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EORs > Renal > Flashcards

Renal Flashcards

1
Q

CKD

- imaging

A
  • US: bilateral small kidneys = CKD
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2
Q

CKD

- RF

A
  • HTN
  • AA
  • DM
  • NSAID use
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3
Q

Hypercalcemia of malignancy

- treatment

A
  • aggressive hydration

- IV bisphosphonates to inhibit ca release from bone

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4
Q

Nephrotic syndrome

- features

A

NAPHROTIC

  • Na decrease
  • Albumin decrease
  • Proteinuria >3.5 / day
  • Hyperlipidemia
  • Renal vein thrombosis
  • Orbital edema
  • Thromboembolism
  • Infection (loss of Ig in urine)
  • Coagulability (loss antithrombin III in urine)
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5
Q

Nephrotic syndrome

- UA

A
  • fatty casts (pathognomonic), “maltese cross”
  • lipiduria (sudsy or foamy urine)
  • > 3 g protein per day
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6
Q

Nephrotic syndomre

- tx

A
  • increase daily protein intake
  • ACE/ARB
  • salt restriction
  • thiazide/loop diuretic for edema
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7
Q

Hydronephrosis

- overview

A

distention of renal calyces and pelvis due to obstruction of distal urine flow

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8
Q

Hydronephrosis

- Causes

A
  • urolithiasis
  • BPH
  • bladder outlet obstruction
  • prostate carcinoma
  • bladder prolapse
  • neoplasms
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9
Q

Hydronephrosis

- dx

A

renal US initial test

  • IV pyelography
  • CT scan
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10
Q

hypokalemia on EKG

A
  • flattened T wave

- prominent U wave (after t wave)

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11
Q

Sodium correction in hyperglycemia

A
  • add 1.6 mEq/L for every 100 mg/dL glucose >100
    OR
    measured sodium + 1.6 (serum glucose - 100)
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12
Q

common cause of hypomagnesemia

A

malnutrition

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13
Q

Glomerulonephritis

- s/sx

A 
Top three:
1- hematuria
2- proteinuria
3- RBC casts **
- HTN
- edema
- CHF 2/2 volume overload
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14
Q

MC type kidney cancer

A

renal cell carcinoma

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15
Q

Renal cell carcinoma

- cells originates from

A

epithelial cells of PCT

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16
Q

Renal cell carcinoma

- RF

A
  • cigs
  • obesity
  • prolonged anti-inflammatory use
  • HTN
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17
Q

Renal cell carcinoma

- clinical

A
  • flank pain
  • flank mass
  • hematuria
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18
Q

Renal cell carcinoma

- dx

A
  • XR: solid, irregular or lobulated border mass that distort renal contour
19
Q

Renal cell carcinoma

- mgmt

A
  • radical/partial nephrectomy
20
Q

Initial treatment for severe hyperkalemia

A
  • calcium
21
Q

Hyperkalemia

- MCC

A

decreased excretion

22
Q

Hyperkalemia

- RF

A
  • renal impairment
  • DM
  • K-sparking diuretics, NSAIDs, ACE
23
Q

Hyperkalemia

- causes

A
  • RF
  • increased intake
  • shift from intracellular to extracellular
24
Q

Hyperkalemia

- clinical

A
  • mostly asx
  • ## sx related to cardiac and msk function, mc fatigue and weakness
25
Q

Hyperkalemia

- treatment

A
  • Calcium**
  • insulin with dextrose, albuterol, bicarb
  • furosemide or dialysis
26
Q

Acute interstitial nephritis

- MCC

A
  • meds (NSAIS, PCN, PPI)

- infection

27
Q

Acute interstitial nephritis

- overview

A

causes AKI dt immune-mediated tubulointerstitial injury

28
Q

Acute interstitial nephritis

- dx

A
  • eosinophiluria in pt with AKI (indicates allergic reaction)
29
Q

Polycystic Kidney Disease

- overview

A
  • autosomal dominant

- 50% ESRD by age 60

30
Q

Polycystic Kidney Disease

- dx

A
  • 30-59 with 2+ cysts on US or CT bilaterally highly likely

- genetic testing to confirm

31
Q

Polycystic Kidney Disease

- clinical

A
  • abdominal / flank pain
  • hx hematuria
  • renal infection
  • nephrolithiasis
  • HTN
32
Q

Polycystic Kidney Disease

- other risks

A
  • cerebral aneurysm
  • MV prolapse
  • Aortic aneurysm
  • Aortic valve abnl
  • colonic diveticula
33
Q

Polycystic Kidney Disease

- mgmt

A
  • no cure
  • aggressive HTN mgmt with ACE/ARB
  • low-protein diet
  • pain control, infection control
  • dialysis or transplant
34
Q

Renal artery stenosis

- dx

A
  • intimal: CTA or renal angiography

- gadolinium-enhanced MRA if decreased renal fn

35
Q

Renal artery stenosis

- mgmt

A
  • ACE/ARB

- revascularization

36
Q

Anion gap calculation

A

Na - (Cl + bicarb)

nl: 3-11

37
Q

Anion gap metabolic acidosis

A

MUDPILES

  • methanol
  • uremia
  • DKA
  • paraldehyde
  • Iron, Isoniazid
  • Lactic acidosis
  • Ethylene glycol
  • Salicylates
38
Q

What other electrolyte disorder is associated with hypokalemia

A

hypomagnesemia

39
Q

Hyponatremia

- pt with neuro sx = what treatment

A
  • hypertonic saline (3%) 100 ml bolus over 10 min
40
Q

Acute tubular necrosis (ATN)

- leads to what

A

1 cause of AKI

41
Q

Acute tubular necrosis (ATN)

- caused by what

A

decreased blood flow to kidney, usu 2/2 drop in blood pressure = renal tubule ischemia = necrosis

42
Q

Acute tubular necrosis (ATN)

- Urine microcopy

A
  • muddy brown cellular casts
  • fine gradual casts
  • renal tubular epithelial cells
43
Q

Acute tubular necrosis (ATN)

- labs

A
  • BUN/Cr < 20
  • FeNa >2%
    • both indicate renal injury
44
Q

Acute tubular necrosis (ATN)

- MC meds that cause

A
  • NSAIDs

- ACE / ARB

EORs (9 decks)

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