Renal Flashcards
Causes of sterile pyuria
Viruses, tuberculosis, nephritic syndrome and kawasaki disease
Causes of ketonuria/ketonemia
Diabetic Ketoacidosis
Euglycemic ketoacidosis(SGLT2)
Starvation ketosis
Keto diet(low carb)
IEMs(rare)
The gaps caused by ethylene glycol
- HAGMA
- High serum osmolarity gap
- Lactate gap
Key investigation in NAGMA
ABG and urine pH tro RTA
Key investigation in HAGMA
Albumin?
Causes of mixed HAGMA and NAGMA
Pancreatitis?
Most common cause of hyponatremia
Thiazide diuretics
Serum osmolarity is a surrogate for?
ADH levels
Criteria for SIADH
Decreased serum osmo
Clinical euvolemic
Urine osm >100
Urine Na >40
Normal thyroid and adrenal fn
Normal renal fn
No diuretic use
No acid base or potassium abnormality
Causes of pseudohyponatremia
High lipids
Myeloma
IVIG
What to check in hypernatremia
Water deficit
ABCDE of CKD Cx
Anemia
Blood pressure:HTN
Calcium and BMD
Decompensation : Uremia
Electrolytes and Acid
Triad of acute interstitial Nephritis
Fever, rash, serum eosinophilia
Triad of acute interstitial Nephritis
Fever, rash, serum eosinophilia
3 forms of Renal Replacement Therapy
- Peritoneal dialysis
- Hemodialysis
- Renal transplant
- Renal supportive care(palliative)
Most common cause of Hemolytic Uremic Syndrome
Shiga toxin of EHEC
Triad of HUS
MAHA, thrombocytopenia and AKI
Stain for amyloidosis(monoclonal gammopathy)
Congo red
Common Cx of Peritoneal Dialysis
Hypokalemia due to lack of K in PD UF
Type A vs Type B lactic acidosis
A is in the presence of hypoxia and hypoperfusion eg sepsis
B is in absence of hypoxia eg liver disease and reduced clearance of lactate
Calculation of serum osmolarity
(Na x2 ) + glucose + urea(for non hyperglycemic emergencies)
Triad of PD peritonitis
1) Abdo pain/ cloudy effluent
2) PD effluent cell count NC >100 (>50% neutrophilia/left shift)
3) Positive effluent culture
Mx of PD peritonitis
Intraperitoneal Cefazolin + Gentamicin
IP vancomycin + gentamicin if MRSA pt
IV abx if bactermic/septic
Adrenal medulla produces
Catecholamines
Adrenal Zona Glomerulosa produces
Aldosterone(mineralocorticoid)
Adrenal Zona fasciculata produces
Cortisol
?
Adrenal Zona Reticularis produces
Androgens
Endocrine causes of Secondary HTN and hypoK
Primary hyperaldosteronism
Cushings syndrome
Pheochromocytoma
Hyperthyroidism
Test for primary hyperaldosteronism
Salt loading test showing unsuppressible aldosterone
Screening test for pheochromocytoma
Urinary metanephrines(produced in adrenals unlike catecholamines)
Treatment of HypoNa, HyperK and Metabolic acidosis in stable pt
Sodium bicarbonate
IV furosemide if hypertensive emergency
Types of Glomerulonephritis that cause low C3 levels
Lupus Nephritis and post infectious GN
Causes of hypokalemia, alkalosis and hypertension
1) Conn syndrome
2) Cushing syndrome
3) Liddle syndrome(renal tubulopathy)
Specific Mx of intermittent claudication
- Exercise therapy
- Pharm
-antiplatelet
-antiHTN
-prostaglandin
Investigation that will detect minimal change disease
Electron microscopy
Cause of hypokalemia with metabolic acidosis
Renal Tubular acidosis
Labs to confirm Conn’s syndrome
Renal panel - hypokalemia
ABG - metabolic alkalosis
Aldosterone/renin ratio: high
Adrenal vein sampling
Salt loading test
Urine: ?
Labs to conform pheochromocytoma
Urine metanephrines
Serum metanephrines(paired)
-patient has to avoid catecholamine containing foods
Target Hb for patients with hemoglobin
13
Hall mark for kidney biopsy in SLE
Full house staining pattern with diffuse granular immune complex deposition
Most common type of lupus nephritis
Class 4
