Renal Flashcards
Compensation
Metab alkalosis
Change in bicarb x 0.7 + 40
Compensation
Acute resp acidosis
For every 10 inc in CO2, bicarb dec by 1
Compensation
Acute resp alkalosis
For every 10 dec in CO2, bicarb inc by 2
Compensation
Chronic resp acidosis
For every 10 inc in CO2, bicarb dec by 3.5
Compensation
Chronic resp alkalosis
For every 10 dec in CO2, bicarb inc by 5
Corrected anion gap for albumin
For every dec in alb by 1, add 2.5 to anion gap
Defect in Barter’s syndrome
Ascending loop of Henle
Acts like lasix
Defect in Gittelman’s
Decreased transport defect in distal tubules
Acts like thiazide
Defect in Liddle’s
Increased transport defect in distal tubules
Re RTAs
RTA type 2 and 1;
Will have stones and hypokalemia
RTA type 4:
Hyperkalemia
Ph 5.5
Compensation
Metab acidosis
1.5 x Bicarb + 8
Urine gap
Na+k - Cl
Positive in RTA and renal dse
negative in diarrhea and GI
Hypernatremia
Think diabetes insipidus
Central- if it corrects w/ ddavp
Nephrogenic- if no change in water deprivation or ddavp
Normal values
Urina Na
urine osm
Urine na: 20-40
Urine osm: 600
Tx of central diabetes insipidus
Demeclocycline, tolvaptan
Conivaptan if acute
Hyponatremia causes (isovolemic)
SIADH vs psychogenic
Siadh: urina na and osm is inc
Psychogenic: urine na and osm is dec
Ua with blood but no rbcs
Rhabdo
PNH
High vit c intake
Contamination w/ povidone iodine
What has been shown to preserve renal fxn in APKD
Tolvaptan
Nephrotic histopath presentations
Minimal change
FSG
Membranous
Membranoproliferative
Nephritic histopath presentations
Post strep GN
IgA nephropathy
HSP
RPGN
RPGN types
1- goodpastures
2- penicillamine
3- wegeners
Dse associated w/ minimal change
Lithium
NSAIDs
Hodgkins
Leukemia
Dse assoc w/ FSG
Obesity black HIV Heroin Sickle cell
Dse assoc w/ membranoproliferative
Sle
Sbe
Cryoglobulinemia
Hep B,C
IM in Minimal change
Normal
IM in FSG
IgM, C3
IM in membranous
IgG, C3
Tramtrack
Membranoproliferative
Wire loop
Membranous
Lumpy bumpy granular
Post strep GN
Complement in post strep GN
Low c3, Normal c4, CH50
Linear igG deposition
Goodpastures
Pauci immune RPGN
Wegeners, PAN
How to confirm renal manifestations of vasculitis
Renal biopsy
