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Medicine MBBS year 2 > Renal > Flashcards

Renal Flashcards

1
Q

Risk factors for kidney cancer?

A 
Smoking 
Renal failure and dialysis 
Obesity
Hypertension
Von Hippel-lindau syndrome(50% develop RCC)
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2
Q

How does the low pressure side of the CVR system respond to high and low pressure?

A

Low pressure -> reduced baroreceptor finding -> signalling to CNS (medulla) -> increase sympathetic activity (and ADH release)

High pressure -> more Atrial stretch ->ANP, BNP released

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3
Q

How can the body decrease sodium reabsorption?

A
  1. Via Atrial natriuretic peptide

2. Via a decrease in B1-sympathetic activity. Thus decreased activation of RAAS

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4
Q

describe the lymphatic drainage of the prostate

A

obturator nodes -> internal iliac chain.

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5
Q

OAB is a syndrome of?

A

Frequency, urgency, nocturia with or without leak

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6
Q

State the signs and symptoms of hypoaldosteronism

A

ECF volume decreases
increased renin, Ang II and ADH :

  • low blood pressure
  • dizziness
  • salt craving
  • palpitation
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7
Q

in what setting do ACE inhibitors need to be paused as they can worsen GFR? how does it cause this?

A

in an acutely unwell patient

reduces perfusion pressure in the glomerulus

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8
Q

how do you treat urge incontinence?

A

Decrease caffeine, stop smoking, lose weight

Bladder retraining, pelvic floor muscle exercises

Drugs to promote detrusor muscle relaxation:

  • Anticholinergics/antimuscarinics - solifenacin, tolterodine, trospium
  • Beta-3-agonists - betmiga
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9
Q

How do carbonic anhydrase inhibitors work?

A
  1. Reduced production of carbonic acid
  2. Thus reduced production of H+
  3. Reduction in exchange of H+ for Na+
  4. Reduced Na+ reuptake in the PCT
  5. Increased Na+ in distal nephron
  6. Reduced water reabsorption
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10
Q

How do osmotic diuretics work?

A

Don’t get reabsorbed

Increases osmolarity in PCT -> less water reabsorbed

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11
Q

Intravenous fluid or oral fluid first enters the __ and then enters the __ compartment

A

ECF then equilibrates with ICF

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12
Q

ADH promotes water reabsorption from ___ __ of kidney

A

Collecting duct

Binds to V2 Receptor -> AQP2 inserted apical and AQP3 into basolateral membrane

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13
Q

What are the consequences of salt and water retention in kidney failure?

A

hypertension, HF, pulmonary oedema

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14
Q

What protein does ADH affect to alter water reabsorption?

A

aquaporins

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15
Q

why is there high blood pressure in Liddle’s Syndrome?

A
  • Mutation in aldosterone activated sodium channel (ENAC)
  • Channel is always “on” -> sodium retention = water retention
  • aldosterone is normal or low *
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16
Q

in a 59 year old man, what would be first line treatment for hypertension?

Which other group of people have this as first line?

A

Aged >55 = Amlodipine. (CCB)

African Americans

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17
Q

How do kidneys typically appear on ultrasound in acute renal failure with no obstruction?

A

normal size

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18
Q

How can the body retain sodium & water

A
  1. Sympathetic activity:
    - stimulates sodium uptake by cells of PCT
    - makes smooth muscle cells of afferent arteriole (AA) contract.
    - Stimulates cells of JGA to secrete Renin. resulting angiotensin II makes PCT take up sodium and resulting aldosterone makes DCT and CT take up sodium
  2. low tubular Na+ stimulates renin production by JGA
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19
Q

risk factors for bladder cancer?

A

Smoking

Occupational exposure (aromatic hydrocarbons) e.g. working with dyes

Chronic inflammation of bladder (bladder stones, schistosomiasis, long term catheter)

Drugs (cyclophosphamide)

Radiotherapy

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20
Q

what are the symptoms of metabolic acidosis seen in kidney failure?

A

Anorexia

Muscle catabolism

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21
Q

A patient suffering from hepatic cirrhosis will have a ___ urine osmolarity

A

high

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22
Q

leakage associated with urinary retention is?

A

overflow incontinence

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23
Q

A respiratory Acid-base disorder is determined by looking at _ levels

A

PCO2

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24
Q

state 4 conditions patients are at risk of post kidney transplantation

A

Diabetes
Cardiovascular disorders
Cancer
Psychiatric disorders

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25
Q

Post prostatectomy, a PSA of ____indicates a relapse

A

> 0.2

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26
Q

risk factors for urine incontinence?

A 
Increasing age 
Drugs e.g. ACE inhibitors 
Pregnancy and vaginal delivery 
Smoking 
Obesity 
Family history 
Constipation prolapse/hysterectomy/menopause
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27
Q

Mr. Holmes is being treated with a loop diuretic and Mr Smith with a thiazide diuretic for the past 3 weeks. Both individuals are drinking insufficient amount of water. Whose urine will have a lower osmolarity and why?

A

Mr. Holmes - because loop diuretics act on loop of Henle whilst thiazide diuretics act on distal convoluted tubule.

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28
Q

risk factors for prostate cancer?

A

Increasing age
Western nations (scandinavian countries)
African americans

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29
Q

The excretion of which major ions/molecules is altered to correct volume expansion and how is it affected?

A

Sodium and water

Their reabsorption is reduced

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30
Q

What is the mechanism/3 causative theories for stress incontinence in men?

A

Sphincter incompetence

Reduction in urethral sphincter length

Postoperative stricture

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31
Q

why might a patients use of trimethoprim invalidate the GFR calculator?

A

Trimethoprim inhibits active secretion of creatinine, causing creatinine to rise.

GFR may not have actually changed but you need further tests to know for sure

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32
Q

what tests are carried out for BPH?

A

Digital rectal exam
Urine test - rule out infection/other causes
PSA - will be elevated in BPH
Flow rate + PVR

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33
Q

State 5 causes of hyperkalemia

A
  1. K+ sparing diuretics
  2. ACE inhibitors
  3. Elderly
  4. Severe diabetes
  5. Kidney disease
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34
Q

state 3 types of acute renal failure and their pathophysiology

A
  1. Prerenal - insufficient blood flow to kidneys e.g. hypovolemia
  2. Intrinsic renal failure - filtration problem e.g tubulointerstitial disorders
  3. Postrenal - bilateral outflow obstruction
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35
Q

the complaint of an involuntary leakage of urine associated with urgency and also with exertion, effort, sneezing or coughing is?

A

mixed urinary incontinence

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36
Q

What is the main intracellular ion? (it is low in extracellular fluid)

A

K+

PISO -Potassium inside and sodium outside

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37
Q

how do you manage CKD?

A

Initial -> Correct fluid balance - if hypo give fluids, if hyper give diuretic/dialysis

Initial -> Reverse hyperkalemia:
Drive into cells - sodium bicarb or insulin dextrose
Drive out of body - diuretics/ dialysis
Gut absorption - potassium binders

Long term - hemodialysis or peritoneal dialysis at home OR in centre hemodialysis

Kidney transplant

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38
Q

advantages of peritoneal dialysis

A

Less food and water constraints

Can travel easily

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39
Q

In what parts of the nephron is K+ secreted?

A

DCT and Collecting duct

Only reabsorbed in these regions if you are K+ depleted

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40
Q

State 4 things that stimulate potassium secretion in the nephron?

A
  1. High plasma K+ (more K+ enters cell via Na/K+ ATPase and leaves via lumen)
  2. high plasma pH
  3. Increase in tubular flow rate
  4. Increase in aldosterone
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41
Q

What is the most prevalent and important solute in the ECF?

A

sodium

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42
Q

Incidence of prostate cancer is _____ but mortality rates ____

A

rising

declining

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43
Q

the complaint of an involuntary leakage accompanied by or immediately preceded by urgency is?

A

urge incontinence

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44
Q

What part of the nephron would a diuretic drug that inhibits the activity of an enzyme found predominantly in the endothelial cells of the lung work?

A

Whole renal tubular system except in loop of henle

Due to lack of angiotensin II AND Aldosterone

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45
Q

A metabolic Acid-base disorder is determined by looking at _ levels

A

HCO3-

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46
Q

what are some differential diagnosis for urge incontinence?

A 
UTI
DO
Urethral syndrome
Urethral divertivulum
Interstitial cystitis
Bladder cancer
Large residual volume
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47
Q

How does the high pressure side of the CVR respond to low pressure?

A

Low pressure -> reduced baroreceptor firing -> signalling to brainstem -> sympathetic activity and ADH release

Low pressure -> reduced baroreceptor firing -> JGA cells -> renin release

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48
Q

___ have a higher prevalence of OAB-wet and ___ have a higher prevalence of OAB-dry

A

women

men

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49
Q

function of prostate

A

liquify ejaculate

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50
Q

prostate cancer investigations?

A

PSA (not prostate-cancer specific but prostate specific). Can be elevated in UTI, prostatitis

MRI

Trans perineal prostate biopsy

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51
Q

If a kidney leaks contrast up into it on an Xray, it means that it is __

A

faulty

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52
Q

continuous leakage is?

A

continous incontinence

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53
Q

what does conservative treatment of CKD involve?

A 
erythropoietin injections to correct anaemia
diuretics to correct salt water overload
 phosphate binders
1.25 vit d supplements
 symptom management
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54
Q

clinical features of bladder cancer?

A

PAINLESS haematuria or persistent microscopic haematuria

Suprapubic pain
Lower urinary tract symptoms e.g. increased frequency
Metastatic disease - bone pain, lower limb swelling

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55
Q

what are some symptoms of AKI?

A

Decreased urine output, although occasionally urine output remains normal

Fluid retention, causing swelling in your legs, ankles or feet

Shortness of breath

Fatigue
Confusion
Nausea
Weakness
Irregular heartbeat
Chest pain or pressure

Seizures or coma in severe cases

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56
Q

Incidence and mortality of bladder cancer in UK is ___

A

declining

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57
Q

the complaint of loss of urine during sleep is?

A

nocturnal enuresis

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58
Q

What is spironolactone used for and what is its mechanism?

A
  • Can be used to treat hypertension (not first-line)

- It is an aldosterone receptor blocker in the DCT

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59
Q

what causes BPH

A

↑ number of epithelial and stromal cells in the periurethral area of the prostate in response to androgens (testosterone)

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60
Q

treatments for stress incontinence?

A

weight loss, kegel exercises, cessation of smoking

oestrogen therapy if evidence of atrophy

Surgery - occlusion, supportive e.g. mid-urethral sling, ileal conduit diversion

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61
Q

the complaint of involuntary leakage on exertion /sneezing/coughing is?

A

stress incontinence

62
Q

what are the symptoms of hyperkalemia?

A

Cardiac arrhythmias
Neural and muscular activity
Vomiting

63
Q

Outside the CNS, where else is sodium regulated?

A

through taste

64
Q

What are the types of kidney cancer in order of frequency?

A

85% is renal cell carcinoma (adenocarcinoma)

10% transitional cell carcinoma

sarcoma/Wilms tumour/other subtypes = 5%

*incidence and mortality is rising. 7th most common cancer in UK

65
Q

what treatment is carried out for BPH?

A

alpha-adrenergic antagonists - amsulosin, alfuzosin, doxazosin. They relax urinary sphincter and allow you to pee

5-alpha-reductase inhibitors - Finasteride, Dustasteride

Surgery - TURP, embolisation

66
Q

What is the effect of increasing ANP/BNP on GFR?

A

increases GFR due to vasodilation

67
Q

The low pressure side of the cardiovascular system contains baroreceptors where?

A

Heart - atria, right ventricle

Vascular system - pulmonary vasculature

68
Q

what are the McNeal’s zones of the prostate?

A 
Transitional zone 
Central zone (25%)
Peripheral zone (65% glandular tissue)
69
Q

how does angiotensin II make aldosterone?

A

Stimulates the synthesis of aldosterone synthase in the zona glomerulosa of adrenal gland

70
Q

what is the result of increased dietary sodium?

A

increased water intake and retention -> increased ECF volume -> increased blood pressure and volume

71
Q

what are the types of prostate cancer?

A

> 95% adenocarcinoma

72
Q

what hormone is responsible for prostate development?

A

DHT

73
Q

clinical features of prostate cancer?

A

Usually asymptomatic unless metastatic

74
Q

What is the effect of plasma concentration of urea on ADH production?

A

No effect

75
Q

Bladder cancer subtypes in order of frequency?

A

> 90% = transitional cell carcinoma

1-7% = squamous cell carcinoma but 75% SCC where schistosomiasis is endemic

2% = Adenocarcinoma

76
Q

In which type of kidney failure might a patient not present with aneamia?

A

acute -> has not had time to develop

77
Q

symptoms of BPH?

A

↓ urinary flow, urinary frequency, urgency and nocturia

78
Q

Why do most diuretics increase potassium excretion?

A

The increase in flow rate is detected in the collecting duct and directly stimulates potassium excretion

79
Q

Give two examples of Drugs eliminated by kidney and will lead to side effects if kidney function is impaired

A

Morphine, metformin

80
Q

state 2 things that trigger aldosterone synthesis

A
  1. Angiotensin II

2. Decrease in bp detected by baroreceptors

81
Q

normal range for HCO3-?

A

22-28 mmol/L

82
Q

If a patient is dehydrated, the filtrate in which area will have the highest osmolarity?

A

Tip of loop of Henle

83
Q

normal range for pH?

A

7.35-7.45

84
Q

What is the effect of a mutant UT-B urea transporter on urine osmolality?

A

decreases

85
Q

What stimulates plasma K+ uptake into tissues? How?

A

INSULIN mainly -> increases intracellular sodium which is exchanged for K+
(also aldosterone and adrenaline)

86
Q

why can ibuprofen worsen GFR?

A

inhibits PG synthesis.
So no prostaglandins to dilate afferent arterioles.
renal blood flow decreases

87
Q

Why does an increase in flow rate cause K+ secretion?

A

cells have cilia that stimulate PDK1 which increases Ca2+

concentration in the cells which stimulates opening of K+ channels

88
Q

___ is an example of a loop diuretic

A

furosemide

89
Q

associations for stress incontinence?

A

Obesity
Vaginal delivery
Prostate surgery

90
Q

what are the side effects of a prostatectomy?

A

Damage to cavernous nerves = ED

Damage to cavernous nerves, removal of proximal urethral sphincter and changes urethral length = urinary incontinence

91
Q

What is the effect of aldosterone on Na+, H+ and K+

A

Increased Na+ reabsorption by increasing permeability of the principal cells
Increased H+ and K+ secretion (hypokalemic alkalosis if in excess)

92
Q

What is the most abundant adrenoceptor subtype in the prostate?

A

alpha-1-a

93
Q

How do potassium sparing diuretics work?

A

Bind to mineralocorticoid receptor and block aldosterone function in collecting duct

Potassium sparing because DOES NOT pump K+ out into lumen
Example = spironolactone

94
Q

state 3 ECG changes that can be seen in hyperkalemia

A 
Peaked T waves
P wave - broadens -> reduced amplitude ->  disappears
QRS widening
Heart block
Asystole
VT/VF
95
Q

where is sodium reabsorbed in the nephron?

A

67% in PCT
25% in thick ascending limb
5% DCT
3% in collecting duct

96
Q

How do you manage kidney cancer?

A

Partial nephrectomy (single kidney, bilateral tumour, multifocal RCC in patients with VHL, T1 Tumours up to 7cm)

Radical nephrectomy

Patients with small tumours unfit for surgery - cryosurgery

Metastatic disease - receptor tyrosine kinase inhibitors

97
Q

What changes occur in terms of lab values during kidney failure?

A

Homeostatic dysfunction - ↑ potassium ↓ bicarbonate ↓pH ↑phosphate, Na+ and water imbalance

Endocrine dysfunction - anemia (erythropoeitin deficiency), 1 alpha-hydroxylase vitaminD deficiency (↓calcium, ↑PTH - hyperparathyroidism)

Excretory dysfunction - ↑Urea, ↑Creatinine, ↓insulin clearance

Impaired glucose metabolism - decreased insulin clearance, decreased gluconeogenesis

98
Q

AKI causes a _ in BUN and Cr.

A

rise

99
Q

What is the mechanisms/5 causative theories for stress incontinence in women?

A 
Urethral position theory 
Intrinsic sphincter deficiency 
Integral theory 
Hammock theory 
Trampoline theory
100
Q

what blood gas values and other blood values would you expect in a renal failure patient?

A 
Urea - high 
Creatinine - up 
K+ - high 
Na+ - varies 
Hb - low 
Blood gas:
pH - down 
pCO2 - down 
PO2 - slightly up 
Bicarbonate - down
Base excess - down
101
Q

the complaint of an involuntary loss of urine immediately after passing urine is called?

A

post-mictruition dribble

102
Q

In which region of the nephron do loop diuretics work?

A

TAL

103
Q

Effect of high EXTRAcellular K+

A

Depolarisation of membranes -> APs, heart arrhythmias

104
Q

disadvantage of peritoneal dialysis?

A

Normally 7 days a week

Chance of infection due to catheter

105
Q

In which region of the nephron do carbonic anhydrase inhibitors work?

A

PCT

106
Q

clinical features of kidney cancer?

A

PAINLESS haematuria or persistent microscopic haematuria (red flag symptom. also for any other urological malignancy)

Loin pain
Palpable mass
Metastatic disease - Bone pain, hemoptysis

107
Q

Why do patients with chronic renal failure have an increased cardiovascular risk?

A

hypertension, dyslipidemia

108
Q

What would be the effect of water reabsorption of increased sodium levels reaching the collecting duct?

A

Less water reabsorbed at collecting duct due to reduction of osmotic gradient

109
Q

The kidney not only secretes H+ and reabsorbs HCO3-, it also ____ HCO3-

A

produces

110
Q

A ___ __ of bladder lesions uses heat to cut out all visible tumours. It provides histology and can also be curative

A

transurethral resection

111
Q

When there is euvolemia, sodium intake is ___. This is achieved through cells responding to the neurotransmitters, ___ and ____.

A

inhibited

serotonin and glutamate

112
Q

How do kidneys typically appear on Ultrasound in CKD?

A

shrunken

113
Q

State 5 causes of Hypokalemia

A
  1. Inadequate dietary intake - too much processed food
  2. Diuretics (increased tubular flow rates)
  3. Surreptitious vomiting
  4. Diarrhoea
  5. Genetics - Gitelman’s Syndrome (mutation in the Na/Cl transporter in the distal nephron)
114
Q

What would be the effect of spironolactone treatment on a patient with Liddle’s Syndrome?

A
  • No effect
  • The mutation in Liddle’s syndrome is in the aldosterone sensitive ENaC sodium channel. This mutation means that the channel is always on
115
Q

describe the venous drainage of the penis

A

peri-prostatic venous plexus -> internal iliac vein

116
Q

How do thiazide diuretics work?

A

Block Na+ Cl- transporter in the DCT

Increases calcium reabsorption as a side effect

117
Q

when is atovarstatin offered to patients?

A

offers atorvastatin if >10% risk of CVD within 10 years. You may need the QRISK3 tool

118
Q

In which type of acute kidney injury would you see salt and water loss as opposed to the typical salt and water retention in renal failure?

A

intrinsic renal failure

119
Q

When there is sodium deprivation, appetite for Na+ is ___ and this is driven by ___ and ____.

A

increased

GABA and Opioids

120
Q

Why might a patient with kidney failure be tachypneic with normal o2 stats and clear lungs on auscultation?

A

metabolic acidosis -> Kausmall respiration

121
Q

A patient with CKD secondary to hypertension is taking amlodipine. his BP is controlled well (125/70) but he now has significant proteinuria (ACR >30).

What treatments should the nephrologist initiate for the proteinuria and what treatment might need to be stopped?

A

Drugs to initiate which improve proteinuria:

  • ACEi or ARB
  • SGLT2 inhibitors e.g dapagliflozin
  • Salt restriction

Stop Amlodipine if the ACEi reduces his BP too low

122
Q

_ recycling and NaCl are both responsible for generating a hyperosmotic medullary interstitium

A

urea

123
Q

What is the normal range for PCO2?

A

33-45 mmHg

124
Q

Effect of high INTRAcellular K+

A

Depolarisation more difficulties -> heart arrhythmias and asystole

125
Q

what are the investigations for kidney cancer?

A

Painless visible haematuria:

  • Flexible cystoscopy
  • CT urogram
  • Renal function

Persistent microscopic haematuria:

  • Flexible cystoscopy
  • US KUB

Suspected kidney cancer:

  • CT renal triple phase
  • Staging CT chest
  • Bone scan if symptomatic
126
Q

What part of the nephron would a diuretic drug that inhibits the release of an extracellular enzyme from the kidney into the plasma work?

A

JGA - extracellular enzyme would be renin

127
Q

In which region of the nephron do thiazide diuretics work?

A

DCT

128
Q

As arterial pressure increases, what happens to GFR? Why?

A

Increases then eventually plateaus:

  1. High tubular sodium
  2. Increased sodium/chloride uptake via triple transporter
  3. Adenosine release from Macula Densa cells
  4. Detected by extraglomerular mesangial cells
  5. Reduces renin production
  6. Promotes afferent SMC contraction
  7. Reduces perfusion pressure and so GFR
129
Q

In which region of the nephron do K+ -sparing diuretics work?

A

CT/collecting duct

130
Q

management of prostate cancer?

A

If young and fit and HIGH grade cancer = Radical PROSTATECTOMY/Radiotherapy

Young and fit and LOW grade cancer = active surveillance

If old/unfit and High grade cancer/metastatic = hormone therapy

If old/unfit +low grade cancer = watchful waiting, regular PSA testing

131
Q

state the signs and symptoms of hyperaldosteronism

A

ECF volume increases
reduced renin, AngII and ADH
Increased ANP and BNP:

  • high blood pressure
  • muscle weakness
  • polyuria - because you are drinking more water
  • thirst
132
Q

How do loop diuretics work?

A

Block Na+ Cl- K+ triple transporter in TAL

133
Q

investigations for bladder cancer?

A

Painless visible haematuria:

  • Flexible cystoscopy
  • CT urogram
  • Renal function

Persistent microscopic haematuria:

  • Flexible cystoscopy
  • US KUB

If biopsy proven muscle invasive then start staging investigations

134
Q

what are 2 obstruction induced changes as a result of BPH?

A

Detrusor instability/↓ compliance → frequency and urgency - storage problem

↓ detrusor contractility -> increased residual urine, hesitancy - voiding problem

135
Q

State 3 reasons why ACE inhibitors lower BP

A

Vasodilation

Renal effect - decreased Na+ reuptake in PCT = increased Na+ in the distal nephron = reduced water reabsorption

Adrenal effect - reduced aldosterone = decreased Na+ uptake in CT = increased Na+ in distal nephron

136
Q

how do you treat erectile dysfunction?

A

PDE5 inhibitors like viagra

137
Q

what are some investigations for urinary incontinence?

A

Urine dipstick

Flow rate and post-void residual

Bladder diary
Pad tests

138
Q

The high pressure side of the cardiovascular system contains baroreceptors where?

A

Vascular system - carotid sinus, aortic arch, juxtaglomerular apparatus

139
Q

what 2 things contribute to hypocalcemia in chronic renal failure

A

Phosphate retention

Low levels of 1-25 VitaminD

140
Q

How does aldosterone make the DCT and CT take up sodium?

A
  • Binds to mineralocorticoid receptor in cell cytoplasm
  • Receptor dimerises and binds to DNA in nucleus leading to production of mRNAs
  • ENaC and Na+K+ATPase and regulatory proteins synthesised
141
Q

what is the most common cancer within men in the UK?

A

prostate cancer

142
Q

Negative water balance is when you have __ water intake

A

low

143
Q

disadvantage of heamodyalisis?

A

Strict dietary constraints and salt/water intake restrictions

Requires dialysis centre visits

144
Q

describe the arterial blood supply to the prostate

A

Arises from branches of the inferior vesical artery

Prostatic artery divides into urethral and capsular groups of arteries

Urethral group give rise to Flock’s and Badenoch’s arteries

145
Q

Describe the mechanism of ANP

A

Dilates afferent arterioles (and constricts efferent arterioles) -> causes increase in GFR and Na+ filtration.

Also Decreases Na+ reabsorption in renal collection duct

Net result = Na+ and volume loss

(counters raas system)

146
Q

How does angiotensin 2 affect production of aldosterone?

A

Increased synthesis of aldosterone synthase in the zona glomerulosa which is required for conversion of cholesterol to aldosterone and therefore increased aldosterone

147
Q

What is the effect of increased sympathetic activity on RAAS system?

A

Increases renin/ Raas activity

148
Q

Which cells secrete renin?

A

JG cells

149
Q

All diuretics except K+ sparing diuretics ___ K+ excretion. Thus they cause ___

A

Increase

Hypokalemia

150
Q

Carbonic anhydrase inhibitors and K+ sparing diuretics both cause metabolic ___. Other diuretics cause metabolic ____ via RAAS and contraction ____.

A

Acidosis
Alkalosis
Alkalosis

151
Q

What are the effect of loop and thiazide diuretics on calcium?

A

Loop diuretics - hypocalcemia

Thiazide diuretics - hypercalcemia

Medicine MBBS year 2 (11 decks)

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