Renal Flashcards
Renal artery stenosis in a young woman from fibromuscular dysplasia is treated how? HY
Treat fibromuscular dysplasia with a STENT, not surgery. use surgery if stent fails (Angioplasty with stent)
What is a sign of uremia in labs?
uremia sign is high BUN and look for asterixis
BUN correlates to what indication for dialysis
BUN elevation can show uremia which is an indication for dialysis
What are signs of uremia (high BUN )
Asterixis with encephalopathy and pericarditis/bleeding
What are uremia signs of dialysis
Dialyze with uremia (high BUN) and pericarditis, bleeding or ecephalopathy
When is an acidosis indication for dialysis
Dialysis when pH
When is dialysis used for eletrolyctes
Refractory K+ >6.5 or EKG changes and ventricular arrythmia
When is dialysis used for volume overload
Dialysis is used for volume overload refractory to diuretics
How is hypernatremia treated?
The MCC of hypernatremia is volume status. First assess volume status and if volume is low then give NS if symptomatic and D5W 1/2NS if asymptomatic
What happens if you replace and lower hypernatremia to fast?
Lower hypernatremia too fast you get cerebral EDEMA
Labs of dehydration?
Increased Cr and BUN, increased HCT from hemoconcetration and dry mucuous membranes, common in elderly
When is hypertonic saline used
use hypertonic saline when severe hyponatremia exists with s/s present (3%) is hypertonic and use until Na is back to 120 and s/s are gone
What happens if hyponatremia is corrected to quick?
Central pontine myelinolysis results when hyponatremia is corrected to quickly
How is mild SIADH treated
Mild SIADH causes hyponatremia, without syx they can just get fluid restriction
how is moderate wiht syx SIADH treated
syx hyponatremia with SIADH = 3% hypertonic saline until Na >120 and syx are gone
First step in hyper K diagnosis
first step in hyper K diagnosis i EKG which determines treatment
what two things determine treatment in hyper K
Hyperk Tx is determiend by K > 7 or changes on EKG
Preferred tx for no EKG changes and K
IV furosemide, or hemodialysis. First line is IV loop diuretics.
EKG hyperK signs?
Long PR and QRS and peaked T
what do peaked T tell you
peaked T tell you there is hyper K
When do you see long PR QRS, peaked T and low P?
Peaked T and long PR and QRS with low P is hyperK
When do you see sine wave
Sine wave is hyper K
How does albuterol affect K
Albuterol nebulizer causes K+ to move into the cells it is B2 agonism
what electrolyte does TMPSMX affect
TMP SMX affects K+