Renal

Question 1

Gi bleed in RENAL pt should get what?

Answer 1

Iv desmopressin bc even tho plt count notmal they are disfunctional and may see incr bleeding time
It incr factor 8 and vwf multimers

Question 2

Hyperkalemia effect on ekg?

Answer 2

Peaked t, p waves disapear, sine waves (widened qrs)

Question 3

If u suspect renovasc htn, next step is

Answer 3

Mra, cta or doppler u/s of renal arteries

Not the urine metanephrines ig they dont have headache, sweats, tachycardia

Question 4

When to start esrd pt on iron?

Answer 4

Transferrin

Question 5

If lupus pt shows renal failure what is first step?

Answer 5

Renal biopsy bc that will guide management!! Some types dont need steroids.

Question 6

Nephrotic proteinuria w pedal edema and aki. Recent uri 4 weeks ago but also takes nsaids. Due to?

Answer 6

Analgesic induced nephropathy- nsaids inh PG production (vasodilatory) and also cause intersitial nephritis (diff story).

Question 7

Pt presents w renal colic pain, takes nsaids, found to have aki, ua shows 1+protein, high wbc but neg le and nitrite, and high rbc. Dx?

Answer 7

Analgesic nephropathy!! Causing chronic necrosis of renal papilla and sterile pyuria

A renal calculus when only affects one kidney!!!

Question 8

Pt w renal tx w htn develops incr cr after initiation of ace inh bc

Answer 8

Renal a stenosis due to improper surg anastamosis, rejection

And stim raa system

Question 9

Pt w esrd w persistent high ca, pth not responding to meds should get

Answer 9

Parathyroidectomy when ca>10.5 and on meds, high phos, pth >1000, intractable pruritis

Question 10

Indication for parathyroidectomy in primary hyperParathyroidism

Answer 10

If symptomatic ie constipation

Asymp if ca >1 mg/dL or osteoporosis or age

Question 11

Pt w renal mass confined to capsule (stage one) gets what tx?

Renal mass extending through capsule gets what tx?

Answer 11

Partial nephrectomy

Radical nephrectomy