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2CK Smartbook > Renal > Flashcards

Renal Flashcards

1
Q

how do you treat hyponatremia from SIADH that is Na > 120;

A

> 120: free water restriction and salt tabs

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2
Q

lymphocyte infiltration and intimal swelling after a renal transplant suggests what condition and how should it be treated

A

acute rejection; give high-dose IV steroids

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3
Q

describe the Potter sequence

A

urinary tract abnormality –> oliguria –> oligohydramnios –> pulmonary hypoplasia, flat facies, limb deformities

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4
Q

what are the findings on light microscopy vs. electron microscopy for minimal change disease

A

normal renal architecture on light

podocyte effacement on electron

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5
Q

what are the causes of hypoosmolar, hypovolemic hyponatremia with UNa

A

nonrenal salt loss (dehydration, vomiting, diarrhea)

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6
Q

painless hematuria is likely ______; what test should you order to confirm?

A

bladder cancer; order cystoscopy to confirm diagnosis

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7
Q

causes of hypoosmolar, euvolemic hyponatremia with:

-Uosm 300

A

300: SIADH

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8
Q

causes of hypoosmolar, hypervolemic, hyponatremia

A

CHF, hepatic failure, nephrotic syndrome

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9
Q

if a patient has urinary obstruction (i.e. BPH) and develops severe back pain what additional urinary sx can occur

A

inability to urinate (pain prevents valsalva needed to bypass obstruction)

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10
Q

describe the algorithm for working up acute oliguria

A

bedside bladderscan –> if urine retention then cath, and do urine biochemistry, if no urinary retention then do biochemistries –> determine prerenal vs. renal causes

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11
Q

what are the findings on light microscopy vs. electron microscopy for minimal change disease

A

normal renal architecture on light

podocyte effacement on electron

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12
Q

what causes kidney stones in Crohn’s

A

damaged and dysfunctional intestinal mucosa –> fat malabsorption –> fat preferentially binds calcium –> calcium no longer free to bind oxalate –> free unbound oxalate gets absorbed into bloodstream leading to increased urinary oxalate

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13
Q

what is the 1st line and 2nd line treatment for isolated enuresis

A 
1st= desmopressin
2nd= TCA's
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14
Q

what are the mechanisms of the three types of renal tubular acidosis

A

RTA is non-anion gap metabolic acidosis due to:
type 1= defect in H+ secretion
type 2= defect in HCO3 reabsorption
type 4= aldosterone deficiency or resistance

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15
Q

in what predisposing conditions would you see IgA nephropathy

A

Henoch Schonlein purpura, after GI or respiratory infection

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16
Q

what kind of kidney disease can acyclovir cause

A

crystal-induced AKI due to acyclovir-crystal deposits in renal tubules leading to obstruction (less commonly causes ATN or AIN)

17
Q

how does bactrim cause hyperkalemia

A

ENaC antagonism (similar to amiloride) which blocks Na reabsoption after the DCT where the macula densa uses high Na to promote aldosterone (therefore aldosterone is not increased and potassium excretion is lower) (note: also causes artificial Cr increase due to impaired secretion of creatinine)

18
Q

how does chronic constipation (think this if you see anal fissures) cause recurrent cystitis in children

A

chronic constipation compresses the bladder leading to urinary stasis

19
Q

what is the treatment for minimal change disease

A

steroids

20
Q

what do the following casts signify:

-muddy brown casts, RBC casts, WBC casts, fatty casts, broad and waxy casts

A

muddy brown casts= ATN, RBC casts= glomerulonephritis, WBC casts=AIN or pyelonephritis, fatty casts=nephrotic syndrome, broad and waxy casts=chronic renal failure

21
Q

dietary recommendations for patients with history of nephrolithiasis

A

decrease protein, decrease oxalate, decrease sodium, increase water, increase calcium

22
Q

what two classes of drugs are used to treat BPH

A

alpha 1 blockers (tamsulosin, doxazosin), alpha 5 reductase inhibitors (finasteride)

23
Q

what drugs cause acute interstitial nephritis

A

penicillins, cephalosporins, rifampin, bactrim, NSAIDs, diuretics, captopril

24
Q

how does bactrim cause hyperkalemia

A

ENaC antagonism (similar to amiloride) which blocks Na reabsoption after the DCT where the macula densa uses high Na to promote aldosterone (therefore aldosterone is not increased and potassium excretion is lower) (note: also causes artificial Cr increase due to impaired secretion of creatinine)

25
Q

what is the best way to test for diabetic nephropathy

A

spot or timed urine microalbumin/creatinine ratio

26
Q

what is the treatment for minimal change disease

A

steroids

27
Q

most common cause of AL (amyloid light chain) amyloidosis is ___________; most common cause of AA amyloidosis is __________

A 
AL= multiple myeloma, (next is Waldenstrom)
AA= rheumatoid arthritis
28
Q

how do you treat hypernatremia that is:

  1. euvolemic
  2. asymptomatic hypovolemic
  3. symptomatic hypovolemic
A
  1. euvolemic: oral free water supplementation
  2. asymptomatic hypovolemic: 5% dextrose
  3. symptomatic hypovolemic: 0.9% NS until euvolemic followed by 5% dextrose
29
Q

what two classes of drugs are used to treat BPH

A

alpha 1 blockers (tamsulosin, doxazosin), alpha 5 reductase inhibitors (finasteride)

30
Q

what drugs cause acute interstitial nephritis

A

penicillins, cephalosporins, rifampin, bactrim, NSAIDs, diuretics, captopril

31
Q

what is the acute management of severe hypercalcemia

A

saline hydration and calcitonin

32
Q

what is the best way to test for diabetic nephropathy

A

spot or timed urine microalbumin/creatinine ratio

33
Q

glomerulonephropathy in a patient with rheumatoid arthritis or IBD is most likely due to

A

amyloidosis

34
Q

most common cause of AL (amyloid light chain) amyloidosis is ___________; most common cause of AA amyloidosis is __________

A 
AL= multiple myeloma, (next is Waldenstrom)
AA= rheumatoid arthritis
35
Q

how do you treat hypernatremia that is:

  1. euvolemic
  2. asymptomatic hypovolemic
  3. symptomatic hypovolemic
A
  1. euvolemic: oral free water supplementation
  2. asymptomatic hypovolemic: 5% dextrose
  3. symptomatic hypovolemic: 0.9% NS until euvolemic followed by 5% dextrose
36
Q

what’s the difference between treatment for contrast-induced nephropathy and contrast allergies

A

prednisone can help contrast allergies; prednisone MAY NOT be used for CIN, which is seen in patients with elevated creatinine or diabetes and a non-contrast alternative must be used

37
Q

most common cause of renal failure in multiple myeloma

A

renal tubular damage due to light chains

38
Q

what precautions decrease incidence of contrast-induced nephropathy

A

IV hydration and acetylcysteine

2CK Smartbook (18 decks)

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