W0 Practice Questions Flashcards
Hypertension, pruritus and xerosis are common findings in which patient?
Uremic patient
Chronic renal failure presents with which LOW electrolyte imbalances?
LOW Ca++
LOW NA+
HIGH phosphate
Metabolic acidosis (low pH)
Hypocalcemia in chronic renal failure is due to two primary causes - increased serum phosphorus and decreased renal production of 1,25 (OH)2 vitamin D.
The former causes hypocalcemia by complexing with serum calcium and depositing it into bone and other tissues.
The latter causes hypocalcemia by decreasing the GI absorption of calcium.
Hematuria
Red blood cells casts
Proteinuria
Nephritic syndrome
Renal colic
Hematuria
UA — crystals resembling coffin lids and
KUB reveals staghorn calculus
What is this?
Treatment?
Percutaneous nephrolithotomy
Struvite stones
Low purine diet for which type of stone?
Uric acid stone
High fluid and low salt diet for which type of stone?
Cystine stone
Treatment for stage 1 testicular seminoma
Orchiectomy and active surveillance
No chemo for this stage
Which syndrome:
Proteinuria
Hyperlipidemia
Hypoalbuminemia
Nephrotic syndrome
Tx for chronic bacterial prostatitis?
Levofloxacin (FQ)
Or
Bactrim
Needed to penetrate the prostate
Treatment for pregnant patient with pyelonephritis
IV ceftriaxone (rocephin)
Broad waxy casts in urinary sediment are a specific finding in what?
Chronic renal failure
Hyaline casts in urinary sediment could be normal or could indicate 3
Dehydration
Strenuous exercise
Febrile illness
Post op patient w/ increase BUN:Cr
FeNa <1%
Most likely diagnosis ?
Prerenal azotemia
Azotemia = elevated levels of urea
Blood at end of urinary stream, origin? 2
Bladder neck
Prostatic urethral source
Which is the preferred pharm agent to decrease bed wetting episodes?
Imipramine OR desmopressin
Treatment of acute renal failure d/t rhabdo is best accomplished with ?
IV fluids (IV sodium bicarb)
Forced alkaline diuresi
Treatment for acute prostatitis + toxic appearing, febrile…
Ampicillin & gentamicin
Patient presents w/ oliguria, hematuria, protinuria following streptococcal pharyngitis 2 weeks ago
Acute glomerulonephritis
(Nephritic syndrome — post infectious GAS)
Which medication to prevent progression of diabetic nephropahty?
What does it do?
ACEI
Prevents the progression of Proteinuria
They improve glomerulus hemo dynamics by decreasing glomerular pressure
2-3 weeks post streptococcal infection, edema, HTN, cola-coloured urine
Dx?
Post streptococcal glomerulonephritis
Edema, hypoproteinemia, hyperlipidemia, >3.5 proteinURIA in 24h.
Children post URI
Minimal change disease
Medication that causes acute tubular necrosis?
Gentamicin — aminoglycosides
Treatment of choice for a patient who develops acute urinary retention with acute bacterial prostatitis (non pharm)
Percutaneous suprapubic tube
Don’t want to catheterise a patient w/ acute bacterial prostatitis
12 year old
Hematuria, cola urine, oliguria, edema of face and eyes in the morning
UA: RBCs, mild Proteinuria and RBC casts
Pharyngitis 2 weeks ago …
Glomerularnephritis — group A strep «post infectious»
Prerenal azotemia is due to what?
Which is due to?
HyPOperfusion of kidneys
D/t:
—volume depletion from diuresis, hemorrhage and GI losses
Treatment for acute epididymitis?
What time of bacteiria?
Ceftriaxone
Neisseria gonorrhoeae — gram negative intracellular diplococci
White cell casts are indicative of?
Renal infection or inflammation:
—pyelo
—interstitial nephritis
Red cell casts are indicative of?
Glomerulonephritis
Patient presents with urge incontinence, some leakage, which medication?
Oxybutynin
Anticholinergics, relax pelvic muscles
Patient w/ lupus, + significant peripheral edema,
UA: Proteinuria, hypoalbuminemia, hyperlipidemia
How to diagnose?
Renal biopsy — performed in adults w/ new onset nephrotic syndrome
Chronic alcoholic presentations w/ hypokalemia must be treated with what? 2
IV magnesium
& potassium
Pt w/ small cell lung cancer presents w/ hyponatremia, treatment?
Hypertonic saline
Complication associated with nephrotic syndrome
DVT
Hypercoagulability may be due to the loss of anti-thrombin III, platelet abnormalities, hyperviscosity of blood caused by Hypovolemic and increased synthesis of clotting factors
Which drugs for these:
Urge:
Stress
Overflow
Urge: anticholinergic
Stress topical estrogen in women
Overflow * alpha blockers**
❗️[must know]
Explain the patho of SIADH and diabetes insipidus
And the impact on Na+
Syndrome of Inappropriate (release) of Antidiuretic Hormone ( “SIADH” ):
—SIADH characterised by oliguria
—Increased water being absorbed
—Increase in intravascular volume
—Diluting Na+ in solution
—Which presents in the lab as low serum Na+
Diabetes Insipidus ( “DI” ):
—A syndrome clinically characterized by polyuria and polydipsia, most commonly either 2/2:
—Decreased production of ADH by the hypothalamus or decreased release f/ posterior pituitary (aka “Central DI”) ← so this is also a central dysfunction
—Decreased renal response to serum ADH (“Nephrogenic DI”) ← various inherited syndromes, ADPKD, ESRD
—DI is highly associated with HyperNatremia (but sometimes HypoNa too)
❗️[must know]
Hyponatremia
Clinical features, 3 dangerous ones
Seizures
Coma
Brainstem herniations
❗️[must know]
Patient admission for UTI
recent procedure!
