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Clin Med > Renal: buzzwords > Flashcards

Renal: buzzwords Flashcards

1
Q

flat neck veins

A

hypovolemia

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2
Q

poor skin tugor, dry mucous membranes

A

hypovolemia

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3
Q

increased serum creatinine, incr serum protein, increased BUN:Cr >20:1

A

hypovolemia

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4
Q

peripheral and vascular edema

A

hypervolemia

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5
Q

pulmonary edema

A

hypervolemia

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6
Q

JVD

A

hypervolemia

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7
Q

decreased hematocrit, decr serum protein and decreased BUN: Cr ratio

A

hypervolemia

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8
Q

pancreatitis

A

hypotonic hypovolemic hyponatremia

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9
Q

diarrhea / vomiting

A

hypotonic hypovolemic hyponatremia

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10
Q

cirrhosis

A

hypotonic hypervolemic hyponatremia

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11
Q

CHF

A

hypotonic hypervolemic hyponatremia

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12
Q

one of MCC of hyponatremia

A

SIADH

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13
Q

polydipsia for cold water

A

hypernatremia

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14
Q

what is hypernatremia almost always assoc with

A

hyperosmolarity

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15
Q

lithium

A

NEPHROGENIC DI

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16
Q

BUN/Cr ratio >20:1

A

hypovolemia

*decr circulating volume=decr flow to kidneys=more bound urea in blood=incr BUN

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17
Q

low urine sodium and high serum sodium

A

DI

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18
Q

decr BUN/Cr ratio

A

HYPOnatremia
or
HYPERvolemia

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19
Q

seizures

A

hyponatremia

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20
Q

causes for hypervolemia hypernatremia

A

iatrogenic

primary hyderaldosteronism

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21
Q

euvolemia hypernatremia causes

A

DI (due to decr ADH)

hypodipsia

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22
Q

hypovolemic hypernatremia causes

A

renal vs extra-renal loses

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23
Q

hypovolemia hyponatremia causes

A

renal and extra-renal causes

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24
Q

euvolemia hyponatremia

A

SIADH (incr ADH)
polydipsia
adrenal insufficiency
hypothyroidism

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25
Q

hypervolemia hyponatremia causes

A

CHF
cirrhosis
nephrotic syndrome

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26
Q

pink serum

A

in vitro hemolysis—pseudohyperkalemia

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27
Q

digoxin toxicity–what drug is contraindicated

A

calcium gluconate or calcium chloride

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28
Q

licorice

A

can incr htn and cause hypokalemia

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29
Q

hypomagnesemia

A

causes hypokalemia

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30
Q

U wave on EKG

A

hypokalemia

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31
Q

diarrhea causes—– metabolic_____

vomiting causes—metabolic ____

A

vomiting=metabolic alkalosis

diarrhea=metabolic acidosis

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31
Q

diarrhea causes—– metabolic_____

vomiting causes—metabolic ____

A

vomiting=metabolic alkalosis

diarrhea=metabolic acidosis

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32
Q

MCC hypokalemia

A

diuretics

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33
Q

what do you not add initially to a K+ chloride solution and why

A

bicarb and glucose

–>beacuse they drive K+ into the cell

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34
Q

thiazide diuretics work where in the nephron

A

DCT

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35
Q

ADH acts on what in the nephron

A

straight segment of the DCT and CD

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36
Q

low PCO2

A

met acidosis

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37
Q

high PCO2

A

met alkalosis

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38
Q

osmolar gap calculation

A

measured-calculated

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39
Q

anion gap calculation

A

[NA] - (Cl + HCO3-)

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40
Q

Winters formula

  • calcualtes what?
  • what is the equation
A

calculates the expected PaCO2 aka how well are the lungs compensation for the metabolic acidosis

{(1.5 x HCO3) + 8}

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41
Q

normal pco2

A

35-45

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42
Q

normal bicarb

A

22-26

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43
Q

how do you know if there is respiratory compensation

A

if the PCO2 is going in the same direction as the ph

  1. acidosis LOW ph so compensation= LOW CO2
  2. alkalosis HIGH ph so compensation=HIGH CO2
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44
Q

oxalate crystals in urine

A

Ethylene glycol ingestion

***causing high osmolar gap acidosis

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45
Q

electrolyte values for metabolic acidosis

A

hyperCA

hyperK

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46
Q

equation for calculated osmolality

A

2 (NA+) + (Glucose/18) + (BUN/2.8)

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47
Q

RTA type 1 causes

A

normal AG met. acidosis via bicarb loss

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48
Q

RTA type 2 causes

A

normal AG met acidosis via decrease acid secretion

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49
Q

RTA type 4 causes

A

normal AG met acidosis via decr acid secretion

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50
Q

two main causes of normal AG MA

A

diarrhea

RTA (1, 2, 4)

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51
Q

potential compliaciton when giving bicarb in lactic acidosis?

A

it produced more lactacte production

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52
Q

(-) UAG

A

diarrhea is the cause aka extra renal

-NH4 over excretion

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53
Q

(+) UAG

A

renal cause

  • RTA
  • NH4 excretion minimal/impaired
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54
Q

hyperaldosteronism causes what metabolic disturbance

-hypoaldosteronism?

A

HYPER= met alkalosis bc increase secertion of H+ and causes HYPOK

HYPO=met acidosis and causes HYPERK

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55
Q

licorice

A

can cause met. alklaosis

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56
Q

when diff b/w measured and calculated osmolality is > 10, what are the causes

A

ETOH–ethanol, methanol, ethyelen gycol, isoproprly alchool

Osmotic diruetics–mannitol

***MET ACODISOS

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57
Q

oval fat bodies on urine sediment

A

hyperlipidemia—indicative of nephrotic syndrome

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58
Q

urine >3,000 PU in 24.hrs

A

nephrotic

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59
Q

fatty cast on urine sediment

A

high urinary protein nephrotic syndrome

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60
Q

maltese cross pattern under polarized light

A

high urinary protein nephrotic syndrome

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61
Q

microscopic blood +/- on urine sediment

A

nephrotic

62
Q

urine “bland”

A

nephrotic

63
Q

lab tests show hypoalbuminemia and hyperlipidemia

A

nephrotic syndrome

64
Q

causes of secondary nephrotic syndrome

A 
SLE 
DM 
HIV 
HEp B and C 
Antiphospholipid syndrome
65
Q

young kid with unexplained edema or ascites

A

nephrotic syndrome

**minimal change dz

66
Q

MC primary cause of nephrotic syndrome

A

Membranous nephropathy

67
Q

MC secondary causes of nephrotic syndrome

A

**SLE–both nephritic and nephrotic
**DM
Preeclampsia

68
Q

edema + HTN + hematuria + RBC cats/dysmorphic RBCS + proteinuria <3,000

A

nephritic

69
Q

“actie” urine sedement

A

nephritic

70
Q

hematuria

A

nephritic

71
Q

RBC casts

A

nephritic

72
Q

WBC casts

A

nephritic

73
Q

dysmorphic RBC on urine sed

A

glomerulonpehritis or nephritic

74
Q

anti-GBM antibodies

A

nephritic

75
Q

+ anti-streptlysin O titer

A

postinfecitous GN

90% upper resp and 50% in skin

76
Q

low complement C3 C4 and high ASO titers

A

post infecitous GN

77
Q

MCC of primary GN worldwide

A

IgA nephropathy

78
Q

tram track apperance

A

Membranoproliferative GN
MPGN
**its the GBM splitting

79
Q

hep c is highly associated with

A

MPGN

80
Q

double counter apperance

A

MPGN

81
Q

MCC of ARF in kids

A

HUS vasculitis

82
Q

smokey brown tinged urine

A

lupus nephritis

83
Q

C-ANCA (+)

A

Wegners aka Granulomatosis Polyangiitis

84
Q

Anti-proteinase 3 (+)

A

Wegners aka Granulomatosis Polyangiitis

85
Q

oral nasal ulcers

A

Wegners aka Granulomatosis Polyangiitis

86
Q

P-ANCA (+)

A

microscopic polyangiitis

87
Q

Goodpastures is what type of hypersensitivty

A

2–antibody mediated

88
Q

foamy urine

A

nephrotic

89
Q

normal 24/hr urine protein

A

<150 mg/day

90
Q

effacement of visceral epithelial foot processes on EM

A

minimal change dz

91
Q

3rd MCC of GMN in adults

A

minimal change dz

92
Q

pathology shows fusion of visceral epithelial cell foot processes

A

minim change dz

93
Q

MCC of nephrotic syndrome in adults

A

membranous

94
Q

antigens against PLA2R

A

membranous nephrotic syndrome

95
Q

MC GN leading to ESRD

A

focal segmental glomerulosclerosis (FSGS)

96
Q

african americans 4x risk of what

A

ESRD if they have focal segmental glomerulosclerosis (FSGS)

97
Q

assoc with heroine use

A

Focal Segmental Glomerulosclerosis (FSGS)

98
Q

assoc with obesity

A

Focal Segmental Glomerulosclerosis (FSGS)

99
Q

most common in non-diabetic adults assoc with malginancies and infection with HBV

A

Membranous nephropathy

100
Q

thick basement membrane on renal biopsy

A

membranous nephropahty

101
Q

podocyte damage on electron microscope

A

miniml chane dz

102
Q

MCC of secondary HTN

A

RAS

103
Q

abdominal bruit

A

RAS

104
Q

string of beads apperance on angio

A

fibromuscular dysplasia of renal artery

105
Q

severe flank pain

A

renal venous thrombosis

106
Q

unexplained hypokalemia

A

primary aldosteronism

107
Q

proxysmal elevations in BP

A

pheochromocytoma

108
Q

rib notching on xray

A

coarcation of aorta

109
Q

diet high in oxalate

A

nephrolithiasis

110
Q

MC type of fusion

A

horseshoe kidney

111
Q

MC inherited cause of kidney dz

A

polycystic kidney dz

112
Q

dull aching flank pain

A

renal cell ca

113
Q

MC kidney CA in adults

A

renal cell CA

114
Q

2nd MC abd tumor in kids

A

wilms tumor

115
Q

nitrogen in blood

A

azotemia

116
Q

MCC of :

  • pre renal AKI
  • intra-renal AKI
  • post-renral AKI
A

pre= renal hypoperfusion

intra= ATN

post=rare=urinary tract obstructions

117
Q

MC type of AKI overall

A

Pre renal

118
Q

MC type of AKI in hosp pt

A

ATN

119
Q

high BUN: Cr ratio

A

AKI

***** >20:1 = high

120
Q

rbc casts

A

glomerular in origin

121
Q

wbc casts

A

suggesitive of inflammatory process that may or may no tbe infectious

122
Q

waxy casts

A

not distinctive to diseases
technically a degenerative phase of a cast
-represents longstanding dz*******

123
Q

broad casts

A

adv chronic kidney disease

124
Q

granular casts

A

represent degenerated cells
-deeply pigmented MUDD BROWN or HEME-GRANULAR casts

attribued to ATN

125
Q

muddy brown casts

A

ATN

126
Q

Compares and contrast the following lab values for Prerenal AKI and ATN

  1. Fractional NA excretion
  2. BUN/Cr
  3. Urinary sodium
  4. urine osmolality
  5. urine/serum creatinine
A

PRE-renal AKI

  1. <1%
  2. > 20
  3. <20
  4. > 500
  5. > 40

ATN

  1. > 2%
  2. 10-15
  3. > 40
  4. <350
  5. <20
127
Q

define normal BUN: Cr ratio

A

10-15: 1

128
Q

fever, eosinophillia, red or white casts

A

allergic interstitial nephritis

129
Q

urine in prerenal AKI vs intrinsic AKI

A

PRe-renal
**kidney reabsorbs water and NA thinking body is hypovolemic–>so urine is CONCENTRATED (no water) but LOW [ ] of NA… <20

intrinsic renal
**kidneys are damaged– so cannot reabsorb—- very dilute water and high [ ] of NA >40 usually

130
Q

major drugs causing ATN

A

Aminoglycosides
amphotericin B
NSAIDs
ACEI

131
Q

WBC casts

A

Acute intersitial nephritis—-from allergic response to a drug MC

132
Q

drugs causing ATN vs drugs causing AIN

A

ATN

  • acyclovir
  • aminoglycosides
  • amphotericin
  • cyclosporine
  • lithium
  • NSAIDs
  • pentamidine
  • vanco

AIN

  • Allopurinol
  • cephalosproin
  • NSAIds
  • PCNs
  • phenytoin
  • PPIs
  • quinolones
  • rifampin
  • sulfas
133
Q

when do we never give abx

A

HUS

134
Q

CKD—-what electrolyte is LOW and why

A

Calcium
-kidneys activate vit d— and vit d allows Ca to be absorbed from the diet— so if theres no vit d—- no CA is being absorbed

135
Q

Criteria to dx CKD

A
  1. durtation >3 MO
  2. GFR <60
  3. kidney damage defined by structural abnm or functional abnm other than decr GFR
136
Q

number ONE cause of CKD? second?

A

number one=DM

two=HTN

137
Q

target BP for CKD

A

<130/80

138
Q

two most imp modifiable RF for progressive CKD

A
  • HTN

- PU

139
Q

which RTA cause hypokalemia and hyperkalmeia?

A

HYPO=1-3

HYPER=4

140
Q

urine pH >5.5 in setting of metabolic acidosis

A

RTA type 1

141
Q

WBC casts in urine

A

pyelonephritis

142
Q

PT with chron’s dz had bypass—-what type of stones

A

since they cannot absorb oxalate—-Calcium oxalate stones

143
Q

mc stone type

A

ca oxalate

144
Q

citrate is

A

a stone inhibitor

145
Q

two mc s/s of urinary stone

A

flank pain and hematuria

146
Q

GN occuring 1-2 DAYS after illness

A

IGA nephropathy

147
Q

fever rash and eosinophilia

A

drug induced AIN

148
Q

cerebral aneurysms (berry) assoc with

A

PKD

149
Q

RBC casts

A

glonerulonephritis

150
Q

wbc casts

A

pyelonephritis

151
Q

flank pain, hematuria and palpable renal mass

A

triad for renal cell CA

152
Q

whats imp for making [ ]ed urine

A

vasa recta

153
Q

va

A

Clin Med (52 decks)

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