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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
treatment of IgA nephropathy
steroids ACEi's FISH oil
26
lupus nephritis ddx
ANA + antidsDNA + renal biopsy (to determine extent of disease to guide therapy)
27
lupus nephritis treatment
sclerosis only -- no treatment mild disease -- steroids severe disease -- mycophenolate + steroids
28
TTP treatment
plasmapharesis
29
nephrotic range proteinuria
3.5 g
30
basic treatment for nephrotic syndromes
Initial therapy with steroids, step up to cyclophosphamide after 12 weeks.
31
differential for transient mild proteinuria
CHF vs. fever/infection vs. exercise vs. orthostatic proteinuria (From standing all day)
32
basic workup of proteinuria
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
fluids on step 3
order bolus, then give continuously
34
causes of nephrogenic DI
hypokalemia hypercalcemia lithium toxicity
35
etiologies of hypervolemic hyponatremia
CHF, nephrotic syndrome, cirrhosis.
36
etiologies of euvolemic hyponatremia
SIADH hypothyroidism psychogenic polydypsia hyperglycemia
37
treatment of Addison's
fludrocortisone (aldosterone replacement)
38
SIADH etiologies
CNS abnormalities lung disease Meds (sulfonylureas, SSRIs, carbamazepine Cancer
39
treatment of chronic SIADH from cancer
demeclocycline
40
constipation differential
dehydration vs. meds (CCB’s, opioids, anticholinergics) vs. hypothyroidism vs. diabetic gastroparesis vs. iron replacement
41
esophagitis differential
Candida, pill, eosinophilic
42
max sodium correction in SIADH
10 meq in first 24 hours
43
hyperkalemia ECG prgoression
peaked T-waves then loss of P-wave, then widened QRS complex
44
contraction alkalosis lab profile
Chloride down + bicarb up + k down in setting of volume depletion
45
hypokalemia ddx
diuretics, hyperaldosteronism, vomiting, RTA

Medicine (71 decks)

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