Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

STEP 2 AG > Renal > Flashcards

Renal Flashcards

1
Q

Hematuria where’s the blood coming from

A 
Kidney/ureter = blood the whole time
Bladder = blood at the end
Urethra = blood at the beginning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Urethral stricture

A

Obstructive sx slow urine stream, dribbling, spraying, large postvoid residual, NO UTI SX, cause often unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Membranous nephropathy

A

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why do we treat pregnant women w asx bacteriuria

A

Prevent pyelo (ureteral smooth muscle relaxes higher risk asc infx), ARDs preterm labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stones

A

Don’t see on XR: (SUCCX)

  • Struvite (urease-prod bact)
  • Uric acid (tx K citrate alk urine)
  • Ca 1-3mm (envelope crystals)
  • Cysteine (SIXteen=hexagonal crystals, genetic, COLA, cyanide nitroprusside test)
  • Xanthine

Radiopaque:
- Ca oxalate >3mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AKI

A

Def=<600mL/24h, Cr inc >50%

Prerenal BUN/Cr>20, UNa<20 appropriately low (kidneys are working), nl UA:

  • hypovolemia (sepsis, DIURETICS)
  • maybe CHF

Intrarenal BUN/Cr 10-15, UNa>40:

  • acyclovir crystals direct damage to tubules 24-48h
  • AIN rx (blactams other abx, PPI >7 days after start the rx) OR systemic dz, WBC casts
  • ATN ischemic injury, can be 2/2 hypovolemia, Uosm >300, UNa >20, FeNa >2% (kidneys suck), give fluids MUDDY BROWN CASTS
  • Glomerulonephritis RBC CASTS (+/- few WBC)

Postrenal hydronephrosis:

  • BPH
  • cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blunt abd trauma, pelvic injury PERITONITIS

A

Bladder dome rupture (ant wall and neck of bladder are extraperitoneal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

W/u for recurrent UTIs in kids

A 
US:
<2 yo
2+ UTIs
Family hx renal dz
Abx don’t work

Voiding cystourethrogram:
Newborn <1 mo
2+ UTIs
Not E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diabetic glomerulosclerosis course

A

1 Glomerular hyperfiltration —> intraglom hypertension ACEi reduce htn
2 BM thickening
3 mesangial expansion
4 nodular sclerosis

DM nephropathy Screening check microalbumin (dipstick detects protein >300, in DM have protein 30-300)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nocturnal enuresis

A

> 5 yo, lifestyle, alarm, desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Indications to remove a stone

A

Time >1mo
Size >1cm
Stuck (complete obstruction)
Sick (AKI, sepsis, PAIN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sickle cell TRAIT kidney stuff

A

Hypostenuria (kidney can’t concentrate the urine)
Renal papillary necrosis (hematuria)
Rhabdo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SSRI

A

SIADH!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Posterior urethral injury

A

Pelvic fx, blood in urethral meatus, perineal hematoma, inability to urinate, high-riding prostate, dx retrograde urethrography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Proteinuria in a preggo

A

Physiologic = trace, dec Cr, hypotens

Diabetic nephropathy = >300 or 1+ protein, inc Cr, hypertension, if <20w likely preexisting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Polycystic kidney disease

A

AD
B/l masses, berry aneurysms, hepatic cysts, INTERMITTENT recurrent b/l flank pain (w/ gardening) +/- hematuria, early onset HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HYPERKALEMIA!! Treatment

A

IF >7 or EKG changes —> Give calcium gluconate or chloride NOT CARBONATE, insulin + glucose, inhaledB2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drug to help pass a kidney stone

A

Tamsulosin a1 antagonist
Bethanechol cholinergic tx for retention
Oxybutinin antichol tx for OAB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Drugs that cause hyperK

A

Notoriously Bad Potassium
NSAIDs
BP drugs (ACEi, ARB, amiloride, Bb, spironolactone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptomatic hyponatremia (encephalopathy)

A

6-8 per 24h, if iatrogenic from hypotonic fluids can give hypertonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Interstitial cystitis

A

Clean UA, pain, tx supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mixed acid-base disorders compensatory

A

Metabolic acidosis, CO2 should be lower to compensate—> CO2=1.5(HCO3) + 8 +-2
Metabolic alkalosis—> CO2 INC 0.7/1 HCO3 >28
Respiratory acidosis—> bicarb INC 1/10 acute, 4/10 chronic
Respiratory alkalosis—> bicarb DEC 2/10 acute, 5/10 chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Nephrotic syndrome increases risk of

A

Atherosclerosis

24
Q

Renal artery stenosis

A

ACEi, ARB, no stent

25
Q

Bladder cancer

A

Unilateral hydronephrosis w/o a stone

26
Q

Electrolyte changes w vomiting

A

Low K, H, Cl

Increased bicarb —> metabolic alkalosis

27
Q

Calciphylaxis (calcifications uremic arteriolopathy)

A

ESRD on HD, kidney transplant
Hyperphosphatemia, hyper-PTH, hyper/normal Ca
Calc of arterioles and soft tissue —> ischemia and necrosis

28
Q

Hypernatremia

A

IF HYPOVOLEMIC, give NS (0.9%) saline until euvolemic, then hypotonic (0.45% saline or D5)

29
Q

Dx of pyelonephritis or renal abscess in kids

A

Abd US (not CT, rad)

30
Q

RCC

A

Flank pain, hematuria, abd mass
L sided varicocele that DOES NOT reduce w recumbancy
Paraneoplastic (thrombocytosis, polycythemia/anemia)

31
Q

Von Hippel-Lindau

A

RCC, CNS hemangioblastomas (cerebellum, retina), pheo

AD

32
Q

Main risk factor for UTI in women vs men

A

Shorter urethra

33
Q

Hyperventilation acid-base stuff

A

Low CO2 —> decreased bicarb, decreased H+ in urine —> alkaline urine

34
Q

Hepatic cyst benign vs malignant

A

Benign —> homogenous, non-enhancing, non-septated, no loculation, asx, usually incidental, provide reassurance

35
Q

Coagulopathy in ESRD patients

A

Platelet dysfxn, prolonged BT, DDAVP inc VIII:vWF multimer release from endothelial cells

36
Q

SIADH tx

A

Na <120 = severe, +symptoms —> hypertonic saline (3%)

Not severe —> fluid restriction +/- salt tabs

37
Q

DM nephropathy, amyloidosis, membranous nephropathy, MCD, membranoproliferative glomerulonephritis, FSGS, IgA

A

DAMMM you FIne

DM nephropathy: hyalinosis af+ef arterioles
Amyloidosis: abnl proteins/inflamm (RA) vs lambda light chains (MM Waldenstrom) congo red apple green birefringence
MCD: kids>adults NSAIDs Hodgkin lymphoma
MN: cancer (breast, lung) hep B, NSAIDs, SLE
MPGN: Hep B/C, lipodystrophy (type 2=anti-C3 convertase IgG)
FSGS: HIV, heroin, obesity, race AA or Hispanic
IgA: URI granular deposits

38
Q

Familial hypocalciuric hypercalcemia

A

High serum Ca, normal-high PTH, low urine Ca/Cr clearance <0.01
Ddx hyperPTH, will have urine Ca >0.02

39
Q

Tx for recurrent calcium stones

A

Low sodium, low protein, fluids, NORMAL Ca, thiazide

40
Q

Tx hypercalcemia

A

> 14 +/- sx—> NS + calcitonin, if can’t get fluids (CHF, RF) HD, bisphos later (MM, but worry about that LATER)

41
Q

MC cause of potter sequence

A

Posterior urethral valves

42
Q

Ethylene glycol vs methanol

A

Both: AG gap + osmolal gap met acidosis (2xNa + glucose/18 + BUN/2.8, nl <10), tx fomepizole
Ethylene glycol kidneys (Ca oxalate crystals in UA, hypoCa)
Methanol eyes

43
Q

Farmer

A

Organophosphate poisoning

44
Q

DKA/HHS

A

Often precipitated by infx (UTI) 30-40%, dehydration 2/2 osmotic diuresis, Na may be normal
IT CAN STILL BE DKA IF GLUCOSE IS 250, iso saline bolus 10mL/kg x 1h, ins + K <5.2 gluc <200

45
Q

Na correction hyperglycemia

A

+2 for every 100>100

46
Q

Hyponatremia

A

sOsm <275, hypovolemic GI (UNa<40) OR renal (UNa>40), euvolemic psychogenic (uOsm<100) OR SIADH (uOsm>100, UNa>40), hypervolemic CHF

sOsm >295 hyperglycemia, mannitol, lipids

47
Q

Nephrogenic diabetes insipidus

A

Criteria: UOsm<300, >50mL/kg/d, urine spec grav <0.01
Etiology: kidneys don’t respond to ADH
Sx: nl-high Na

48
Q

Renal infarct

A

wedge-shaped lesion on CT, flank pain, n/v (+/- fever), hematuria + protein no casts

49
Q

Lithium toxicity

A

GI, tremor, ataxia, sz, Rx NSAIDs, metronidazole ACEi, tetracyclines HCTZ

Prenatal: Ebstein’s anomaly (enlarged RV, ASD)

50
Q

Renal vein thrombosis

A

Pt w cancer, COMPLICATION OF NEPHROTIC SYNDROME enlarged kidney, UA isolated hematuria, LDH, causes hypercoagulability (loss of protein C, S), AC or AKI surg thrombolytics

51
Q

Kidney stone w/u

A

US, CT NO CONTRAST

52
Q

Renal tplant complications

A

ROCA BUM
rejection, occlusion (vascular, ureteral), cyclosporine, ATN
Bx, US, MRI

tx for rejection = steroids

53
Q

MUDPILES

A 
Methanol
Uremia
DKA
Propylene glycol
Iron/Isoniazid
Lactic acidosis
Ethylene glycol
Salicylate (tinnitus)
54
Q

Iron poisoning

A

<6yo GI losses=hypovolemic shock corrosive hematemesis, radiopaque XR tx deferoxamine

55
Q

Alport syndrome

A

Type IV collagen, kidney probs + SN hearing loss

56
Q

PSGN

A

1-4w, immune complexes (vs IgA during or days after illness)

57
Q

Normal lactate

A

<1 (<2 if critically ill)

STEP 2 AG (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions