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Medicine > Step 3 3 > Flashcards

Step 3 3 Flashcards

1
Q

workup of any renal cause on CCS

A

UA + chemistry + renal US

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2
Q

intrarenal kidney failure differential

A

hepatorenal vs. cardiorenal vs. DM/HTN induced vs. ATN vs. meds (contrast, cisplatin, amioglycosides)

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3
Q

clue that kidney failure is contrast induced

A

usually extremely rapid in onset.

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4
Q

most accurate test for AIN

A

Wright or Hansel urine stain for eosinophils

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5
Q

AIN presentation

A

rash + fever + recent drug exposure

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6
Q

rhabdo causes

A 
crush injury
seizure
cocaine
prolonged immobility
hypoK
statins
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7
Q

Tests to order on CCS

A
  • UA + urine myoglobin

- Potassium, calcium, BMP

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8
Q

Rhabdo orders

A

EKG
NS bolus
Mannitol + diuretics
Alkalinize urine

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9
Q

crystal induced renal failure treatment

A

ethanol or fomepizole + dialysis

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10
Q

management of patient who needs contrast and has mild renal insufficiency

A

hydrate with NS and possibly bicarb, N-acetyl cysteine or both

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11
Q

kidney pathologies caused by NSAIDs

A

direct toxicity and papillary necrosis
AIN
nephrotic syndrome

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12
Q

goodpasture’s treatment

A

plasmapheresis + steroids

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13
Q

initial test for goodpasture’s

A

anti-basement membrane antibody

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14
Q

GPA presentation overall

A

Upper respiratory problems (eg sinusitis, ottitis) + lower respiratory (cough, hemoptysis, abnormal CXR) + renal involvement + systemic findings (joint, skin, eye, GI)

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15
Q

best initial test for GPA

A

c-ANCA

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16
Q

HTN orders on CCS

A

UA
EKG
Eye exam for retinopathy
Cardiac exam for murmur and S4 gallp

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17
Q

most effective lifestyle modification for HTN

A

weight loss

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18
Q

lifestyle modifications to tell patients for HTN reduction

A

Sodium restriction
Weight loss
Exercise

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19
Q

treatment of renal artery stenosis

A

renal artery angioplasty and stenting

20
Q

best initial test for renal artery stenosis

A

doppler US

21
Q

syncope orders

A 
If murmur on exam → TTE
If focal deficits on neuro exam → CT + EEG
Chem 7
Telemetry
Oximeter
CBC
Echo
CT head
EKG
If ventricular dysrhythmia diagnosed, consult cardiology for ICD
CK-MB/troponin
22
Q

RLS management

A

Pramipexole or ropinirole
Test for iron
if low, iron replacement can help

23
Q

pleural effusion management

A 
if small:
NTD
Consider diuretics
if large (and pH < 7.2):
chest tube
if large and recurrent:
pleurodesis 
If pleurodesis fails:
decortication
24
Q

IgA nephropathy diagnosis

A

renal biopsy

25
Q

treatment of IgA nephropathy

A

steroids
ACEi’s
FISH oil

26
Q

lupus nephritis ddx

A

ANA + antidsDNA + renal biopsy (to determine extent of disease to guide therapy)

27
Q

lupus nephritis treatment

A

sclerosis only – no treatment
mild disease – steroids
severe disease – mycophenolate + steroids

28
Q

TTP treatment

A

plasmapharesis

29
Q

nephrotic range proteinuria

A

3.5 g

30
Q

basic treatment for nephrotic syndromes

A

Initial therapy with steroids, step up to cyclophosphamide after 12 weeks.

31
Q

differential for transient mild proteinuria

A

CHF vs. fever/infection vs. exercise vs. orthostatic proteinuria (From standing all day)

32
Q

basic workup of proteinuria

A

Repeat UA to rule out physiologic (and consider etiologies in differential) → if still elevated, evaluate for physiologic proteinuria –> if not, then get spot urine for protein:creatinine ratio → renal biopsy (positive >3.5:1)

33
Q

fluids on step 3

A

order bolus, then give continuously

34
Q

causes of nephrogenic DI

A

hypokalemia
hypercalcemia
lithium toxicity

35
Q

etiologies of hypervolemic hyponatremia

A

CHF, nephrotic syndrome, cirrhosis.

36
Q

etiologies of euvolemic hyponatremia

A

SIADH
hypothyroidism
psychogenic polydypsia
hyperglycemia

37
Q

treatment of Addison’s

A

fludrocortisone (aldosterone replacement)

38
Q

SIADH etiologies

A

CNS abnormalities
lung disease
Meds (sulfonylureas, SSRIs, carbamazepine
Cancer

39
Q

treatment of chronic SIADH from cancer

A

demeclocycline

40
Q

constipation differential

A

dehydration vs. meds (CCB’s, opioids, anticholinergics) vs. hypothyroidism vs. diabetic gastroparesis vs. iron replacement

41
Q

esophagitis differential

A

Candida, pill, eosinophilic

42
Q

max sodium correction in SIADH

A

10 meq in first 24 hours

43
Q

hyperkalemia ECG prgoression

A

peaked T-waves then loss of P-wave, then widened QRS complex

44
Q

contraction alkalosis lab profile

A

Chloride down + bicarb up + k down in setting of volume depletion

45
Q

hypokalemia ddx

A

diuretics, hyperaldosteronism, vomiting, RTA

Medicine (71 decks)

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