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2024 - élo - usmle rx qbank > renal pharma > Flashcards

renal pharma Flashcards

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USMLE® Step 1 flashcards
1
Q

list of aminoglycosides

A

amikacin, tobramycin, gentamicin, neomycin, streptomycin

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2
Q

pt started on HAART presents with flank pain and needle crystals in urinary segmentation …. which drug can cause this

A

crystal induced nephropathy by protease inhibitors (avirs)… the drug precipitates the urine

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3
Q

whn is abacavir contraindicated

A

whn a pt has HLAb5710 mutation due to increase in hypersensitivity

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4
Q

pt with SIADH due to small cell tumor what is the best initial management step

A

water resitriction ……. SIADH already causes hyponatremia so if u restrict water intake it may help increase the sodium levels ….
hyponatremia increases ADH secretion

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5
Q

mannitol side effects

A

pulmpnary edema dehydration

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6
Q

pt with impaired renal and hepatic function how shd the loading dose and maintenance dose be changed

A

loading remains same as it depends on Vd …. maintenance is lower

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7
Q

hepatic encephalopathy can be exacerbated by many conditions like?

A

hypokalemia, alkalosis and hypovolemia

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8
Q

how can the use of thiazide diuretics lead to increase in ammonia production

A

use of thiazide cause hypokalemia… this causes the K+ n the cells to move out into ECF and H+ moves intracellularly making an acidic environment for more ammonia productiopn

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9
Q

why is celcoxib contraindicated in dehydrated pts

A

dehydration causes increase release of angiotensin II … this causes vasoconstriction at efferent that keeps GFR in checj
also prostaglandins are produced that vasodialate the afferent .. if this is blocked it will cause perfusion problems in the kidney

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10
Q

Na2ClK inhibtors

A

loooop diuretics … feurosemide … thick asc lmb

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11
Q

lithium can cause what

A

diabetes insipidus … as it is an aldosterone antagonist

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12
Q

pt has diabetes insipidus and is undertreatment with a drug that causes tooooth discoloration what is this drug

A

demeclocycline

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13
Q

what antibiotics are contraindicated during pregnancy

A

tetracyclines, TMP SMX, fluoroquinlones, aminoglycosides

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14
Q

cyclosporin mechanism

A

blocks transcription of IL2 which is needed for T cell differentiation and activation

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15
Q

inhibition of t cell nucleotide production and DNA synthesis

A

azathioprine

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16
Q

conn syndrome pt what is the txt

A

spirinolactone

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17
Q

celecoxib effect on kidney

A

constrict afferent

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18
Q

uncomplicated UTI first line of txt and also txt incase of sulfa allergy

A

TMP SMX … nitrofurantoin

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19
Q

causes of AIN

A

sulfa drugs like thiazaid diuretcs

20
Q

what is special of blood gas values in aspirin overdose

A

mixed … resp alkalosis and metabolic acidosis which makes the pH look normal

21
Q

what does acetazolamide do to the urine

A

alkalizes urine … treat mountain sickness

22
Q

when could urine dipstick be psotive for blood but urinalysis reveals 0 RBCs

A

in tubular necrosis … dipstick tests for heme … for ex in rhabdomyoliss

23
Q

how does loop diuretic cause metabolic alkalosis

A

loss of na in urine … ENAC starts reabsp more Na … promotes potassium and proton secretion into urine … acidifies urine

24
Q

how to treat acute exacerbations of heart failure

A

if kidney function fine - thiazide

if not + severe HF - looop

25
Q

liddle syndrome

A

hypertension… excess sodium reabsp by ENac … low potassium reabsp … hypertension, low renin and aldosterone, hypokalemia and metab alkalosis …. txt with k sparring diuretics

26
Q

barter syndrome

A

resembles loop diuretics … problem with Na2clK

27
Q

which diuretic secondarily increases calcium reabsp

A

thiazide

28
Q

effects of PTH

A
  1. decrease phosphate reabsp in PCT
  2. increase calcium reabsp in DCT
  3. converting 25 hydroxycalciferol to 1,25
29
Q

which CAH has increased renin

A

21 hydroxylase … problem in making minerelocorticoid

30
Q

what happens to oncotic pressure in glomerular capillary and bowmans space

A 
cap= pressure decreased 
bowmans= increased
31
Q

mesna

A

cyclophosphamide to prevent hemorrhagic cystitis

32
Q

colchicine mechanism

A

inhibits neutrophil chemotaxis

33
Q

amifostine

A

prevent renal damage in cisplatin txt

34
Q

proximal tubule is the site of what type of reasbso

A

isosmotic water and solute

35
Q

which segment reabsp solute but not water

A

thick asc loop … site of loop diuretics

36
Q

PTH

A
  1. kidney decrease phosphate reabsp
  2. gut activate alpha 1 hydroxylase and inc calcium absp
  3. osteoclast activity increased
37
Q

v2 mechanism

A

Gs coupled increases aquaporins

38
Q

v1 mechanism

A

Gq.. smooth muscle

39
Q

ctivation of G-protein–coupled receptors in the adrenal cortex elevates cAMP levels and leads to increased production and secretion of corticosteroids.

A

mechanism of hormones including ACTH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid-stimulating hormone (TSH)

40
Q

what overestimates the GFR

A

creatinine … secreted by pCT

41
Q

marathon runner rapidly ingests water … what happens ate the level of medullary colleting duct

A

decreased reabsp of urea from medullary collecting duct

42
Q

aldosterone will cause metabolic acidosis or alkalosis

A

metabolic alkalosis due to hypokalemia and movement of H= intracellularly

43
Q

iron tablets can be a cause of metabolic acidosis yes or no

A

YESS

44
Q

dialysis pt misses his dialysis apt and presnts with acidosis why

A

uremia

MUDPILES

45
Q

altered mental status, polyuria, polydipsia, hypotension, hyponatremia, hyperkalemia, and elevated anion gap are consistent with diabetic ketoacidosis (DKA) caused by type 1 diabetes mellitus (T1DM). …mechanism

A

pathophysiology of T1DM is a viral or autoimmune process causing inflammation in the β islets.

46
Q

what is the net result of Na+ H+ in PCT

A

increased HCO reabsp

2024 - élo - usmle rx qbank (29 decks)

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