca)

A

adequate PO water intake

41
Q

contraindications for tolvapatan (samsca) (3)

A

liver failure

hypovolemia

hypernatremia

42
Q

s.e of tolvapatan (samsca) (5)

A

liver toxicity → increasted LFTs

polyuria

polydipsia

cp

ha

43
Q

non pharm tx for pkd

A

increased fluid intake → 3L/day

dialysis

kidney transplant

pain mangament → surgical aspiration

44
Q

how does increased fluid intake inhibit cyst growth

A

suppresses ADH levels

45
Q

mc cause of death in pkd pt’s

A

cardiac

other: neurologic from ruptured intracranial aneurysm/hemorrhage

Clin Med II - Exam 4 (20 decks)

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