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Clinical Med II Exam 3 (Annie and Lauren) > Renal Diagnostics 🥼 > Flashcards

Renal Diagnostics 🥼 Flashcards

1
Q

Where does serum creatinine come from?

A

Breakdown of creatinine in skeletal muscle and from dietary meat intake.

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2
Q

What happens to creatinine in the kidney?

A

Released into circulation at a constant rate, and is freely filtered and excreted

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3
Q

What is a normal creatinine?

A

0.5-1.2

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4
Q

Where does BUN come from?

A

A product of protein catabolism

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5
Q

What kinds of things other than kidney problems can increase BUN?

A

Dehydration

GI bleed

Medications (Steroids and Tetracyclines)

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6
Q

What ratio can be used as a marker for volume status?

A

BUN/Creatinine ratio

BUN elevated= dehydrated

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7
Q

What is this:

Rough measure of the number of functioning nephrons

A

GFR

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8
Q

Can we directly measure GFR?

A

No

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9
Q

What measurement do we use to estimate GFR?

A

Creatinine clearance

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10
Q

What lab value will the pharmacist ask you for if you need help renally dosing a med?

A

Creatinine clearance

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11
Q

If someone is on dialysis, what stage of CKD are they at?

A

5 (no matter what their GFR is)

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12
Q

What stage CKD:

GFR: 90+

A

Stage 1

“Kidney damage with normal or increased GFR

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13
Q

What stage CKD:

GFR 60-89

A

Stage 2.

“Kidney damage with normal or decreased GFR)

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14
Q

What stage CKD:

GFR: 30-59

A

Stage 3

“Moderately decreased GFR”

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15
Q

WHat stage CKD:

GFR 15-29

A

Stage 4

“Severely decreased GFR”

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16
Q

What stage CKD:

GFR <15

A

Stage 5

“Kidney failure”

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17
Q

If you suspect lupus (SLE) what lab test do you need to order?

A

Antinuclear antibodies (ANA)****

double stranded DNA antibody

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18
Q

If you suspect GPA, what lab tests do you need to order?

A

C-ANCA

P-ANCA
**

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19
Q

What lab test do you need to order if you suspect Goodpasture syndrome
/

A

Anti-glomerular basement membrane antibodies (anti-GBM) ****

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20
Q

Why do we measure Prostate-Speciifc Antigen?

A

Screening method for early detection of prostate cancer

Monitor cancer after treatment

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21
Q

What can cause increased PSA levels

A

Prostate cancer

BPH

Prostatitis

Following prostate manipulation (ultrasound, biopsy, DRE)

not always elevated due to cancer

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22
Q

One of the first signs of kidney disease may be:

A

Protein in urine

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23
Q

Is protein in the urine ever normal?

A

No. Do not ignore it

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24
Q

RBC casts in the urine may indicate:

A

Glomerulonephritis

Vasculitis

25
Q

WBC casts in the urine may indicate:

A

Tubulointerstitial disease

Acute pyelonephritis

Glomerular disorders

26
Q

Epithelial cell casts in the urine may indicate:

A

Acute tubular necrosis*

Glomerulonephritis

27
Q

Hyaline casts in the urine may indicate:

A

Dehydration

28
Q

What kind of crystal may appear in the urine?

A

Uric acid

Calcium phosphate

Calcium oxalate

Cystine

Magnesioum ammonium phosphate (struvite)

29
Q

What does a urine culture and sensitivity tell you

A

Identifies causative organism of UTI

Shows Antibiotic sensitivity and resistance

30
Q

What is this:

“The earliest clinically detectable stage of diabetic nephropathy (or other early kidney damage)”

A

Microalbumin

31
Q

Urine eosinophils are most commonly seen in _____________

A

Acute interstitial nephritis

32
Q

What is Urine Protein Immunoelectrophoresis (UPEP) used to screen for?

A

Bence-Jones Proteins (multiple myeloma)

33
Q

Why would you do a 24 hour urine collection?

A

Provides a better quantitative measurement for proteinuria or GFR

34
Q

What is the name of the specific X-ray view used to evaluate urological stuff

A

KUB film

Kidneys ureters, and bladder

35
Q

What can you see on a KUB film?

A

Calcification in the urinary tract (with some exceptions)

Prostatic calculi

Bladder distention

36
Q

What kinds of stones will NOT be seen on a KUB film?

A

Small stones

Radiolucent stones (URIC ACID)***

Stones overlying bony structures
****

37
Q

What is a “stag horn” pattern on a KUB film?

A

Stones that involve the renal pelvis and extending into 2 or more calyces

38
Q

What is the test of choice to exclude*** urinary tract obstruction?

A

Renal ultrasound

Non invasive, no contrast required

39
Q

What kind of imaging is best used to evaluate renal vascular flow

A

Renal Doppler Utrasonography

40
Q

Which is more sensitive to detect a renal mass: US or CT

A

CT

41
Q

If you do an ultrasound of a kidney and see a “hypodense mass with internal echoes” what are you looking at

A

Acute pyelonephritis

42
Q

What is the test of choice to diagnose nephrolithiasis

A

Non-contrast CT

Can detect uric acid stones not seen on KUB

43
Q

What imaging do you use to distinguish between a benign and malignant cyst

A

CT scan

44
Q

How long after using contrast in a CT do you have to hold Metformin

A

48 hours afterwards

45
Q

If you see a “stranding” pattern on CT what do you suspect

A

Pyelonephritis

46
Q

What is the gold standard for diagnosis of renal vein thrombosis

A

MRI

47
Q

No gadolinium is GFR is less than ______

A

30

48
Q

What are the contraindications for MRI/MRA

A

Chronic renal failure with GFR<30

Acute renal failure of any severity

49
Q

What is an intravenous Pyelogram?

A

You inject contrast and take x rays to look at how the kidneys excrete it

50
Q

Why dont we use intravenous pyelograms very much

A

Requires contrast dye

Much more informative tests exist (CT)

(Why give them contrast and then just do Ann x ray)

51
Q

What might we use renal angiography for?

A

Preoperative mapping of renal vasculature (looking for blockages etc)

52
Q

If you do a renal angiography and see the classic “string of pearls” appearance of the renal artery, what disease is it

A

Fibromuscular dysplasia

53
Q

How do you do a cystourethrogram?

A

Bladder is filled with contrast

X rays are taken while the patient is voiding

(Contrast is ONLY in bladder=less damage to kidneys)

54
Q

What can you use cystourethrogram to diagnose

A

Vesicoureteral reflux

55
Q

What is a cystoscopy

A

A flexible or rigid camera tube is inserted through urethra and into the bladder to loook around

56
Q

What do you need to tell your patient after you do a cystoscopy?

A

Post procedure hematuria is expected and should clear within 3** voids

57
Q

What are the potential compliacation of cystoscopy

A

Sepsis

Hemorrhage

Perforation of the bladder**

Dysuria

58
Q

What test will be done on any male with testicular pain

A

Testicular ultrasound with DOPPLER

59
Q

How do you do a prostate ultrasound and biopsy?

A

Transrectally (TRUS)

Helpful in detection of prostate cancer in patients with high PSA

Clinical Med II Exam 3 (Annie and Lauren) (5 decks)

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