Renal Flashcards
Uncommon but important side effect of loop diuretics?
Ototoxicity, especially at high doses.
Other side effects include hypocalcemia, hypokalemia, and hypomagnesemia
Where does uric acid precipitate in the tubule
Where the pH is lowest – collecting ducts due to low urine pH
Most cases of kidney stones due to…
Idiopathic hypercalciuria with normocalcemia.
Major cause of renal failure in young children
HUS. Causes acute kidney damage.
May look like HSP, but HSP will always have joint pains and arthralgias.
NSAID associated renal injury
Is papillary necrosis or chronic interstitial nephritis. Is reversible
ACE inhibitor side effects
Cough and first dose hypertension (especially in combination with thiazide diuretics).
Angiomyolipoma in…
Tuberous sclerosis (ash leaf spots, brain hamartomas, cardiac rhabdomyomas).
Difference between finasteride and tamulosin
Finasteride actually shrinks prostate (6-12 months to work), tamulosin just relieves outflow (days to weeks).
Tolterodine/oxybutinin
Antimuscarinic that reduces urgency in BPH.
Toxin that causes calcium oxalate crystals?
Ethylene glycol
Do beta blockers affect GFR
Nope, not clinically.
Side effects of spironolactone
Hyperkalemia, but more importantly, gynecomastia.
Tubular buffer systems in response to acidemia
H+ secreted can be buffered by PO4 and NH3 (from glutamine). NH3 is more important, but in acidemia, PO4 will decrease too.
Physiology of continence
Bladder emptying is controlled by detrusor muscle contraction. Continence is maintained by the urethral sphincter muscles. The internal sphincter is under autonomic control (parasympathetic =relaxation), and external is under voluntary control (a pelvic floor muscle). EUS trauma during childbirth or damage to pudendal nerve can lead to stress incontinence. Also loss of estrogen leads to decreased tone in the EUS.
DM effect on arterioles
Hyaline arteriolosclerosis.
How to treat bladder urge instability?
Use antimuscarinics which relax detrusor muscle.
Common cause of UTI in catheterized patients?
Klebsiella
Diabetic autonomic neuropathy and bladder function
Can prevent complete emptying of bladder leading to loss of urine (overflow incontinence).
Screen for diabetic nephropathy by monitoring…
Albumin
Citrate role in kidney stones
Prevents their formation.
Amphotericin renal toxicity causes
severe hypokalemia and hypomagnesemia
Blood supply of proximal 1/3 of ureter?
Renal artery
Renal osteodystrophy
Lack of active vitamin D causes hypocalcemia and hyperphosphatemia
Conn’s Syndrome
Aldosterone secreting tumor. Causes hypertension, hypokalemia (low energy and muscle fatigue).
Treat with eplerenone or spironolactone
Side effect of osmotic diuresis with mannitol?
Life-threatening pulmonary edema. Hypernatremia
Kidney drugs of choice in diabetes patients?
ARB or ACEi
Does spironolactone improve mortality in CHF patients?
Yes
Most important prognostic factor in PSGN?
Age. Adults are fucked!
Vasopressin increases the permeability of collecting duct to what substance?
H2O and Urea
Regardless of hydration state, which part of the nephron absorbs the most water?
Proximal tubules
Sickle cell kidney injury?
Papillary necrosis
WBC Casts indicates
Pyelonephritis
