Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

step 2 ck > Urology/Nephrology/ocular > Flashcards

Urology/Nephrology/ocular Flashcards

1
Q

HIV associated nephropathy is what kind of kidney disease…

A

collapsing focal and segmental glomerulosclerosis

=proteinuria with renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

protein to creatinine ratio versus 24 hr urine protein

A

ratio can be more accurate and is easier/faster

if have to choose, do the ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

if patient has microalbuminuria, next step

A

microalbuminuria can worsen renal function over time

start patient on an ace i or arb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if eosinophils are found on UA, 2 possible conditions?

A

acute interstitial nephritis or allergic interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

false positives for hematuria on dipstick are caused by what 2 factors?
confirm dipstick with?

A

hemoglobin or myoglobin

confirm with urine microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

intravenous pyelogram is always ____

A

wrong

it is slow and contrast is toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

“dysmorphic” red cells on UA =

A

glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
types of cast = ....
1 rbc cast
2 wbc cast
3 eosinophil cast
4 hyaline cast
5 broad way cast
6 granular muddy brown cast
A

1 glomerulonephritis
2 pyelonephritis
3 acute (allergic) interstitial nephritis
4 dehydration (normal tamhorsfall protein)
5 chronic renal disease
6 ATN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

types of AKi

A 
prerenal azotemia (dehydration/hypotension, or renal artery stenosis)
postrenal (obstruction - must obstruct both kidneys for Cr to rise)
intrinsic renal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

UNa and FeNa for PRERENAL

A

UNa <20

FeNa<1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

urine osmolality in ATN is….

A

inappropriately LOW because the tubule cells are damaged and cant resorb water correctly

isosthenuria (osm of U = osm of serum) indicated ATN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

lab values seen in CONTRAST induced renal failure/injury

UNa, FeNa, and specific gravity

what about for normal ATN?

A

UNa LOW
FeNa <1% (afferent arteriole spasm)
U spec grav very high

normal ATN shows high UNa( >20), Fena >1%, and low spec grav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

after chemo, Cr rises 2 days later….
cisplatin or hyperuricemia?

what could have prevented this?

A

hyperuricemia due to tumor lysis syndrome
cisplatin would not produce a rise in Cr for 5-10 days

give allopurinol, hydration, and rasburicase prior to chemo to prevent renal failure from TLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

you see ingestion hx plus renal failure 3 days later + low calcium level and envelop crystals

toxic ingestion?

A

ethylene glycol

oxalate crystals (calcium oxalate) lead to low ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

rhabdomyolysis UA and dipstick findings

what happens to electrolytes?

A

UA no cells
dipstick positive for large amount of blood (myoglobin spilling into urine)
CPK high

hyperK and hyperuricemia (both from lysis of cells)
and hypoCa (ca bound to damaged muscle)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

tx for rhabdomyolysis

A 
saline hydration
mannitol as osm diuretic
(saline and diuretic to increase flow through tubular cells and prevent damage)
\+
bicarbonate to drive K back into cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

first step if someone comes in w seizure from suspected rhabdo?

A

EKG to make sure there isnt a like threatening hyperK

dipstick and cpk can wait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

diuretic that can cause ototoxicity?

A

furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

indications for dialysis?

A 
fluid overload
encephalopathy
pericarditis
met acidosis
hyperK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

hepatorenal syndrome

A

kidney failure d/t liver dz

cirrhosis + prerenal picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

blue/purple lesions in fingers toes + livedo reticularis + AKI

A

cholesterol emboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

meds that cause acute (allergic) interstitial nephritis and drug rash (SJS/TEN)

A 
penicillins
cephalosporins
sulfa (diuretics like furosemide and thiazide)phenytoin
rifampin
quinolones
allopurinol
PPI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what stain to see if eosinophils are in urine?

A

hansel or wright stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

papillary necrosis
presentation
dx
tx

A

sloughing of renal papillae
(extra nsaid use, sickle, DM)

looks like pyelo = sudden onset flank pain, fever, hematuria
UA with necrotic tissue and culture is normal (no growth)
CT scan shows loss of papillae

no tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

drugs AKI occurs in what structure

A

tubules

glomerulus is not damaged from drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

goodpastures

A

lung and kidneys (no upper resp involvement or systemic signs which differentiates it from wegeners)

anti GBM ab = linear deposits

tx plasmapheresis and steroids

27
Q

berger disease (iga nephropathy)
vs
post strep glomerulonephritis

A

gross hematuria 1-2days after URI

post strep is dark urine/periorbital edema ~ 1-2 weeks after strep

28
Q

alport syndrome

A

defect of collagen leading to glomerular disease and hearing loss + vision disturbance

29
Q

polyarteritis nodosa

A

fatigue, weight loss, arthralgias/myalgias
glomerulonephritis + GI abd pain + other organ systems

aneurysmal dilatiation on angiography or biopsy

tx cyclophosphamide and prednisone + treat for hep B if present

30
Q

amyloidosis
biopsy?
tx?

A

large kidneys –> green birefringence on congo red staining

melphalan and prednisone

31
Q

nephrotic syndrome

A

proteinuria (>3.5 g/24 hrs) so large that liver can no longer compensate with production
protein loss leads to edema, hyperlipidemia, and thrombosis (urinary loss of natural anticoagulants like protein S, C, and antithrombin)

32
Q

what kind of nephrotic syndrome occurs with injection drug use and AIDS?
cancer?
kids?

A

focal segmental

cancer –> membranous
kids –> minimal change

33
Q

WHAT CAN BE GIVEN TO bind phosphate in end stage renal disease with hyperphos?

A 
ca acetate
or
ca carbonate
or
sevelamer or lanthanum
34
Q

in HUS and TTP what happens to PT and aPTT

tx?

A

they are NORMAL

HUS willresolve spontaneously
TTP requires plasmapheresis or FFP (NOT steroids)

35
Q

features of a benign simple kidney cyst

A

echo free, smooth thin walls, sharp demarcation, and good transmission to back

no aspiration needed!

36
Q

mc cause of death in polycystic kidney disease?

A

renal failure

37
Q

DI

A

water loss from insufficient or ineffective ADH

38
Q

which responds to ADH: central or nephrogenic DI

A

central

39
Q

if water deprivation test shows decreased U volume….if it shows continued high volume U?
next test?

A

dec: psychogenic polydipsia
stays high: DI

next test: ADH administration

40
Q

addison disease which is loss of ___fxn causes ______ due to loss of _____

A

adrenal fxn
hyponatremia
aldosterone

41
Q

demeclocycline

A

tx for chronic SIADH

blocks ADH action at tubules

42
Q

correction of Na must occur ____

if it is too ___, you risk increases of….

A

slowly
less than 0.5 -1 meq per hr or 12-24 meq per day

central pontine myelinolysis (osmotic demyelinization)

43
Q

insulin and K relationship

A

insulin usually drives K into cells

44
Q

ekg shows peaked t waves and wide qrs

A

hyperKalemia

45
Q

tx for hyperkalemia

A

if there are ekg changes –> calcium cl or gluconate will protect the heart (but doesnt lower K level)

insulin/gluc and bicarb redistribute it

kayexylate will remove it from body over days

46
Q

u waves or flat T waves

A

hypokalemia

47
Q

calculate anion gap (norm 12 or less)

A

Na - (Cl + bicarb)

48
Q

distal renal tubule acidosis (type 1)

A

distal tubule makes new bicarb
if damaged, UA ph will be >5.5 since acid cant be excreted

tx give bicarb

49
Q

proximal RTA (type 2)

A

proximal tubule is damaged and kidney cant resorb all the filtered bicarb
pH is low <5.5

chronic met acidosis leaches ca out of bones = osteomalacia

tx thiazide diuretics

50
Q

type 4 rta

A

urine salt loss (hyperenin, hypoaldosterone)

tx with flucortisone

51
Q

type of rta with nephrolithiasis

A

type 1 distal

52
Q

first steps for someone with acute kidney stone and pain

A

ketorolac /analgesics

then get CT

53
Q

kidney stones that are 0.5 - 2 cm are tx w

A

lithotripsy

surg for 2 cm

54
Q

man w ca oxalate stone
gets lithotripsy
has hyperca in urine
what med?

A

HCTZ

55
Q

Uveitis v glaucoma v abrasion

A

Uveitis- W autoimmune diseases, photophobia, dc w slit lamp, Tx topical steroids

Glaucoma - pain, fixed midpoint pupil, dx w tonometry, Tx acetazolamide or mannitol

Abrasion - trauma, sand in eyes, dx w fluorescein stain, tx none

56
Q

Tonometry is used to dx…

A

Glaucoma

57
Q

Sudden onset painful red eye that is hard, no reaction of pupil to light

A

Acute angle closure glaucoma

58
Q

Red swollen eye w pain

Dendritic pattern seen in fluorescein stain

A

Herpes keratitis
DONT GIVE STEROIDS
Tx w oral acyclovir (or famicyclovir or valacyclovir)

59
Q

Nonproliferation retinopathy is treated w

A

Controlling glucose

60
Q

Proliferative retinopathy in diabetics is treated with

A

Laser photocoagulation

61
Q

Sudden onset monocular vision loss

Dx? Tx?

A

Retinal artery or vein occlusion

Retinal examination
Artery occ will have cherry red macula and pale retina
Vein occ will have blood extravasation into retina (red image)

Tx for artery occlusion is 100oxygen, ocular massage, acetazolamide, and thrombolytics

62
Q

Sudden onset painless unilateral loss of vision like curtain coming down

A

Surgical reattachment

63
Q

Best tx for macular degeneration

A

Vegf inhibitor

Like ranibizumab or bevaciumab

64
Q

vitreous hemorrhage

A

onset of loss of vision suddenly and floaters!

step 2 ck (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions