UWORLD RENAL Flashcards
palpable purpura, GN, non specific signs like arthrlagia, hepatosplenomegaly, low complement levels,
usually associated with HCV
cryoglobulinemia
symptoms of hypercalcemia
weakness, GI distress, neuropsychiatric (confusion/stupor/coma)…patients also usually volume depleted due to polyuria and hypercalcemic induced nephrogenic DI.
treatment of hypercalcemia
- AGGRESSIVE FLUIDS
- calcitonin
- bisphosphonates (pamidronate, alendronate, zaote something acid), but may take longer to get rid of calcium
MCC of kidney stones
calcium oxalate stones from fat malabsorption (chronic diarrhea, small bowel disease, resection)
When to not use metformin
in critically ill patients
induces lactic acidosis which can be nephrotoxic
chronic bladder pain worse with filling, relieved by voiding, increased urgency/frequency, dyspareunia. normal U/A
interstitial cystitis (painful bladder syndrome)…
exclude PID (cervical motion tenderness/fever), or UTI (nitrates/leuko esterase on UA)
euvolemic (BUN:Cr < 20), hyponatremia with high urine Na and osmolarity, decreased serum osm, failure to correct with fluids
SIADH
non anion gap metabolic acidosis + hyperkalemia + preserved/moderately reduced kidney function
type 4 RTA (hyperkalemic RTA)
best way to test for DM nephropathy
urine microalbumin/Cr ratio
When to give calcium gluconate for hyperkalemia?
K> 7.0 or ECG changes
common causes of hyperkalemia
AKI
CKD
MEDICATIONS
RAAAS disorder
side effect of H1-antihistamines (i.e. diphenhydramine)
anti-cholinergic effects = urinary retention (due to detrusor hypoactivity), eye/mouth dryness
treatment for UNCOMPLICATED and COMPLICATED cystitis
uncomplicated - nitrofurantonin, bactrim, or fosfomycin
complicated - culture + quinolone?
complicated = pyelo, penis, procedure, pregnancy, immunocompromised, diabetes/renal failure
MCC glomerulopathy associated with HIV
FSGS
side effects of thiazides
hyperglycemia, increased LDL + triglycerides, increased uremia, hyponatremia, hypokalemia, hypomag, hypercalcemia
hypotonic (serum osm< 275) hyponatremia + euvolemia + increased urine Osm, + increased urine Na
SIADH (associated with SSRIs in elderly as one cause)
single kidney + low volume urine + flank pain
obstructive uropathy
common side effect of rifampin
red/orange discoloration of urine; but must r/o renal diagnosis with u/a
recent coronary procedure/catheterization, elevated serum creatinine, eosinophilia, hypocomplement, purple mottling of skin
cholesterol emboli (leads to multisystem involvement)…contrast nephropathy usually doesn’t present with multi system involvement
elderly, combining analgesics-> renal failure
analgesic nephropathy from papillary necrosis or chronic tubuluointerstitial nephritis
What can cause mixed metabolic acidosis and respiratory alkalosis
aspirin toxicity
hypovolemic hypernatremia how to treat
symptomatic and asymptomatic
asymtomatic - d5w
symptomatic (hypotension, dehydration) - 0.9 saline FIRST then d5w after patient is euvolemic
markedly elevated Ca, low PTH, normal/low phos
hypercalcemia of malignancy (due to secretion of PTH related protein by cancer cells…can be lung, head and neck, bladder, breast, ovarian cancers
expected lab values in hypovolemia
increased BUN:Cr ratio, decreased urine Na (RAAAS system activated so sodium is reabsorbed and less excreted, also more K is excreted)
hypercalcemia (polyuria, polydipsia), kidney stones, neuropsychiatric presenations (depression, psychosis, ood swings), HTN
primary hyperparathyroidism
