Renal

Question 1

presentation, causes, and treatment of renovascular HTN?

Answer 1

presentation: HTN refractory to treatment, renal bruit, headaches
causes: fibromuscular dysplasia in young people; atheromatous plaque in the elderly
treatment: angioplasty with stent placement for fibromuscular dysplasia.

Question 2

prerenal azotemia?

Answer 2

BUN:Cr >20

Question 3

Formula for FENa? How do you interpret the results?

Answer 3

serum sodium x urine creatinine

FENa

Question 4

what can indinavir cause?

Answer 4

crystal-induced nephropathy. it can precipitate into needle-shaped crystals, cause stones, hematuria

Question 5

findings for contrast-induced nephropathy?

Answer 5

muddy-brown granular and epithelial cell casts, increased serum Cr

Question 6

At what point do you begin to worry about uremic pericarditis? What is the treatment?

Answer 6

Concern over uremic pericarditis with BUN >60

Urgent dialysis is the treatment

Question 7

Indications for urgent dialysis

Answer 7

A - symptomatic acidosis refractory to treatment (pH 6.5, refractory to treatment)
I - ingestion of toxins
O - volume overload refractory to diuretics
U - symptomatic uremia (encephalopathy, pericarditis, bleeding)