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Renal (Phase II) > Tulane (HIGH YIELD) > Flashcards

Tulane (HIGH YIELD) Flashcards

1
Q

What does para aminohippurate (PAH) measure and why?

A

Renal plasma flow; it is freely filtered and secreted, but not reabsorbed (nearly 100% excretion)

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2
Q

5 most common causes of HTN?

A

Sleep apnea (most important), drug-induced, CKD, primary aldosteronism, renovascular disease

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3
Q

4 biologic effects of 1, 25 vitamin D

A
  • Incr. Ca++ and PO4 reabsorption from gut
  • Feedback inhibition of itself
  • Feedback inhibit PTH
  • Bone mineralization and turnover
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4
Q

What causes intracellular potassium movement?

A

Insulin, epinephrine (into muscles; important for fight-or-flight), alkalosis, incr. plasma K+

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5
Q

What causes extracellular potassium movement?

A

Lack of insulin, beta blockers, acidosis, decr. plasma K+

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6
Q

What are the most common causes of sustained hypokalemia?

A

Potassium losses (renal or GI, e.g. vomiting or diarrhea)

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7
Q

Most common causes of abnormal potassium distribution

A

Lack of insulin, beta blockers, hyperosmolarity

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8
Q

Anion gap formula

A

Na - (HCO3 + Cl)

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9
Q

Winter’s formula (with interpretation)

A

pCO2 = (1.5 x HCO3 + 8) +/- 2
If actual pCO2 > predicted, it’s combined acidosis
If actual pCO2 = predicted, it’s just metabolic acidosis
If actual pCO2 < predicted, it’s compensated metabolic acidosis

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10
Q

Formula for Net Acid Excretion

A

NAE = Urinary titratable acid + NH4 - HCO3

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11
Q

Define uremia

A

Azotemia + symptoms (nausea, vomiting)

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12
Q

High anion gap metabolic acidosis causes

A 
GOLDMARK:
Glycols: ethyl glycol or propyl glycol from moonshine, hand Sani, antifreeze
5-Oxoproline: classically Tylenol consumption in LOLs
L-lactate
D-lactate
Methanol
Aspirin (i.e. salicylates)
Renal failure (incl. uremia)
Ketones (incl. DKA)
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13
Q

Normal anion gap metabolic acidosis causes

A 
HARDASS:
Hyperalimentation
Acetazolamide – CA inhibitor incr. “flushing” of bicarb
RTA
Diarrhea
Addison’s disease = lack of aldosterone
Saline infusion (RAAS not needed  low Ang II  loss of bicarb)
Spironolactone (hypothetical)
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14
Q

Under what particular circumstances would you see high anion gap acidosis with compensatory resp. alkalosis?

A

Ingestion of aspirin

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15
Q

Describe the appearance of gonorrhea on gram stain

A

Gram negative intracellular diplococci

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16
Q

Full syphilis presentation

A

Stage 1 – painless chancre 1 wk post-sex
Stage 2 – maculopapular rash on hands + trunk
Stage 3 – end organ damage, neuro + cardio problems (recall aneurysm), dementia

17
Q

Characteristic syphilis labs

A

VLDR+, darkfield microscopy

18
Q

Describe 2 ways by which the sympathetic nervous system responds to decr. ECV?

A 
o Vasoconstriction (decr. RBF and GFR)
o alpha receptors in PCT incr. Na+ resorption
19
Q

Describe the pathophysiology of edema in heart failure

A

Decr. CO –> decr. RBF –> RAAS activation –> incr. Na+ (and water) resorption AND vasoconstriction –> incr. capillary hydrostatic pressure –> fluid loss to interstitial space (perpetuates the cycle)

20
Q

What part of the nephron is referred to as the “diluting segment” and why?

A

Thick ascending limb, DCT, and collecting duct; in the absence of ADH, reabsorption of solute (but not water) occurs here

21
Q

Hypovolemic hyponatremia clinical presentation

A

Hypotension, lightheadedness, orthostatic hypotension, vomiting, diarrhea, GI losses, etc.

22
Q

Most common cause of hypernatremia d/t low ADH

A

Diabetes insipidus

23
Q

Diabetes insipidus presentation

A

Polyuria (most important), polydipsia, normal to elevated sodium, dilute urine

24
Q

Hypernatremia treatment

A

Water!!!! water water water water

25
Q

Dumbbell shaped kidney stones

A

Calcium oxalate monohydrate

26
Q

Envelope shaped kidney stones

A

Calcium oxalate dihydrate

27
Q

Wedge-shaped prism kidney stones

A

Calcium phosphate

28
Q

“Coffin lid” shaped kidney stones

A

Ammonium magnesium phosphate

29
Q

Rhomboid (or rosette), or football-shaped kidney stones

A

Uric acid

30
Q

Hexagonal kidney stones

A

Cystine

31
Q

Unique predisposing factors for calcium phosphate stones

A

RTA, CA inhibitors (in addition to everything predisposing calcium ox stones)

32
Q

What other GU congenital malformation is associated with bladder extrophy?

A

Epispadias (meatus on dorsal urethra)

33
Q

Possible causes of pyuria without bacteruria

A

NGU, TB, malignancy, calculi

34
Q

Possible causes of bacteruria without pyuria

A

Contamination, colonization

Renal (Phase II) (2 decks)

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