Renal Flashcards
prevent contrast induced nephropathy
IV hydration with isotonic bicarbonate or NS few hours before and after CT; N-acetylcysteine for vasodilatory/antioxidant properties; stop NSAIDs due to renal vasoconstriction; use non-ionic contrast dye
focal segmental glomerulosclerosis associated with ____ population
African Americans, hispanics, obesity, HIV, heroin use
membranous nephropathy associated with _____ population
adenocarcinomas (solid like breast/lung), NSAIDs, HepB, SLE
Membranoproliferative glomerulonephritis associated with ____ population
hep B&C; lipodystrophy
minimal change disease associated with ______ population
NSAIDs, lymphomas, kids
IGA nephropathy associated with
upper respiratory tract infection
indications for urgent dialysis
A: metabolic acidosis refractory to meds ph6.5 refractory meds
E: effusion (pericardial)
I: ingestion - methanol, ethylene glycol, slaicylate, lithium, Na-valproate, carbamazepine
O: volume overload refractory to diuretics
U: symptomatic uremia (encephalopathy, pericarditis, bleeding)
RBC transfusion thresholds
10: generally not indicated
Cystinuria pathology, symptoms, diagnostic tests
impaired amino acid transport (dibasic AAs cystine, lysine arginine, ornithine) by brush borders of renal tubular and intestinal epithelial cells; cysteine is poorly soluble in H2O - hard radioopaque renal stones;
hx of recurrent stones, + fam hx, typical hexagonal crystals, +cyanide nitroprusside test
indications for cysstoscopy
- gross hematuria w/ no glomerular disease/infection
- microscopic hematuria with no “ “ but risk for CA
- recurrent UTIs
- obstructive symptoms with suspicion for stricute/stone
- irritative sx w/o UTI
- abn bladder imaging or urine cytology
medication for passage of uncomplicated renal stone
stone >10mm; alpha blockers like tamsulosin - relaxes ureteral muscle and decreases ureteral pressure
