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UWorld journal > Renal, but shit I got 99% > Flashcards

Renal, but shit I got 99% Flashcards

1
Q

Hyperurcemia as a s/e diruetics

A

Thiazide

Furosemide

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2
Q

What drugs will decrease mortality in CHF

A

ACE/ARB
BB
spironolactone

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3
Q

What is at least 1 good reason to rx a thiazide

A

htn

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4
Q

What is at least 1 good reson NOT to use a thiazide

A

Thiazides are implicated in Lithium toxicity

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5
Q

What do thiazides do

A

Block DCT– Na/Cl channel

happens to also ↓ Ca excretion

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6
Q

What is a genetic problem that looks exactly like life long thiazide use

A

Gitelman

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7
Q

What 2 drugs treat Calcium renal stones

A

Thiazide

Citrate

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8
Q

Namethe thiazides

A

Hydrochlorothiazide
Chlorthalidone
Metolazone

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9
Q

What is triamterene

A

K sparing diuretic

acts on collecting tube

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10
Q

Why does CKD have hypocalcemia as a trait

A

In CKD, PO4 cannot clear due to ↓ GFR

PO4 binds Ca–> hypoca

↑ PHT due to ↓ Ca

Further a problem b/c kidney not making vit d–> even less Ca

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11
Q

How do you fix a low Ca in CKD

A

Calcitriol and Ca supplements

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12
Q

What are the most important steps in evaluating metabolic alkoloasuis

A

Volume Status

Urine Cl

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13
Q

What are the most common reasons for metabolic alk

A

Vomiting- Loss of H/ Cl

Thiazide/ Loop- loss of H/ Cl

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14
Q

What is almost always present for development of acute pylo

A

Vesicoureteral reflux or other anatomic problem

usually more likely to get normal UTI

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15
Q

What are the 3 different types of Rapidly progressive glomerulonephritis

A

1- Anti-GMB RPGN (goodpature)

2- Immune Complex RPGN (PSGN, SLE, IgA/ henoch sconein purpura)

3- Pauci Immune RPGN (no immunoglob) ex weCners- anca

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16
Q

When Does ADPKD present

A

40-50 years

newborns- cycts way too small to see

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17
Q

When do Waxy Casts present

A

CKD

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18
Q

What is the best way to detect early nephrOpathy

A

UA albumin

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19
Q

What receptors does ADH act on

A

V1- vasoconstriction

V2- antidiuretic

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20
Q

Where is PAH reabsorbed

A

para-aminohippuric acid is not reabsorbed anywhere

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21
Q

When would you see a WBC cast

A

Pyelo
Transplant reject
tubulointerstitial inflammation

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22
Q

How do you calculates filtration fraction

A

FF= GFR / RPF

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23
Q

What are the side effects of loop diuretics

A 
Ototoxicity
HypoK
Dehydration 
Allergy (sulfa)
Alkalosis
Nephritis
Gout

OH DAANG

24
Q

Why do loop diuretics cause ototoxicity

A

loops inhibit Na/K/2Cl in ascending loop

similar inhibition in inner ear–> ototoxicity

25
Q

How is acyclovir metabolized

A

Renal

May crystallize in tubes–> tubular damage

Aggressive hydration = prevention

26
Q

Describe the proteinuria of minimal change disease

A

highly SELECTIVE proteinuria- loss of charge selectivity

loss of only small proteins (albumin)

NO loss of large (IgG)

27
Q

What is the most common primary renal tumor

A

Renal Cell carcinoma

often asymptomatic

Polycythemia often seen due to tumor –> ↑ EPO

28
Q

What is Conn syndrome/ what is rx

A

primary hyperaldosteronism

rx: eplerenone (less s/e vs spironolactone)

29
Q

What does aldosterone excess look like

A

Hypertension, met alk, ↓ renin

30
Q

What kind of incontinence does Oxybutynin treat

A

Urge

Anti-M drug

31
Q

How would you treat post op failure to void

A

Bethanechol - direct M agonist

a1 blocker

32
Q

What is a normal post void volume

A

Less than 50 CC

33
Q

How is bradykinin metabolized

A

By ACE

that’s why ACE has ↑ bradykinin

34
Q

How does cyclosporin work

A

Calcineuron inhibitor ( prevents IL 2 and thus T cells)

35
Q

What does grapefruit juice do to p450

A

inhibits p450

36
Q

What diuretic can treat glaucoma

A

acetazolamide- carbonic anhydrase inhibitors

↓ HCO3 ↓ Aqueous humor –> better pressure

37
Q

What might MCD be related too

A

defect in immune fx, b/c MCD is often seen with uri, vacancies, etc

38
Q

define overflow incontinence

A

due to incomplete emptying

when bladder pressure exceeds sphincter–> continuous urine leakage

39
Q

Define stress incontinence

A

loss of pelvic floor support

cough–> ↑ pressure–> brief UA loss

40
Q

What is the triad of hemolytic uremic syndrome

A
  • microangiopathic hemolytic anemia
  • thrombocytopenia
  • acute kidney injury
41
Q

Describe Henoch Schonlein purpura

A

vasculitis

IgA immune deposition in skin, kidney, joint, intestine

presents with palpable purpura

42
Q

Describe Kawasaki

A

medium vessel arteritis

Fever, conjunctivitis, cervical LAD, strawberry tongue

43
Q

What is a common cause of death in ADPKD

A

berry aneurysm

44
Q

How does one calculate net filtration

A

(Pc- Pi) - (nc-ni)

hydrostatic difference - oncotic difference

45
Q

How is paraaminohippuric acid filtered

A

Freely filtered

Carrier mediated process into tube cells (secretion from blood to tube)

46
Q

Which part of the kidney will have the argest issues with ischemia

A

straight proximal tubule
Thick ascending limb

These areas use ↑↑ ATP and thus have highest O2 demand

47
Q

What causes acute tubular necrosis

A

decreased renal perfusion

hypovolemia, shock, surgery

48
Q

what is a bad prognostic factor for PSGN

A

presentation in adults

kids do better

49
Q

What does angiotensin 2 do in the kidney

A

constricts efferent

ACE inhibitor therefor–> dilated efferent

50
Q

What would look special in ethylene glycol poisoning in ATN (vs other ATN)

A

ethylene glycol will have Calcium Oxalatecrystals

51
Q

What is the most common site for mets from a RCC

A

lung

RCC shows abundant clear cytoplasm

52
Q

What is the defect in fabray

A

x linked a-galactosidase A deficiency

53
Q

What should all DM patients with kidney problems be started on

A

ACE inhibitors
ARB

helps prevent the progression of diabetic nephropathy

54
Q

What lab value can tell you GFR

A

Insulin or creatinine clearance

55
Q

What lab value can tell you renal plasma flow

A

PAH clearance

56
Q

How do you calculate the clearance of anything (s)

A

Clearance = ([UAs] x UA flow rate) // ([PlasamS])

57
Q

How do you calculate the excretion of anything (s)

A

excretion= (GFR)([plasma-s]) - (tubular reabsorption s)

UWorld journal (51 decks)

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