Renal Flashcards
Risk of Oxalate Stones
1) _______
2) ______
IBD (malabsorption)
Ethylene Glycol
_____ syndrome that affects kidney + lung, attacks basement membrane leaving linear deposits (collagen IV target). Treated with_______
Good pastures syndrome
Steroid, DMARD, plasmapheresis
c-ANCA disease
_____ is a disease affecting sino-pulm + kidney, cough, otitis, sinusitis, C-ANCA disease
Wegners (Granulomatosis with Polyangiitis)
_____ vasculitis, associated with HepB. Can be diagnosed with sural nerve biopsy
polyarteritis nodosa
______ causes painless hematuria among asians , proteinuria, elevated IgA
Berger’s disease (IgA Nephropathy)
________ is a nephropathy primarily among children, causing purpura + joint pain
HSP
PSGN characterized by perioribital edema, dark urine, and ____ complement
Low (C3, IgG nephron deposits)
_____ associated with HepC, causes joint pain/purpuric lesion, ____ complement
Low (C4)
Treatment: steroids useless since IgM disease
___ and ___ associated with FSGS
HIV, Heroin use
Weakly acid fast, filamentous, gram (+) bacteria that can cause endocarditis_____, treated with _____
Nocardia , bacterim
Branching, filamentous, anaerobe making yellow exudate following dental procedure______, treated with _____
Actinomyces, penicillin
Wright/Hansel stain for eosinophils in the urine, eosinophilia, IgE level to test for _____
Interstitial nephritis
Drugs causing interstitial nephritis
penicillins, sulfa, rifampin, phenytoin, allopurinol, cyclosporin
Treatment of child with pyelonephritis ________
Gentamycin + Ampicillin, NOT Cipro/Levo, fluoroquinolone are age restricted , However there is an FDA indication to use them for children <18 years. Not exactly wrong.
Age restriction for :
1) Nitrofurantoin______
2) Tetracycline______
Age 1
Age 7
During minimal change disease you have ____ C3/C4
Normal ; proteinuria usually following an illness and self resolved
Child age 2 - 8, presenting with limp and avascular necrosis of the femoral head _______
Legg Calve Perthes
Child age 2 - 8, presenting with limp and avascular necrosis of the femoral head _______
Legg Calve Perthes
Tx: Surgery after age 6
Adolescent who is heavy, limping, externally rotated leg (posterior displacement)______
Tx: _____
SCFE
Surgical pinning
_____ disease effects medium vessels, characterized by Conjunctivitis, strawberry tongue, oral erythema, swelling of hands/feet, cervical lymphadenitis, high ESR/CRP, massive thrombocytosis
Kawasaki Disease
Treatment of Kawasaki Disease______, _____
IVIG, Aspirin, but NO steroids
Prominent complication of Kawasaki disease
Coronary artery aneurysm
A kid with Hyperactivity, constipation, growth delay suspicion for ______. Characterized by _____ on peripheral smear
Lead poisoning
Basophillic stippling, microcytic anemia
Chelation for lead poisoning indicated if Lead>_____
45
Drugs that may cause AIN: Penicillin, sulfa, ______
Urine stain for diagnosed____
phenytoin, rifampin, allopurinol, cyclosporine, NSAID
Wright hansel: eosinophilia
Treatment of good pasture’s
Steroids, plasmapheresis, linear anti-glomerular deposition pattern
_____ is a granuloma less disease, that causes lung/renal involvement
Microscopic polyangitis
_____ is a lung sparing disease that can be diagnosed with a sural nerve biopsy
PAN
neuropathy, weight loss, fever, GI bleed, purpura (global symptoms)
Painless recurrent hematuria in asians, in the context of recent viral illness ______
Bergers disease (IgA nephropathy)
For any kind of proteinuria, start ACE/ARB
Treatment ladder for lupus nephritis
Mild:_______
Severe:_______
Steroid
Steroid + Cyclophosphamide
CN3 nerve palsy can be a sign of _____
PCA aneurysm , needs IR/neurosurgical embolization
Drugs that can cause AIN_______
Stain to find eosinophils_____
Phenytoin, cyclosporine, rifampin, quinolones
Wright Hansell
Tx: Supportive, only steroids if no response in 48 hours
_____ electrolyte is low in rhabdomyalosis
Calcium
Tx: Fluids, mannitol, alkalinization (acetazolamide)
______ causes a constellation of kidney issues (Afferent constriction, AIN, direct papillary necrosis, nephrotic syndrome)
NSAIDS
____ characterized by hemoptysis + G nephritis
Dx_______
Tx______
Good Pastures
Anti glomerular antibody, p-ANCA
Plasmapharesis/steroids
*best initial test for wegners = c-ANCA
____ is a lung and kidney disease with no granuloma/eosinophilia, p-ANCA +
Microscopic Polyangitis
Most accurate test for PAN______
Sural nerve biopsy
Post viral, painless hematuria _____
IgA nephropathy, Tx: steroids, ACE/ARB
Dx: Requires biopsy no serological test just clues: Normal complement, slightly elevated IgA
Deafness + renal disease____
Alport syndrome
HIV/Heroin use are associated with _______
Focal Segmental Glomerulosclerosis
Lymphoma associated with _____
Membranoproliferative nephritis
Treatment of nephrotic syndromes ______
Steroids
Drugs requiring dialysis with significant renal injury
1) Lithium
2) _____
3) Aspirin
Ethylene glycol
____ is an autosomal recessive tubule disorder resulting in hypokalemia, metabolic alkalosis due to salt wasting since sodium/chloride cannot be re-absorbed in the tubules
Barters Syndrome (Secondary hyperaldosteronism)
Gitelmann : Also get hypomagnesium, low urine calcium
Causes of nephrogenic DI_____
Hypokalemia
Hypercalcemia
Lithium
*ddAVP only improved central DI (Head Injury)
Drugs associated with SIADH______
SSRI, Sulfa, Carbamazepine
___is a clue to aminoglycoside/amphoterecin induced renal injury
Magnesium
___is a clue to aminoglycoside/amphoterecin induced renal injury
Magnesium
Normal Anion Gap Metabolic Acidosis
1) Diarrhea
2) RTA
*How to distinguish between diarrhea and RTA ________
Urine anion gap (sodium - chloride)
negative number = normal, diarrhea
positive number = abnormal , RTA
Type 1 RTA is a disease of the _____ tubule. Failure of H+ excretion in the kidney leading to acidosis. Potassium will be _____
Urine pH is _____
Dx: ______
Tx:_____
Distal
Low
High
Acid Challenge, no response
Bicarb
Type 2 RTA is a disease of the ____ tubule. Failure of bicarb re-absorption
Potassium will be _____
Urine pH is _____
Tx:
Proximal
Low
Varies: Low over time, but after bicarb challenge increases
Dx: Bicarb challenge
Thiazide, high dose bicarb
Which RTA has risk of kidney stones______
Type 1, cannot excrete H+ which means urine pH is high, which allows for stones
The only RTA with high serum potassium ________
Type 4 (Hypoaldosteronism)
The only RTA with high serum potassium ________
Type 4 (Hypoaldosteronism)
When to start 2 BP meds in an outpatient _____
SBP>160
