Renal- Rx Flashcards
What does tumor lysis syndrome do on renal? What ion balances (3) are changed?
acute renal failure
- hypocalcemia
- hypophosphotemia
- metabolic acidosis
- way to remember: hypocalcemia and hypophosphotemia are exactly opposite to the function of vitamin D.
Describe two mechanisms regarding ion balance in severe vomitting
- volume loss -> contraction alkalosis
- acid loss ->alkaline tide
These two mechanisms result in metabolic alkalosis
renin is released from what cells? Is this cell located in afferent arteriole? or DCT?
JGA cells, afferent arteriole
at DCT, macula densa is located!
Macula densa serves as a sensor, but not renin secretion
Grape juice + statin: how these may cause acute tubular necrosis?
grape juice: P450 inhibitor
- > more statin -> RHABDOMYOLYSIS
- > myoglobin is toxic to kidney
How to treat PSGN?
supportive care
PSGN is self-resolving. Especially kids show almost 90% of self-recovery
- Don’t pick antibiotics. It is immune complex that mediates PSGN, not bacteria itself
How to treat aspirin overdose?
sodium bicarbonate
aspirin overdose (late) can cause metabolic acidosis
How to treat uremia?
dialysis
Pyelonephritis vs. UTI: how to differentiate by physical exam finding?
pyelonephritis: fever, flank pain
UTI: NO fever, suprapelvic pain
Hypertension, bruits in abdomen just left to midline on ascultation. what is most like etiology?
renal artery stenosis
stenosis -> decreased RBF/GFR -> more RAAS
ACE level in renal artery stenosis
unchanged
It is RENIN that goes up, not ACE
Effect of H+ by AngII: reabsorption? excretion? or no change?
NO CHANGE
remember AngII promotes H+ pumping into luminal tubule via NHE, but H+ will be returned back to tubular epithelium in the form of H2O to regenerate bicarb
bladder cancer: transitional vs. squamous cell carcinoma
: how does histology look differently?
- transitional: PAPILLARY hyperchromic nuceli
- SCC: NOT PAPILLARY
