Renal Flashcards
Hyponatremia mx, risk of faster correction
3% saline. should be 0.5mEq/L/hr due to osmotic demyelination. LOW TO HIGH PONS WILL DIE
Risk of correcting hypernatremia quickly
Cerebral edema. HIGH TO LOW BRAIN WLL BLOW
Vomiting for 4 days. electrolytes? Rx?
hypokalemic hypochloremic metabolic alkalosis, urine Na decreased due to compensatory reabsorption, urine Cl decreased. RX- NS
Renal failure in AML
Tumor lysis synd- hyperphos, hypocalc, hyperK, hyperuricemia. Calcium phosphate, uric acid stones- AKI- tubular obstruction
Mx of tumor lysis syndrome
Aggressive hydration, rasburicase, allopurinol, rx electrolyte abn
Dull left flank pain, non radiating, hematuria. Swelling of left testis, dil and tortous veins. H/o MN.
Renal vein thrombosis due to hypercoag - nephrotic synd
RF for renal vein thrombosis
Nephrotic syndrome, trauma, renal malig
24F dysuria, hematuria, lower abd tenderness, bladder tender on palpation of ant vaginal wall. UA- RBC+
Endometriosis
Wilms. NBS
Abd USG. For extent- CECT, MRI, CT chest for mets
BPH causing LUTS, Cr elevated evaluation
UA, PSA, CR. AKI- do renal USG, place catheter
SCZ-confused. Na low, S.osm- low, u.osm-low
Primary polydipsia
22M urti 3 days ago, hematuria, RBC casts, CR high
IgA nephropathy
SIADH Rx
Hypertonic saline, fluid restriction +salt tablets
Posterior urethral injury mx
Retrograde urethrography, urethrography and urethroscopy before sx, suprapubic catheter followed by delayed repair
Primary VUR in children diag and rx
Renal USG, voiding cystourethrography. Rx- mild- observation+ppx antibiotics, severe- ppx antibiotics+sx
ESRD pt has painful skin lesions. Biopsy shows arteriolar calcification, occlusion, subintimal fibrosis. Diag, rx?
Calcific uremic arteriolopathy- calciphylaxis. Analgesics, wound care,treat RF, optimize dialysis
Conditions causing enuresis
constipation, bladder dysfunction, CKD, UTI, DM, DI, OSA
5M enuresis, recurrent UTI, tired, HTN, proteinuria. NBS
serum Cr- CKD suspect of PUV. can check renal usg, vsug
Blood in urine, 1-2 RBC in urine causes
hemoglobinuria, myoglobinuria
Hypertonic saline given for hyponatremic pt NBS to find cause
Urine osmolality
72M on TCA, lower abd tenderness
Urinary retention- catheterize, stop TCA
4M right varicocele, mass doesnt decrease in supine, HTN
Do USG abd
Elevated Cr, small kidneys, bland sediment, mild proteinuria
chronic HTN
RA with proteinuria
Nephrotic syndr- amyloidosis AA. Take renal biopsy
PSGN + vol overload status. NBS
Loop diuretic
HTN in PSGN
CCB- DOC, Dont use ACEi for AKI
Liver cirrhosis on furosemide, spironolactone, hypotension, low Na, High K, High BUN/Cr, Urine Na low
Prerenal AKI- renal hypoperfusion Hepatorenal syndrome. Rx- albumin+splanchnic vasoconstrictors- terlipressin, NE, midrodrine, octreotide, liver transplant
Nephrotic syndrome, HIV+
FSGS. 2/2 HIV continue ART
Struvite stone formation mechanism
Urease producing organisms- increased urine ammonia production
Decompensated HF with increased BUN/Cr
Prerenal azotemia due to elevated CVP
Rx for asymptomatic bacteriuria
cefpodoxime, fosfomycin, augmentin, nitrofurantoin only in T2
Transplanted kindey x 5 months, elevated Cr, biopsy shows heavy lymphocyte infiltrate + vascular intimal swelling
Acute rejection, increase dose of suppressants
Afferent and efferent vasoconstriction- prerenal AKI, HTN, BUN/Cr >20, transplanted kidney pt
Tacrolimus toxicity
Ischemic stroke, cvs, rs- normal, EPO-elevated, smokes
RCC- secondary polycythemia. Do CT abdomen
NBS after ABG shows metabolic alkalosis
Urine chloride to diff saline responsive or not
Metabolic alkalosis, high urine Cl in hypovolemic pt
Bartter, gitelman synd
Alkalosis, high urine Cl in hypervolemic pt
Primary hyperaldosteronism, cushing, ectopic ACTH production
Mx of magnesium toxicity
Stop the drug, IVF + loop diuretics, IV calcium, hemodialysis
1st line mx for any incontinence
bladder training, kegel
