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Clin Med II > Renal Diagnostics > Flashcards

Renal Diagnostics Flashcards

1
Q

What lab measurement is released into the circulation at a relatively constant rate, has a stable plasma concentration, and is freely filtered across the glomerulus and excreted by the kidney?

A

Serum creatinine

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2
Q

What lab measurement is a product of protein catabolism, is excreted by the kidneys, and can be elevated with dehydration, GI bleed, or meds such as steroids and tetracyclines?

A

BUN

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3
Q

What lab measurement is commonly used as a marker for volume status?

A

BUN/ creatinine ratio

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4
Q

What measurement is used to measure the # of functioning nephrons and is used to track progression/ regression of disease and dose medications?

A

GFR

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5
Q

Can GFR be measured directly?

A

No, must be calculated

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6
Q

Creatinine clearance is helpful to know when what?

A

Choosing or dosing meds

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7
Q

CKD is defined as the presence of kidney damage or decreased kidney function for how long?

A

≥ 3 months

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8
Q

If a pt presents w hx of no urine output, what should you be concerned about? (generally)

A

Very concerning- renal failure

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9
Q

What stage of kidney disease is a pt considered if they are on dialysis?

A

End stage renal disease/ kidney failure

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10
Q

Pt with the following is in what stage of CKD? Kidney damage with N or ↑ GFR GFR ≥ 90

A

Stage 1

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11
Q

Pt with the following is in what stage of CKD? Kidney damage with N or ↓ GFR GFR 60-89

A

Stage 2

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12
Q

Pt with the following is in what stage of CKD? Moderately ↓ GFR (30-59)

A

Stage 3

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13
Q

Pt with the following is in what stage of CKD? Severe ↓ GFR (15-29)

A

Stage 4

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14
Q

Pt with the following is in what stage of CKD? Kidney failure GFR < 15 or on dialysis

A

Stage 5

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15
Q

You might order ANA levels if you suspect what?

A

SLE

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16
Q

You might order C-ANCA and P-ANCA levels if you suspect what?

A

Granulomatosis w polyangitis

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17
Q

You might order anti-GBM levels if you suspect what?

A

Goodpasture syndrome

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18
Q

You might order antistreptolysin O levels if you suspect what?

A

Post-strep glomerulonephritis

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19
Q

You might order SPEP and UPEP levels if you suspect what?

A

Multiple myeloma

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20
Q

What lab value has the potential to improve estimates of GFR?

A

Cystatin C

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21
Q

Prostate-specific antigen (PSA) can be used for what?

A

Screening for early detection of prostate cancer and to monitor disease after treatment

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22
Q

When should you consider testing PSA levels in men?

A

Consider ~50 yo (but shared decision making)

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23
Q

Men with an abn PSA should be what?

A

Referred to urology

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24
Q

What 2 values on a urinalysis can indicate possible kidney issues?

A

Protein and blood (always further investigate)

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25
Q

What test is used in the work-up to find the cause of kidney disease?

A

Microscopic urinalysis

26
Q

On microscopic urinalysis, a pt with glomerulonephritis or vasculitis might show what?

A

RBC casts

27
Q

On microscopic urinalysis, a pt with acute pyelonephritis might show what?

A

WBC casts

28
Q

On microscopic urinalysis, a pt with acute tubular necrosis might show what?

A

Epithelial cell casts

29
Q

On microscopic urinalysis, a pt with dehydration might show what?

A

Hyaline casts

30
Q

On microscopic urinalysis, a pt with abn levels of uric acid, calcium phosphate or calcium oxalate, cystine, or magnesium ammonium phosphate (struvite) might show what?

A

Crystals

31
Q

What urine study id’s the causative organism of a urinary infection and shows sensitive and resistance abx?

A

Urine C+S

32
Q

What urine finding serves as the earliest clinically detectable stage of diabetic nephropathy?

A

Microalbumin

33
Q

What urine study is most commonly seen in acute interstitial nephritis?

A

Urine eosinophils

34
Q

What urine study provides a better quantitative measurement for proteinuria or GFR determination?

A

24-hour urine collection

35
Q

Bence Jones are a positive for what test, leading to suspicion for MM?

A

Urine protein immunoelectrophoresis (UPEP)

36
Q

What may be a helpful initial diagnostic tool but is not typically used clinically?

A

Abd x-ray (KUB or abd)

37
Q

While a KUB study can identify calcium-containing, struvite, and cysteine stones, what will it likely miss (making it NOT 1st line imaging)?

A

Smaller stones, radiolucent stones (uric acid) or stones overlying bony structures

38
Q

What are stones involving the renal pelvis and extending into ≥ 2 calyces?

A

Staghorn

39
Q

What is the appropriate initial test in patients with renal failure of unknown etiology?

A

Renal US

40
Q

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

A

Renal US

41
Q

What is the test of choice for evaluating renal vascular flow?

A

Renal doppler US (can also use CT angiography)

42
Q

What imaging provides more detailed info than US, helps distinguish between types of cysts and masses, and is used to eval and stage renal cell carcinoma?

A

CT scan

43
Q

What is the diagnostic test of choice for nephrolithiasis?

A

Non-contrast CT

44
Q

What cautions should you be aware of when using a contrast CT?

A

Contrast potentially nephrotoxic Hold metformin for 48 hrs post

45
Q

What is the gold standard for diagnosis of renal vein thrombosis?

A

MRI

46
Q

What c/i should you be aware of with Gadolinium in MRI testing?

A

May increase risk of nephrogenic systemic fibrosis in pts with chronic or acute renal failure

47
Q

What diagnostic test is used to eval size/ shape of kidneys/ ureters/ bladder, kidney stones, and obstruction (although NOT used frequently)?

A

Intravenous pyelogram (IVP)

48
Q

How is excretory fxn of the kidneys measured with IVP?

A

Length of time for passage of contrast through kidneys

49
Q

What test is used for preoperative mapping of renal vasculature (if needed)?

A

Renal angiography

50
Q

What might you be concerned for if you see bilateral radiopaque branched, staghorn calculi filling on collecting systems on KUB?

A

Nephrolithiasis

51
Q

What might you be concerned for if you see triangular hypodense streaks spreading from the pelvis to the renal cortex on CT scan?

A

Bilateral pyelonephritis

52
Q

What might you be concerned for if you see a “string of pearls” appearance on angiography?

A

Fibromuscular dysplasia

53
Q

What test is used to obtain a renal sample to assist with dx?

A

Renal bx

54
Q

What test involves the bladder being filled with contrast and x-rays being taken to visualize contrast?

A

Cystourethrogram

55
Q

Primary bladder conditions such as vesicoureteral reflux, distortion of the bladder, fistula, and perforation are better seen with what study (compared to IVP)?

A

Cystourethrogram

56
Q

What test is a scope of the bladder involving a thin fiberoptic tube passed through a hollow sheath?

A

Cystoscopy

57
Q

What should be expected post cystoscopy, and how soon after should this clear?

A

Post-procedure hematuria, should clear w/i 3 voids

58
Q

What test is used to assess bladder and ureteral involvement due to malignancies, to eval urogynecologic conditions, and to dx intrinsic bladder disease?

A

Cystoscopy

59
Q

What should be ordered in all male pts complaining of testicular pain?

A

Testicular US

60
Q

What test is used to eval of testicular/ scrotal masses or pain, testicular size, location of undescended testes and what else should you get with this test?

A

Testicular US, should also get a doppler to look at BF

61
Q

How is a prostate US and biopsy performed and what does it help detect?

A

Transrectally Helpful in detection of prostate cancer in pts with increased PSA

Clin Med II (12 decks)

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