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PANCE 2024 > RENAL > Flashcards

RENAL Flashcards

1
Q

Casts for post strep glomerulonephritis

A

RBC Casts

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2
Q

What type of bacteria is associated with with PSGN

A

G A Beta hemolytic strep pyogenes

GAS

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3
Q

PSGN is common most in what age

A

5-12 years old

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4
Q

Urine color in PSGN

A

Coca Cola urine

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5
Q

/mc reason for PSGN worldwide

A

IgA Nephropathy [Berger Disease]

Hematuria 1-2 days after URI

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6
Q

3 common findings in PSGN

A

Hematuria
RBC casts
Proteinuria

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7
Q

What is Azotemia ?

A

Elevated BUN and Creatinine

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8
Q

Mangement PSGN

A

Supportive care = fluid restriction loop diuretics antihypertensive meds

ABX care = treat the Strep PCN

Last line = dialysis

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9
Q

Nephrotic syndrome thoughts

A

Anasarca
Protein uria [ 3.5 g over 24 hours ]
Lipid in the urine pool,.- FROTHY URINE
Low ALBUMIN ]
Orbital edema
Infection

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10
Q

MC reason for nephrotic syndrome in kids

A

Minimal change disease

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11
Q

Casts seen in nephrotic syndrome

A

Fatty casts

Maltese cross pattern under polarized light

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12
Q

Renal bx of nephrotic syndrome [membranous nephro]

A

Podocyte loss of foot processes

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13
Q

3 medications that can be used in nephrotic syndrome

A

ACE Arbs

Statins

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14
Q

Neprhtitic syndrome casts

A

RBC casts = PSGN

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15
Q

Nephrotic syndrome or nephritic syndrome produces more protein

A

Nephrotic does more than 3.5 g / day with EDEMA

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16
Q

3 type of AKI

A

Pre

Intra

Post

“Kidney”

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17
Q

BPH can cause what type of AKI

A

Post

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18
Q

Watery diarrhea can cause waht type of AKI

A

Pre renal AKI

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19
Q

BUN to creatine what should the ratio be

A

Greater than 20:1 = PRE RENAL

Less than 20:1 = INTRINSIC

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20
Q

MC type of AKI

A

ATN = tubular necrosis

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21
Q

3 pre renal AKI causes

A

Cardio shock
Hemmorhage
Sepsis

Decreased perfusion ; think before the kidney; blood flow problem

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22
Q

Renal AKI causes

A

Toxins
Drugs
Infection
Hypoperfusion

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23
Q

3 type of post renal AKI

A

Enlarged prostate
Kidney stone
Tumors

Obstructive issues

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24
Q

3 type of diseases that can cause glomerulonephritis to know

A

Lupus
Anti GBM
Henoch Schlenoch Purpura

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25
Q

Metallic tase in mouth think what

A

If malaise and decreased urine output = general

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26
Q

Creatinine increase of what = AKI

A

Greater than 50 % increase from baseline

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27
Q

Low FE of NA+ suggests an AKI where

A

Pre Renal affecting the kidney

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28
Q

Best image for obstruction or hydronephrosis

A

Kidney U/S

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29
Q

ATN casts =

A

Muddy brown casts

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30
Q

Indications for dialysis AEIOU

A

Acidosis

Electrolytes = remove high K+

Ingestions

Overload

Uremia = pericarditis , encephalopathy

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31
Q

MC cause of CKD

A

Diabetes ; CKD dx = longer 3 months

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32
Q

CKD findings common 4

A

Uremia
Anemia
HyperK
Fluid retention

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33
Q

Casts assoc with CKD

A

Broad waxy casts

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34
Q

Mutation of what kind can cause PCKdz

A

PCKD1 and PCKD2

35
Q

PCKDz has what kind of presentation

A

Palpable kidney
Get renal U/S ; see huge cystssss

36
Q

3 management for PCKDz

A

Increase fluid
Hydration
Restrict Sodium

Vasopressin blockers = tolvaptan

ACE or ARB if with HTN

Dialysis / Transplant if ERDz

37
Q

Worst complication of PCKdz

A

Cerebral aneurysm ; happens 5-10% of the time

38
Q

Heart valve disorder associated with PCKDz

A

Mitral valve prolapse

39
Q

metabolic alkalosis is usually if a person is

A

Vomiting !

40
Q

Metabolic acidosis 3 common findings

A

Kussmauls = breathe off CO2
Headache lightheadedness
Decreased muscle reflexes

41
Q

Metabolic alkalosis 3 common findings

A

Twitching or spasms
Increased reflexes
Bradypnea

42
Q

Low bicarbonate = less than what

43
Q

Low PCo2 = less than what

44
Q

PCO2 less than what is considered respiratory alkalosis [compensatory]

45
Q

PCo2 greater than what is considered respiratory acidosis [compensatory]

46
Q

Bicard greater than what Causes bicarbonate to drive the alkalosis

A

Greater than 28

47
Q

Anion gap equation ; and what is considered elevated

A

Na+ - Cl- -HCO3 ;; greater than 12 = ELEVATED

48
Q

With COPD commonly think what type of acid base issue

A

Respiratory acidosis

49
Q

3 other causes of respiratory acidosis

A

CNS depression = opiates
Myasthenia Gravis
NMSK disorders = GB

50
Q

Hyperventalation causes what

A

Respiratory alkalosis because you are losing CO2

51
Q

3 common causes of respiratory alkalosis

A

Salicylate toxicity

Acute asthma attack

Pulmonary Embolism

52
Q

Describe sxs of respiratory acidosis

A

Things go DOWN

Coma
Death

53
Q

PCO2 necassary for respiratory acidosis =

A

Greater than 45 and acidic

54
Q

PCO2 necassary for respiratory alkalosis

A

Less than 35 and alkalotic

55
Q

Bicarbonate for metabolic alkalosis [compensatory]

A

Greater than 29

56
Q

Bicarbonate for metabolic acidosis [compensatory]

A

Less than 22

57
Q

what is the acronym for acid base disorders as a rule

A

ROME

PCo2 normal = 40

Bicarbonate normal = 25

Physio pH = 7.4

58
Q

With PCO2 think what compensation and same for HCO3 ?

A

PCO2 = Lungs

HCO3 = Kidney

59
Q

Intracatbale vomiting can cause what

A

Low potassium
Metabolic alkalosis

60
Q

Tumor lysis syndrome usually does what

A

Lysis cells which means K+ goes up

61
Q

3 potassium intracellular shifting agents / states

A

Insulin
Albuterol
Alkalosis

62
Q

Renal over excretion of potassium ; 3 reasons?

A

Thiazides
HypoMagnesium
Hyperaldosteronism

63
Q

3 manifestation of Hypokalemia

A

Cramps
Delirium
Tetany

64
Q

Potassium is low if less than

65
Q

When do you give IV K+ instead of PO

A

Less than 3 usually and dont forget Mg

66
Q

Hyperkalemia cell stabilizing medication

A

Calcium gluconate

67
Q

3 common reasons for Hyperkalemia

A

Burns
Drugs = ACE , DIgoxin , K+ Diuretics
Addisons Disease

68
Q

High K+ is usually as high as

A

Greater than 5.2

69
Q

What type of overdose can cause hyperkalemia sine wave

A

TCA overdose

70
Q

Insulin
Albuterol
Bicarbonate

How do they affect K+

A

Insulin = shifts potassium into the cell
Albuterol = upregulates cAMP and shifts K+ into cell s
Bicarbonate = shifts potassium into the cell

71
Q

Furosemide causes what for hyperK+

A

Renal excretion of K+

72
Q

Neuro complication of rapid low sodium correction

A

Osmotic demyelination syndrome

73
Q

Urine Na+ low makes you think a what cause low ECF volume think

-vomiting
-diarrhea

A

Pre renal

[before the kidney] metabolic

74
Q

Urine Na+ high with low ECF volume ; think a what cause

-Addisons disease
-CKD

A

Kidney [intrrenal]

75
Q

SIADH is a what volume status disease

A

Normovolume

The urine will have more osmolality than the serum

76
Q

If the serum has more osmolality than the urine think what

A

Water intoxication [ TEA or BEER]

77
Q

If we are fluid overload with low NA+ ; think what

-Cirrhosis
-Nephrotic syndrome

A

Increased interstitial salts

78
Q

If we are fluid overload with high urinary salt [greater 20] think?

-HS
-Steriods

A

Kidney failure

79
Q

3 triad of sxs in renal cell carcinoma

A

Flank pain
Palpable mass
Gross hematuria

80
Q

MC type of renal cell carcinoma

A

Clear cell carcinoma

81
Q

What is a reason to go look for this in a male [ renal cell carcinoma ]

A

Right sided varicocele

82
Q

Describe Wilm’s tumor

A

Nephroblastoma with
-anirdia = absent iris
-developmental delays

83
Q

Most common renal kidney cancer in kids

A

Wilms tumor

84
Q

1st test for Wilms =

A

U/S

Then CT or MRI

PANCE 2024 (15 decks)

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