Renal Flashcards
Which diagnosis? Hyaline casts
Concentrated urine
Which diagnosis? Granular casts
Proteinuria
Which nephrotic syndrome? Associated with HBV
Membranous Glomerulopathy
Which nephrotic syndrome? Associated with HIV
FSGS
Tx Hypo-osmolar Hyponatremia- Hypervolemic
Na/H2O restriction, diuretics
Tx Hypo-osmolar Hyponatremia- Euvolemic
Water Restriction
Tx Hypo-osmolar Hyponatremia- Hypovolemic
IVF
Rate of correction for hypernatremia
<1mEq/hr
Rate of correction of hyponatremia
1-2mEq/hr up to 120, then 0.3-0.5mEq/hr
Tx Central DI
Vasopressin
Tx Nephrogenic DI (2)
Salt restriction, thiazide diuretic
EKG changes in hypokalemia
U waves, flattened/inverted T waves
EKG changes in hyperkalemia
flattened P waves, peaked T waves, widened QRS
Which finding/electrolyte disturbance? spasms with tapping of facial nerve
Chvostek sign/hypocalcemia
Which finding/electrolyte disturbance? carpal spasm with blood pressure cuff inflation
Trousseau sign/hypocalcemia
EKG changes in hypocalcemia
Prolonged QT
EKG changes in hypercalcemia
Shortened QT
Tx Hypercalcemia (first-line)
IVNS
Which diagnosis? Non-Anion Gap Metabolic Acidosis with positive urine anion gap
Renal tubular acidosis
Which diagnosis? Non-Anion Gap Metabolic Acidosis with negative urine anion gap
GI bicarb losses, acid ingestion
Urine Anion Gap =
Na + K - Cl
Compensation chronic Metabolic acidosis
PCO2 = Bicarbonate + 15
Compensation metabolic alkalosis
1HCO3/0.7pCO2
Compensation Respiratory Acidosis
10pCO2 - 1HCO3 (acute) or 3.5HCO3 (chronic)
Compensation Respiratory Alkalosis
10pCO2 - 2HCO3 (acute) or 4HCO3 (chronic)
What FENa? ATN
> 2
What FENa? Acute GN
<1
What FENa? AIN
> 2
Tx Hepatorenal syndrome (3)
Albumin, Norepinephrine/midodrine, octreotide
Goal Hgb in CKD
10
Indications for phosphorous binders
> 4.5
Tx hyperphosphatemia in CKD
Calcium based if CaPO4 <55, non-calcium based if CaPO4 >55
Which stones? Envelope shaped
Calcium oxalate
Which stones? diamond/rhomboid shaped
Uric acid
Which stones? associated with tumor lysis syndrome
Uric acid
Which stones? coffin-shaped
Struvite (Mg-NH4-PO4 or CaCO3-apatite)
Which stones? can form stag horn calculus
Struvite (Mg-NH4-PO4 or CaCO3-apatite)
Which stones? Hexagonal stones
Cystine
Which stones? reduced incidence with increased calcium intake
Calcium oxalate
Which stones? AR inheritance
Cystine
Which stones? Associated with Klebsiella or Proteus UTI
Struvite (Mg-NH4-PO4 or CaCO3-apatite)
Dx Nephrolithiasis
Non-contrast CT (or US)
Nephrolithiasis indication for urology consult
size >7mm
Tx nephrolithiasis >7mm
Tamsulosin (or CCB)
Tx recurrent cystine or uric acid stones
Potassium citrate (raises urine pH)
Tx recurrent calcium oxalate stones
HCTZ, potassium citrate