renal pharma

Question 1

list of aminoglycosides

Answer 1

amikacin, tobramycin, gentamicin, neomycin, streptomycin

Question 2

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

Answer 2

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

Question 3

whn is abacavir contraindicated

Answer 3

whn a pt has HLAb5710 mutation due to increase in hypersensitivity

Question 4

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

Answer 4

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

Question 5

mannitol side effects

Answer 5

pulmpnary edema dehydration

Question 6

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

Answer 6

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

Question 7

hepatic encephalopathy can be exacerbated by many conditions like?

Answer 7

hypokalemia, alkalosis and hypovolemia

Question 8

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

Answer 8

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

Question 9

why is celcoxib contraindicated in dehydrated pts

Answer 9

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

Question 10

Na2ClK inhibtors

Answer 10

loooop diuretics … feurosemide … thick asc lmb

Question 11

lithium can cause what

Answer 11

diabetes insipidus … as it is an aldosterone antagonist

Question 12

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

Answer 12

demeclocycline

Question 13

what antibiotics are contraindicated during pregnancy

Answer 13

tetracyclines, TMP SMX, fluoroquinlones, aminoglycosides

Question 14

cyclosporin mechanism

Answer 14

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

Question 15

inhibition of t cell nucleotide production and DNA synthesis

Answer 15

azathioprine

Question 16

conn syndrome pt what is the txt

Answer 16

spirinolactone

Question 17

celecoxib effect on kidney

Answer 17

constrict afferent

Question 18

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

Answer 18

TMP SMX … nitrofurantoin

Question 19

causes of AIN

Answer 19

sulfa drugs like thiazaid diuretcs

Question 20

what is special of blood gas values in aspirin overdose

Answer 20

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

Question 21

what does acetazolamide do to the urine

Answer 21

alkalizes urine … treat mountain sickness

Question 22

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

Answer 22

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

Question 23

how does loop diuretic cause metabolic alkalosis

Answer 23

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

Question 24

how to treat acute exacerbations of heart failure

Answer 24

if kidney function fine - thiazide

if not + severe HF - looop

Question 25

liddle syndrome

Answer 25

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

Question 26

barter syndrome

Answer 26

resembles loop diuretics … problem with Na2clK

Question 27

which diuretic secondarily increases calcium reabsp

Answer 27

thiazide

Question 28

effects of PTH

Answer 28

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

Question 29

which CAH has increased renin

Answer 29

21 hydroxylase … problem in making minerelocorticoid

Question 30

what happens to oncotic pressure in glomerular capillary and bowmans space

Answer 30

``` cap= pressure decreased bowmans= increased ```

Question 31

mesna

Answer 31

cyclophosphamide to prevent hemorrhagic cystitis

Question 32

colchicine mechanism

Answer 32

inhibits neutrophil chemotaxis

Question 33

amifostine

Answer 33

prevent renal damage in cisplatin txt

Question 34

proximal tubule is the site of what type of reasbso

Answer 34

isosmotic water and solute

Question 35

which segment reabsp solute but not water

Answer 35

thick asc loop … site of loop diuretics

Question 36

PTH

Answer 36

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

Question 37

v2 mechanism

Answer 37

Gs coupled increases aquaporins

Question 38

v1 mechanism

Answer 38

Gq.. smooth muscle

Question 39

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

Answer 39

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

Question 40

what overestimates the GFR

Answer 40

creatinine … secreted by pCT

Question 41

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

Answer 41

decreased reabsp of urea from medullary collecting duct

Question 42

aldosterone will cause metabolic acidosis or alkalosis

Answer 42

metabolic alkalosis due to hypokalemia and movement of H= intracellularly

Question 43

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

Answer 43

YESS

Question 44

dialysis pt misses his dialysis apt and presnts with acidosis why

Answer 44

uremia | MUDPILES

Question 45

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

Answer 45

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

Question 46

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

Answer 46

increased HCO reabsp