Renal, Urinary, Electrolytes

Question 1

First change in basement membrane in DM = ?

Answer 1

First change in basement membrane in DM = GLOMERULAR HYPERFILTRATION

Question 2

HyperCa tx:
>14 or sx =

12-14 =

<12 or asx =

Answer 2

> 14 or sx = NS hydration w/ or w/o calcitonin to inhib osteo-clast mediated boen reporption and reduce serum Ca (no loops); long-term bisphosphonates

12-14 = no immediate tx, probs long term bisphosphonates.

<12 or asx = none

Question 3

FeNa <1% or urine Na <10mEq/L; think ?

this can occur after reduced renal perfusion in
setting of advanced cirrhosis.

Answer 3

hepatorenal syndrome

Question 4

VERY HIGH YIELD:

acute renal rejection best treated with what?

Answer 4

corticosteroids

Question 5

left sided varicocele that doesn’t empty when pt LR - think what?

Answer 5

renal cell carcinoma bc tumor obstructing gonadal vein

Question 6

paraneoplastic syndromes associated with renal cell carcinoma

Answer 6

polycythemia (RBC) - dt ectopic EPO production

• hypercalcemia,
• thrombocytosis (Plts)

Question 7

Henoch schonlein purpura has what deposits in nephritic

Answer 7

IgA nephropathy = nephritic dt IgA deposits

Question 8

MCD in a kid - next step in mgmt?

Answer 8

CS

Question 9

define Membranoproliferative Glomerulonephritis

Answer 9

C3 nephritic factor - dense deposit disease

Question 10

what diuretic can induce hyperglycemia, incr LDL, plasma TGs, hyperuricemia. electrolytes: hypoMg,
hyperCa, hyperNa, hypoK

Answer 10

thiazide

Question 11

why does nephrotic syndrome predispose to hyperlipidemia?

Answer 11

hypoproteinemia causing incr liver portein and lipid synthesis.

Question 12

lithium SE renally

Answer 12

diabetes insipidus

Question 13

Define ASA toxicity

Answer 13

mixed resp alkalosis and met acidosis.

(1) causes tachypnea = resp alk.
(2) causes HAGMA dt incr production of ketoacids/lactic acid

Question 14

if a pt has renal calculi (MC calcium), what dietary modifications?

Answer 14

1. Incr fluid intake.
2. decr Na intake.
3. normla Calcium intake

(Na encourages Na and Ca reabsorption = less excreted for stone formation).

Question 15

IgA versus Post infectious glomerulonephritis

• timeline.
• older v. younger population?
• diff in serum complement

Answer 15

(1) IgA nephropathy is w/i FIVE DAYS of URI. young men 20-30. Normal serum complement. (2) Postinfectious glomerulonephritis is TEN-TWENTY DAYS post URI. more common in 6-10yo. Lo C3 complement

Question 16

*First change in basement membrane in DM =

Answer 16

GLOMERULAR HYPERFILTRATION

Question 17

ecurrent HEXAGONAL stones + FHx + +urine nitroprusside test= ?

Answer 17

cystinuria (amino acid transport)

Question 18

FeNa <1% or urine Na <10mEq/L; think ?

Answer 18

Hepatorenal syndrome.

Question 19

When a pt is in prerenal azotemia, why stop metformin and NSAIDs?

Answer 19

both nephrotoxic and would

worsen AKI if pt’s condition deteriorated.

Question 20

hep B associated with when nephropathy?

Answer 20

hep B associated with MEMBRANOUS NEPHROP ATHY (think unvax).

Question 21

WBC CASTS and hematuria and pyuria, URINARY EOSINOPHILS. had taken DRUG like pen/TMP-SMX/cphalosporin/NSAID.

Answer 21

Acute interstitial nephritis

Question 22

~AD polycystic kidney disease manifestations EXTRARENAL -

Answer 22

hepatic cysts (MC), valvular heart diseaes (MVP, AR), colonic diverticula, abd wall and inguinal hernia. INTRACRANIAL BERRY ANEURySMS.