Renal

Question 1

mannitol: mech

Answer 1

(prox tubule) increase tubular fluid osmolarity, increase urine flow, decrease intracranial / intraocular pressure

Question 2

mannitol: use

Answer 2

drug OD, elevated ICP

Question 3

mannitol tox

Answer 3

pulm edema, dehydration

Question 4

mannitol contra

Answer 4

anuria, chf

Question 5

acetazolamide mech

Answer 5

(prox tubule) carbonic anhydrase inhib, bicharb diuresis / reduction in total body bicarb stores

Question 6

acetazolamide use

Answer 6

glaucoma, urinary/metabolic alkalizin, altitude sickness, pseudotumor cerebri

Question 7

acetazolamide tox

Answer 7

hyper Cl- metabolic acidosis, paresthesias, NH3/ammonia toxicity, sulfa allergy

Question 8

furosemide

Answer 8

(loop, thick ascending) sulfa diuretic. inhibits Na/K/2Cl cotransport

Question 9

furosemide: re concentrating

Answer 9

prevents concentration of urine, abolishes hypertonicity medulla

Question 10

furosemide: effects

Answer 10

stimulates PGE (which is inhib by NSAIDs): vasodilates afferent arteriole. increases Ca extretion (lose calcium)

Question 11

furosemide: use

Answer 11

get rid of edema (chf, cirrhosis, nephrotic syndrome, pulm edema), htn, hyperCa

Question 12

furosemide: tox

Answer 12

OH DANG: ototox, hYPOkalemia, dehydration, allergy (sulfa), neprhitis (interstitial), gout

Question 13

ethacrynic acid

Answer 13

(ascending loop) phenoxyacetic acid derivative (~furosimide), but OK for those with sulfa allergies

Question 14

ethacrynic acid tox

Answer 14

(~furosemide), hyperuricemia, contra with gout

Question 15

hydrochlorothiazide

Answer 15

(distal convoluted tubule) inhibits NaCl resorption in early DCT, reduces diluting capacity.

Question 16

hydrochlorothiazide: Ca

Answer 16

decreases Ca excretion (retains Ca, unlike loops / furosemide)

Question 17

hydrochlorothiazide use

Answer 17

htn, chf, hypercalciuria, nephrogenic DI

Question 18

hydrochlorothiazide tox

Answer 18

hypo: hypokalemic metabolic acidosis, natremia (+1 ions only: K and Na)
hyper: glycemia, lipidemia, uricemia, calcemia (GLUC)
sulfa allergy

Question 19

K sparing diuretics

Answer 19

spironolactone, eplerenone, triamterene, amiloride (SEAT: K is taking a SEAT since it is spared)

Question 20

spirono, eplerenone

Answer 20

(cortical collecting tubule) competitive aldosterone R antag

Question 21

amiloride, triamterene

Answer 21

(collecting tubule) blocking Na channels

Question 22

SEAT use

Answer 22

hyperaldosterone, K depletion, chf

Question 23

SEAT tox

Answer 23

hyperK (arrrythmia: tented T waves)

Question 24

spiro tox

Answer 24

gynecomastia, antiandrogen etc

Question 25

NaCl (urine)

Answer 25

increase in all direutics, so sometimes decrease serum NaCl

Question 26

K (urine)

Answer 26

increase, except SEAT. so serum K decrease

Question 27

Ca (urine)

Answer 27

increase with loops (serum Ca decrease), decrease with thiazides (more Ca resorbed in PCT, loop)

Question 28

acidemia

Answer 28

carbonic anhydrase inhib

Question 29

alkalemia

Answer 29

loops, thiazides

Question 30

ACE I (captopril, enalapril, lisinopril)

Answer 30

decrease angiotensin II, decrease GFR (constricts efferent arteriole), increase renin, prevents inactivation of bradykinin (resulting in vasodilating)

Question 31

ACE I / ‘prils use

Answer 31

htn (prevents unfavorable heart remodelling), chf, proteinuria, diabetic renal dz

Question 32

ACE I / ‘prils tox

Answer 32

CATCHH: cough, angioedema, teratogen (affecting fetal renal), creatinine increase (decrease gfr, so avoid ACEis in bilat renal artery stenosis), hyperKalemia, HYPOtension