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Internal Medicine > RENAL > Flashcards

RENAL Flashcards

1
Q

ddx for…
RBC casts:
WBC casts:
Granular casts:

A

RBC casts: glomerulonephritis, ischemia, or malignant HTN

WBC casts: pyelonephritis, tubulointerstitial dz, or txp rejection

Granular casts: acute tubular necrosis (ATN)

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2
Q

ddx for…
Broad waxy casts:
Fatty casts:
Hyaline casts:

A

Broad waxy casts: CRF w/ dilated ducts

Fatty casts: nephrotic syndrome

Hyaline casts: nonspecific

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3
Q 
Prerenal ARF:
UOsm?
UNa?
FeNa?
BUN/Cr?
A 
UOsm = >500
UNa = 20:1
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4
Q 
Intrinsic ARF:
UOsm?
UNa?
FeNa?
BUN/Cr?
A 
UOsm = 20
FeNa = >2%
BUN/Cr = <15:1
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5
Q 
Postrenal ARF:
UOsm?
UNa?
FeNa?
BUN/Cr?
A 
UOsm = 40
FeNa = >4%
BUN/Cr = >15:1
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6
Q

Indications for dialysis?

A

Acidosis(severemetabolicacidosis)

Electrolytes (severe hyperkalemia)

Intoxication (methanol, ethylene glycol, lithium, aspirin)

Overload (severe hypervolemia)

Uremia (severe uremia, pericarditis, BUN >150)

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7
Q 
Nephritic syndrome:
etiology
sx?
glomeruli = 
casts?
A

glomerular inflmm

hematuria, oliguria, HTN, azotemia, proteinuria

hypercellular

RBC

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8
Q 
Nephrotic syndrome:
etiology
sx?
glomeruli = 
casts?
A

loss of GBM negative charge

proteinuria, edema, hypoalbuminemia, hyerlipidemia, hypercoagulability

normo-/hypocellular

fatty casts

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9
Q

Nephritic syndrome × chronic pain →

A

analgesic nephropathy

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10
Q

Nephritic syndrome × hemoptysis →

A

Goodpasture vs Wegener

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11
Q

NephrOtic syndrome × deafness/blindness →

A

Alport

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12
Q

NephrOtic syndrome × HBV →

A

membranous glomerulonephritis

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13
Q

NephrOtic syndrome × HIV →

A

FSGS

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14
Q

NephrOtic syndrome × Hodgkin lymphoma →

A

minimal change disease

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15
Q

Minimal change dz:
presentation?
dx?
tx?

A

nephrOtic syndrome in kids following a viral infx

Dx EM (foot process effacement)

Tx steroids

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16
Q

FSGS:
population?
dx?

A

nephrOtic syndrome in adults and HIV+ pts

Dx LM (segmental sclerosis)

**steroid-resistant

17
Q

Membranous glomerulonephritis:
a/w…
dx?

A

drugs, infx, SLE, and solid tumors

Dx LM (diffuse GBM thickening), EM (“spike and dome” appearance)

18
Q

IgA nephropathy (Berger’s dz):
presentation?
a/w…
dx?

A

nephritic syndrome following URI or gastroenteritis

associated w/ Henoch-Schonlein (palpable) purpura in kids

Dx LM (mesangial deposits), IF (IgA stain)

19
Q

Lupus nephropathy:
cause?
dx?

A

ag-ab deposits

Dx LM (“wire loops”), EM (subendothelial deposits), IF (“full house”)

20
Q

Membranoproliferative glomerulonephritis (MPGN):
a/w…
dx?

A

a/w HCV

Dx EM (“tram tracks” or “dense deposits”)

21
Q

Goodpasture syndrome:

dx?

A

LM (crescent shaped), IF (linear staining)

22
Q 
Acute interstitial nephritis:
presentation?
dx?
tx?
etiology?
A

drug allergy → acute renal railure, rash, fever, eosinophilia

Dx UA (eosinophuria)

Tx d/c meds

Etiology: gentamycin, IV dye, Hb/Mb

23
Q 
Renal papillary necrosis:
presentation?
dx?
tx?
etiology?
A

damage to renal papillae causes necrosis → slough off and cause ureteral obstruction

Dx excretory urogram

Tx underlying cause

Etiology: analgesic nephropathy (chronic NSAID/Tylenol use), diabetic nephropathy, sickle cell, obstruction, txp rejection

24
Q

Renal tubular acidosis type 1:
pathophys?
presentation/lab abn?
tx?

A

collecting duct can’t excrete H+

metabolic acidosis, hypo-K, nephrolithiasis, alkaline urine

Tx IV HCO3-

25
Q

Renal tubular acidosis type 2:
pathophys?
presentation/lab abn?
tx?

A

proximal tubule can’t reabsorb HCO3-

metabolic acidosis, hypo-K, hypophosphatemic rickets, alkaline urine

tx underlying cause

26
Q

Renal tubular acidosis type 3:

presentation?

A

type 1 + type 2

27
Q

Renal tubular acidosis type 4:
cause?
presentation/lab abn?
tx?

A

either hypoaldosteronism or lack of response to aldosterone

metabolic acidosis, hyper-K, acidic urine

Tx fludrocortisone

28
Q

Hartnup syndrome:
genetic abn?
presentation?
tx?

A

AR ∆neutral amino acid transporter → ↓neutral amino acids

↓tryptophan for niacin synthesis → pellagra (3 Ds – diarrhea, dermatitis, dementia)

Tx niacin replacement

29
Q

Fanconi syndrome:
pathophys?
presentation?
tx?

A

proximal tubule dysfxn → defective transport of glucose, amino acids, HCO3-, phosphate

glucosuria, aminoaciduria, type 2 RTA, hypophosphatemic rickets

Tx electrolyte replacement

Internal Medicine (15 decks)

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