Renal Flashcards
1
Q
RBC Casts
A
Glomerulonephritis
2
Q
WBC casts
A
interstitial nephrItis
3
Q
Fatty Casts
A
NephrOtic syndrome
4
Q
Muddy-brown casts
A
acute Tubular necrosis
5
Q
Prerenal Azotemia UA
A
- Cause = dec. perfusion –> want tot KEEP water
- Urine Osmolality: >500 (high)
- FeNa: Low (
6
Q
Renal Azotemia UA results
A
- Tubular or glomergular damage –> cant resorb!
- Urine Osmolality: High (>500-800)
- FeNa: HIGH (>2%)
- Urine Na: HIGH (>40)
7
Q
Rhabdomyolysis
A
- Crush injury or immobility
- High Myoglobin (renal toxic)
- High K + Ca
- Tx: IVF + Mannitol
8
Q
Management of CKD
A
- Low protein + Low salt diet
- ACE inhibtor (dec. risk ESRD & control HTN)
- Ca-Citrate (phosphate binder)
- Vit D & Ca supplemetn
- Erythropoietin
9
Q
Dialysis Indications (6)
A
- Pulmonary Edema
- Refractory HTN
- Hyper K w/ EKG changes
- HyperMg
- Metabolic Acidosis
- Drug Toxicity: Methanol. Ethylene glycerol, Lithium, ASA
10
Q
Nephritic vs, Nephrotic
A
Nephritis:
- Inflammatory process
- Hematuria (RBC casts)
- Mild Proteinuria (3.5
- Edema (2/2 hypoalbuminemia)
- Hyperlipidemia (fatty casts)
- Hypercoaguable state (antithrombin loss)
11
Q
Membranous Nephropathy
A
- # 1 in adults
- Hep C + B, Syphilius, SLE, NSAIDs
- Granulary Immunoflour (Phospholipase A2)
12
Q
Focal Segmental Glomerulosclerosis
A
- Blacks + Hispanics
- HIV + Heroine + Sickle cell
- Effacement of foot processes
- Sentimental sclerosis
- Tx: Steroids + Immunosuppression
13
Q
Membranoproliferative Glomerulonephritis
A
Type 1:
- Mesangial splittin (“Tram tracks”
- Hep B + C + SLE
Type 2:
- Intramembranous (dense deposits)
- C3 neprotic factor
14
Q
Minimal Change Disease
A
- # 1 in kids
- Lymophoma
- Foot process effacement
- Tx: Steroids
15
Q
Poststreptococcal Glomerulonephritis
A
- # 1 cause of nephritic
- 2 weeks after strep infection
- Immune complex depositiion (Type III hypersensativity)
- Granular on immunoflour.
- “coca cola” colored urine
16
Q
Alport Syndreom
A
- Collagen IV mutation
- Glomerular membrane splitting
- Deafness
- Eye problems
17
Q
Berger Disease
A
- Episodic hemautris FOLLOWING Upper respiratory or GI illness
- asst with Henoch-Scholein purpura
- Mesangeal proliferation
- IgA deposits on Immunoflour
18
Q
Rapid Progressive Glomerulonephritis
A
- Crescent lesion (fibrin, macrophages, C3)
Causes: - Goodpasture (GN + Pulmonary hemorrhage + antiGMB = linear immunoflour)
-Wegeners (cANCA + GN + Pulmonary + Upper Resp sx) - Churg Straus (pANCA + Eosinophlia + asthma)
- Diffuse Proliferative (Ig-C3 Complex deposition on immunoflour + “Wire looping”
19
Q
Acute Interstitial Nephritis
A
- Allergic Rxn --> fever, eosinophilia, AKI Causes (6): 1. Contrast 2. Drugs (6) (penicillin, Phenytoin, PPI, Sulfa, Rifampin, Diuretics, NSAIDs) 3. Infections 4. SLE 5. Sjogerns 6. Sacoidosis
20
Q
Renal Tubular Necrosis
A
- Granular, Muddy-brown casts
1. Injury - Toxin (Aminoglycosides, Lead, Cisplatin, Rhabdomyolysis)
Ischemia
2. Maintenance: Olguiria lasts 1-3wks - hyperK + Metabolic acidosis
3. Recovery: Polyuria - hypoK
21
Q
Ca Stones
A
- Most common
- Idiopathic (#1 cause); ethylene glycol, Vit C. Overdose, Chrons
- Radiodense
- dumbell shaped
- Tx: Thiazide diuretics
22
Q
Ammonium-Mag-PO4 stones
A
- Urease (+) bacteria (Proteus, Klebsiella, Staph)
- Radiodense
- Coffin shaped
- Tx: Surgical removal
23
Q
Uric Acid Stones
A
- Olgiuia
- RadioLUCENT
- Rhomboid shaped
- Tx: Alkaline urine
24
Q
Cystine Stones
A
- Cystinuria (kids)
- Radiodense
- Hexagon
25
Kidney Stone Dx testing?
```
Abdo US (for hydronephrosis)
CT is gold standard
```
26
Urinary tract Obstruction Dx testing?
- US first
| - IVP is gold standard
