Uworld

Question 1

Autosomal Dominant Polycystic Kidney Disease

Answer 1

CFs: 
Hepatic cysts (20-80% of patients) 
Pancreatic cysts 
Cerebral aneurysm (5-20% of pts) 
Cardiac valve disease (MR, AR) 
Diverticulosis 

US characteristics:
Age 15-39 = 3 or more unilateral or bilateral renal cysts
Age 40-59 = >2 cysts in each kidney
Age 60 = > 4 cysts in each kidney

Tx: Supportive; need aggressive HTN management

Question 2

Orthostatic proteinuria

Answer 2

Seen in pts < age 30; significant proteinuria in upright position but none after laying flat

Dx: Check a first thing in the morning spot urine protein/creatinine

Tx: Nothing, goes away with age

Question 3

Exercise associated hyponatremia

Answer 3

Occurs due to excessive intake of hyponatremic fluids, like water, combined with exercise-induced release of ADH =» Hyponatremia

More likely in inexperience female athletes; typically doesn’t present with a “collapsed” athlete or dehydrated appearing person

Can avoid by only drinking when you’re actually thirsty lol

Question 4

Treatment of hypercalcemia > 14

Answer 4

IV saline, calcitonin (if neuro symptoms), and IV zoledronic acid
-Provides sustained calcium lowering effect