Renal

Question 1

Types of renal failure

Answer 1

Prereanal
Renal: glomerular/tubular
Post renal

Question 2

Falsely elevated BUN

Answer 2

High protein diet

Blood in git

Question 3

Falsely low BUN

Answer 3

Liver ds

Malnutrition

SIADH

Question 4

How is GFR measured??

Answer 4

Creatinine clearance

Product of skeletal muscle

Slighlty overestimates the GFR because it is secreted

Question 5

Even if person is anuric , the rate of rise in creatinine ll be

Answer 5

0.5 to 1.0 /day

The rise ll be faster if the body muscle mass ll be more

Question 6

Cause of prerenal azotemia

Answer 6

Due to any cause

• hypovolemia
• hypotension
• third spacing of fluids
• addisons ds(low aldosterone)

Question 7

Blood pressure in systemic and renal artery

Answer 7

Systemic- high( due to aldosterone)

Renal - low (kidney perceive as systemic hypotension)

Question 8

Parameters to find out the cause of oliguria

Answer 8

FeNa
BUN/Cr ratio
UOSm
Urine Na
Urinanalysis

Question 9

What ll happen to the parameters in prerenal azotemia

Answer 9

FeNa. -less than 1%

BUN/Cr ratio - > 15:1

UNa. - less than 20 mEq/L

UOsm - more than 500

Urinanalysis - normal

Question 10

What ll happen to parameters in post renal azotemia

Answer 10

UNa - more than 40

uOsm - less than 350

FeNa - more than 2%

BUN/Cr ratio -

Question 11

diagnosis of hepatorenal syndrome

Answer 11

exclude intrinsic renal ds first . no improvement in renal failure after 1.5 L of colloid.

Question 12

Rx of liver ds

Answer 12

Rx liver ds . Midodrine ( alpha agonist) . octreotide . liver transplantation.

Question 13

best Rx in hepatorenal syn

Answer 13

liver transplantation

Question 14

angiotensin acts on

Answer 14

constricts efferent normally

Question 15

role of PGs in kidney

Answer 15

dilates afferent( inhibited by NSAIDS)

Question 16

how do ACEI prevent renal failure

Answer 16

for short term : increase bun/ creatinine by dec GFR in long term: dec intraglomerular pressure

Question 17

can there be renal failure with obstruction in one kidney

Answer 17

no

Question 18

cause of postrenal azotemia

Answer 18

obstruction in both kidneys/ in bladder

Question 19

retroperitoneal fibrosis caused by which drugs

Answer 19

bleomycin, methotrexate ,methylsurgide

Question 20

MCC of neurogenic bladder

Answer 20

diabetes and multiple sclerosis

Question 21

most serious complication of postoliguric phase

Answer 21

hypokalemia

Question 22

ATN types

Answer 22

ischemic and toxic

Question 23

phases of ATN

Answer 23

Prodromal oliguric postoliguric

Question 24

Rx of ATN

Answer 24

no specific Rx
hydration to rx prerenal component

no effect of diuretics , mannitol or dopamine

Question 25

clinical features of AIN

Answer 25

fever
rash
joint pain

Question 26

drugs responsible for Skin rash due to allergy

Answer 26

penecillins
cephalosporins
sulfa
allopurinol
rifampin
quinolones

Question 27

causes of AIN

Answer 27

drugs mainly
infections
autoimmune

Question 28

lab findings in AIN

Answer 28

eosinophilia
eosinophiluria(many people have this)
hematuria
proteinuria
inc Ige