Review 1

Question 1

AKI

1st thing to do

Answer 1

try to identify the primary cause

		- Prerenal
		- Intrarenal
		- Postrenal

Question 2

if prerenal cause of AKI, think of ______

Answer 2

decreased perfusion to the kidneys

=> hypotension, hypovolemia, decreased CO, systemic vasodilation (sepsis

Question 3

Pt with AKI will present most likely w

Answer 3

decreased urine output

Question 4

3 diagnostic tests for AKI

Answer 4

1. UA with micro
2. Urine albumin/creatnine; protein; creatinin
3. Renal US

Question 5

General management for most cases of AKI

Answer 5

1. Avoid nephrotoxins.
2. Avoid hypotension due to ischemia (goal is for systolic to be above >130)
3. Avoid dehydration, which can cause hypotension
4. renally dose all meds- any drugs cleared by kidneys should be discontinued or lowerd in dose (metaformin is not toxic, but cleared by kdineys)

Question 6

CKD

1st thing to do is ID primary cause

Answer 6

DB
HTN
-glomerulonephritis

Question 7

pt with CKD will present most likely with what sx

Answer 7

1. decrease UO**
2. EDEMA **
3. HTN
4. Uremia
   5/ Uremic frost

Question 8

3 tests for CKD

Answer 8

1. eGFR
2. Urinealbimnin/Cr
3. UA with micro

Question 9

renal US with CKD pt will show

Answer 9

atrophic kidneys, cortical thinning and hydronephrosis

Question 10

doppler renal US with CKD pt will show

Answer 10

renal artery stenosis or renal vein thrombosis

Question 11

nephrotic syndrome dx

Answer 11

24 hour urine protein collection

Def; renal biopsy

Question 12

nephritic syndrome dx

Answer 12

24 hour urine collection (no proteinuria)

Def; renal biopsy

Question 13

Pneumococcal vaccine should be given to _______

Answer 13

all adults >65 and all immunocompromised individuals

Question 14

_______ identify high risk patients with pneumo

Answer 14

CURB-65

Question 15

CURB-65

Answer 15

Confusion
	U BUN >20
	Respiratory rate >30
	BP <90
	Age >65

Question 16

Enlargement of ________ or __________ lymph nodes suggest fungal or mycobacterial infection

Answer 16

hilar

mediastinal

Question 17

_________appropriate initial imaging for PE

Answer 17

Either contrast-enhanced CT or VQ scanning

Question 18

Normal D-dimer will _____

Answer 18

effectily rule out PE

if +; does not confirm

Question 19

Pulmonary Embolism

Most common symptoms are:

Answer 19

Dyspnea
		Pleuritic chest pain****
		Cough
		Hemoptysis
		Tachypnea
		Crackles
		Tachycardia

Question 20

Pulmonary HTN

Defined as an elevation of mean pulmonary artery pressure of ____ or greater at rest

Answer 20

25mmHG

Question 21

Over 80% of cases of pulmonary HTN are due to conditions causing elevation of what

Answer 21

left-sided heart filling pressures or pulmonary disease

Question 22

what should we look for with pulmonary HTN

Answer 22

fatigue and dyspnea

Question 23

Advanced pulmonary HTN has

Answer 23

syncope,
edema,
acites
hepatomegaly

Question 24

Dx pulmonary HTN

Answer 24

right heart catheterization

Question 25

______ provide a simple and important functional assessment of pulmonary HTN

Answer 25

6 min walk test

Question 26

You hear a new systolic murmur in a pt post MI, what do you think it is?

Answer 26

1. mitral valve prolapse - due to papillary muscle rupture

2. VSD

Question 27

You hear a new systolic murmur in a pt post M (3-7 days later)I, what do you think it is?

• Mitral valve prolapse – due to papillary muscle rupture
• VSD

Answer 27

MVP will radiate to L axilla

Question 28

Both MVP and VSD present with

Answer 28

pulmonary edema; treat with surgery

Question 29

Cardiogenic shock will have

Answer 29

decrease CO and CI

High SVR, CVP and PCWP

Question 30

Septic shock will have

Answer 30

decrease CO and CI

Decrease SVR, CVP and PCWP