Renal Flashcards
Early onset htn and bilateral upper abdominal masses plus proteinuria are suggestive of
Polycystic kidney disease
Dx of adpkd
Abdo us
Meds that increase natriuresis, decrease serum ang II concentration and decrease aldo production
Direct renin inhibitors (aliskiren)
Really dehydrated kids should be rehydrated with
Normal saline (not half or quarter)
When is ct abdo/pelvis necessary in uncomplicated pyelo?
If it hasn’t improved within 72 h
Acute pyelo can result in gram ___ ___
Negative sepsis
Tx for anemia related to ckd
Epo
Se of epo
Htn
Hypokalemia and hypocalcemia will not correct without ___ correction
Magnesium
Urine calcium oxalate crystals are associated with
Ethylene glycol poisoning
For every change in albumin of __, calcium changes in ___ direction by ___
One
Opposite direction
0.8
Management of hypocalcemia
First check albumin to make sure hypocalcemia is real, then give iv calcium
Tx of hypercalcemia
Iv fluids and bisphosphonates
Bun/creatinine ratio in prerenal aki
> 20:1
Bun/creatinine ratio in intrarenal aki
<15:1
Urine sodium in prerenal aki
<20mEq/L
Urine sediment findings in prerenal aki
Hyaline casts
Muddy brown casts is pathgonomonic for
Atn
Dx of kidney stones
Noncontrast abdo ct (ultrasound preferred for preg pts and children)
Envelope shaped kidney stones are
Calcium oxalate stones
Most common cause of calcium oxalate stones
Idiopathic hypercalcemia
Coffin lid shaped kidney stones are
Struvite (ammonium mag phosphate stones)
Rhomboid shaped kidney stones are
Uric acid stones
Hexagonal shaped kidney stones are
Cystine stones
Adpkd is associated with what kind of aneurysm
Berry aneurysm
Analine dye is a rf for
Bladder cancer
Bladder cancer is usually what kind of cancer
Transitional cell carcinoma
Dx of bladder cancer
Cystoscopy with biopsy
Bhcg in men think
Choriocarcinoma
Middle aged smoker with left sided varicocele think
Renal cell carcinoma
How does acetazolamide work
Increases bicarb and water excretion by inhibiting carbonic anhydrase
Side effect of carbonic anhydrase inhibitors (acetazolamide)
Hyperchloremic metabolic acidosis
Most common use of acetazolamide
Glaucoma
Acetazolamide helps prevent __ sickness
Mountain
Thiazides ___ sodium and potassium
Loose
Aspirin is cleared by the
Kidneys
Symptoms of aspirin overdose
Ams
Tinnitus
N/v
Management of postpartum urinary retention (inability to void or small volume voids)
Intermittent catheterization
Central and nephrogenic di is a problem with
Adh
Mechanism of tamsulosin
Alpha 1 antagonist that relaxes ureteral muscle
Med to help passage of ureteral stone
Tamsulosin
Antihistamines in elderly can cause urinary
Retention (detrusor hypocontractility)
In adpkd, why can you feel right kidney and not left
Because right kidney sits lower than left
Urinary alkalinization (ph>8) in uti raises suspicion for
Urease producing bacteria such as proteus
Burr cells, also called ___, can be seen in peripheral smear in pts with __ dz
Echinocytes
Renal diseAse
Confusion and abdominal pain can occur in pts with uremia due to renal failure, typically when bun is above
100
Urinary incontinence in elderly what should you get initially
Ua-uti s are a big cause of urinary incontinence
Tx of primary nocturnal enuresis
Desmopressin
Side effect of metformin (renal)
Lactic acidosis in acute kidney injury - avoid until renal function improves
Side effect of hydroxychloroquine
Retinal toxicity
Hypovolemia results in ___ urine sodium
Decreased