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Q3 Clin Med II Test 3 (GU) > Renal Failure > Flashcards

Renal Failure Flashcards

1
Q

Assessment of Renal Disease must include?

A

Cause and Severity

UA
GFR
Pre/Post renal or intrinsic
Acute (hrs/days)/Chronic (months/yrs)

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2
Q

Renal Dz UA:

Blood/RBC Casts/Mild Protein?

High Protein/Lipids?

WBC/WBC Casts/Mild Protein?

WBC Casts?

Pyuria?

A

Blood/RBC Casts/Mild Protein = (P) glomerulonephritis

High Protein/Lipids = (P) nephrotic synd

WBC/WBC Casts/Mild Protein = (P) interstitial nephritis

WBC Casts = (P) pyelonephritis

Pyuria = (P) UTI

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3
Q

Proteinuria caused by?

A

1) Fxnl, benign result of illness/exercise
2) Overprdxn of plasma proteins (i.e. Bence Jones in MM)
3) Abnormal glomerular basement memb (U high albumin spike)
4) Proximal Tubule damage (drugs, metabolic disord)

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4
Q

Proteinuria best test?

A

24 hr collection

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5
Q

Cr clearance eqn?

A

Ccr = (140 - age) x weight kg / Pcr x 72

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6
Q

Cr clearance elevated by?

A 
ketoacidosis
drugs (asprin, tagamet, bactrim)
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7
Q

Cr clearance decreased by?

A

old age
wasting from dz
liver dz

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8
Q

BUN/Cr ratio should be?

A

10-15:1

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9
Q

BUN/Cr increased by?

A

dehydration, GI bleed, steroids, CHF

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10
Q

BUN.Cr decreased by?

A

liver dz

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11
Q

Renal US used for?

A

hydronephritis
polycystic kidney dz
kidney size
postvoid residule

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12
Q

Renal IVP (intravenous pyelogram) used for?

Contraindicated?

A

contrast xray of entire urinary tract

DM w/ high Cr
Chronic renal fail
Mult Myeloma

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13
Q

Renal CT used for?

A

neoplasms

retroperitoneal space

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14
Q

Renal MRI used for?

A

loss of corticomedullary fxn

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15
Q

Renal arterio/venography used for?

A

stenotic lesions
aneurysms
renal vein thromb

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16
Q

Renal bx used when?

A

unexplained acute renal failure,
proteinuria,
lesions

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17
Q

Acute Renal Failure presentation?

A 
SUDDEN ↑ BUN or serum Cr
Oliguria
N/V, malaise
Altered sensory
Pericard effus/Heart friction rub
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18
Q

Acute Renal Failure labs findings?

A

hyperK+
Tall T
Anemia (from ↓ erythrop)

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19
Q

Most common cause of Acute Renal Fail?

A

Prerenal Azotemia from renal HYPOperfusion

leads to ischemia -> intrinsic renal fail

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20
Q

↓ Renal Perfusion caused by?

A

↓ intravascular volume (GI loss/pancreatitis/Burns)

Δ in vascular resistance (sepsis, ACE, NSAID, Epi)

↓ CO (CHF, PE, arrhy)

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21
Q

Prerenal Azotemia assessment must involve?

A

Volume status
Drugs
Cardiac fxn

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22
Q

Prerenal Azotemia lab results?

A

UA = vol depletion, tubular casts
BUN/Cr = high
Urine Na+ = low if vol depl, high if acute tub necrosis

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23
Q

Postrenal Azotemia caused by?

A

urinary flow obstruction
(BPH, antichol meds, stones, etc)
*Reversible

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24
Q

Postrenal Azotemia presentation?

A

low abd pain

distended bladder

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25
Postrenal Azotemia lab results?
Urine Osmo = high Urine Na+ = low BUN/Cr = high
26
Postrenal Azotemia imaging?
US or catheterization | If results are normal, do CT or MRI
27
Intrinsic Renal Failure from Acute Tubular Necrosis caused by?
EXOGENOUS CAUSES Ischemia: from hypoTN, hypoxemia, dehyd, shock/sepsis Toxins: aminoglycosides radiograph contrast cyclosporine (transplant med)
28
Acute Tubular Necrosis lab results?
UA = brown urine, pigmented granular casts | (P) hyperK+, hyperPO4
29
Acute Tubular Necrosis tx?
Mitigate vol overload/hyperK+: loop, ↓ diet protein Dialysis if: extreme e- imbal, tx not working
30
Interstitial Nephritis (U) caused by?
Drugs: PCN, cephalo, sulfa, NSAIDs Infection: strep, CMV, histoplasmosis
31
Interstitial Nephritis signs/sxs?
fever, rash, arthralgia
32
Interstitial Nephritis lab results?
Eosinophilia UA = RBC, WBC, WBC Casts Proteinuria if NSAIDs
33
Interstitial Nephritis tx?
stop cause | short/high dose prednisone
34
Glomerulonephritis (U) caused by?
Immune complexes (post infection, lupus,etc) Malignant HTN Hemolytic-uremic Synd
35
Glomerulonephritis signs?
HTN | Periorbital/Scrotal edema
36
Glomerulonephritis lab results?
Hematuria Proteinuria Red Cell Casts
37
Glomerulonephritis tx?
high dose steroids
38
Post-Infectious Glomerulonephritis from?
group A beta-hemolytic strep
39
Post-Infectious Glomerulonephritis lab results?
ASO titer = high | Urine = cola colored
40
Post-Infectious Glomerulonephritis tx?
not necessary
41
Glomerulonephritis caused by IgA Nephropathy test?
biopsy
42
Membranous Nephropathy caused by? Signs? Tx?
Immune disorder (SLE, hep B) neoplasms of lung, stomach, colon prednisone transplant
43
Chronic Renal Disease (U) caused by?
DM | HTN
44
Chronic Renal Disease presentation?
multi-system sxs uremic fetor (fish breath) progressive
45
Chronic Renal Disease lab results?
BUN/Cr = high
46
Chronic Renal Disease imaging?
US = bilat small kidneys (diagnostic)
47
Chronic Renal Disease complications?
hyperK+ metabolic acidosis HTN CHF
48
Chronic Renal Disease tx?
protein/Na+/K+/H2O restriction | dialysis
49
Nephrotic Syndrome is?
Urine protein > 3.5 gm/24 hr, Albumin < 3, peripheral edema (U Na+ retention)
50
Nephrotic Syndrome caused by?
DM Amyloidosis SLE
51
Nephrotic Syndrome tx?
protein restriction Na+ restriction and diuretic If albumin < 2gm, anticoag
52
Diabetic Nephropathy is most C cause of what?
end-stage renal dz
53
Always check DM pts for what?
microalbuminuria
54
Diabetic Nephropathy tx?
glycemic control and HTN tx can slow progression ACE
55
Tubulointerstitial Disease caused by?
Acute: toxins or ischemia ``` Chronic: obstructive uropathy, vesicoureteral reflux (U kids), analgesics, heavy metals ```
56
Acute Tubulointerstitial Disease tests?
UA = hematuria | US, CT
57
Chronic Tubulointerstitial Disease from obstruction caused by?
prostatic dz bilat ureteral calculi CA of cervix, colon, bladder
58
Chronic Tubulointerstitial Disease signs/sxs?
Polyuria (inability to [urine]) hyperK+ (aldost-resistant DCT) hyperCl- acidosis (reduced NH4+ prdxn)
59
Simple cysts in kidney are benign if?
on US or CT they are all three: 1) echo-free 2) sharp demarcation w/ smooth walls 3) enhanced back wall
60
Polycystic Kidney Disease epidemiology?
strong family hx 1/2 a/w HTN (P) Hx of UTI/stones 1/2 progress to end-stage by 60yo
61
Polycystic Kidney Disease presentation?
abd/flank pain w/ hematuria | palpable kidney
62
Polycystic Kidney Disease diagnostic?
US = multiple cysts

Q3 Clin Med II Test 3 (GU) (6 decks)

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