uworld renal review 9/24 Flashcards
What medications cause Hyperkalemia?
nonselectived BB ACE-i ARBS K-Sparing DIuretics Cardiac Glycosides aka Digoxin NSAIDS
When do you use Calcium Gluconate in a patient with hyperkalemia?
when the ECG is NORMAL.
Patient has Hyperkalemia, Chronic Kidney disease, hyperlipidemia, a d ischemic cardiomyopathy, and a normal ECG. What do you do next?
Review current medications.
Patient has persitent, unexplained hyperkalmeia, and issues with blood pressure. What do you do next?
Check serem renin and aldosterone levels
Ptnt has a lower GI bleed, and was on albuterol, asa, furosemide and liniopril. She has COPD On admission BP was 80/50, hgb was 6.5 Then she was stabilized. On 4th day, she is lethargic. Vitals are normal, but Labs significant for a BUN 62, cr 2.7, Na 132, Bicarb 18. PH 7.15, PaO2 80, PaCO2 60. Why is she lethargic?
Hypoventilation. She has respiratory acidosos, but also has metabolic acidosis. The acute respiratory acidosis resulted from Hypercarbia, which would cause CO2 NECROSIS in COPD.
How would Respiratory acidosis effect a pre-existing COPD?
the hypercarbia would lead to CO2 narcosis
If a patient has metabolic acidosis, but has nonanion gap, what would an increased uremia mean?
It means an elevated BUN would be due to something else.
What acid base disturbance woudl you see in RTA from loop or thiazide use? and why?
metabolic ALKALOSIS. The loss of volume activates the RAAS system, you cause chloride loss, and thuse excretion of H+
Indications for Renal/Bladder US?
babies and kids less than 2 years old with a febrile UTI.
Recurrent febrile UTIs of any kids
Children who cant respond to abx.
Characteristics of Familial Hypocalciuric Hypercalcemia.
Normal renalf function, symptomatic, high calcium with normal PTH levels.
What causes Fam Hypocalciuric Hypercalcemia
Mutation in the CaSR
What differentiates FHH with Primary Hyperparathyroidism.
the Urine Calcium.Creatine clearance ratio. it would be very low in FHH (<0.01. In Primary HyperPTH, it would be increased (>0.02) since Ca is excreted when extracted from bone.
