Karteikarten
Nephrology - 1
Karten in diesem Stapel (47)
- 1Chronic renal failure will have the following effects:It makes the kidneys smaller
With renal failure of more than 2 weeks, the hematocrit will drop from loss of erythropoietin production
Calcium levels drop from the loss of vitamin D hydroxylation (i.e., activation) - 2Prerenal azotemiaBUN to creatinine ratio of > 15:1 and often > 20:1
Urinary sodium is low (< 20)
Fractional excretion of sodium < 1%
Urine osmolality > 500
May have hyaline casts on urinalysis - 3Mechanism of BUN elevation in prerenal azotemiaLow volume status increases ADH --> ADH increases urea absorption at the collecting duct --> There is a urea transporter that brings urea in --> ADH increases the activity of the urea transporter
- 4___ uropathy will give an elevated BUN-to-creatinine ratio of > 15:1, similar to that seen in prerenal azotemiaObstructive
- 5BUN-to-creatinine ratio closer to 10:1 Urinary sodium > 40 Urine osmolality < 350Intrarenal renal failure
- 6Causes of Toxin-Induced Renal InsufficiencyAminoglycosides (gentamicin, tobramycin, or amikacin)
Amphotericin
Contrast agents
Chemotherapy (cisplatin) - 7Rapid rise in creatinine Low urine sodium (<20)Contrast-induced renal failure
- 8Most accurate test for allergic interstitial nephritisWright stain or Hansel’s stain of the urine
that will show eosinophils - 9Cyclophosphamide causes ___, not renal failureHemorrhagic cystitis
- 10Most accurate test for rhabdomyolysisUrine myoglobin
- 11Metabolic acidosis with an elevated anion gap Envelope-shaped oxalate crystalsAntifreeze ingestion (ethylene glycol)
- 12Best initial treatment of ethylene glycol intoxicationEthanol or fomepizole with immediate dialysis
- 13Kidney Damage Caused by NSAIDs- Direct toxicity and papillary necrosis
- Allergic interstitial nephritis with eosinophils in the urine
- Nephrotic syndrome
- Afferent arteriolar vasoconstriction and decreased perfusion of the glomerulus, worsening renal function - 14Painless recurrent hematuria, particularly in an Asian patient after a very recent viral respiratory tract or GI tract infectionIgA nephropathy (Berger's disease)
- 15Treatment for Henoch-Schönlein purpuraNo treatment; resolves spontaneously over time
- 16History of hepatitis C with renal involvement Joint pain and purpuric skin lesions Complement levels (especially C4) are lowCryoglobulinemia
- 17Best initial test for cryoglobulinemiaSerum cryoglobulin component levels (immunoglobulins and light chains, IgM)
- 18Reason for biopsy in lupus (SLE) nephritisTo determine the extent of disease to guide
therapy - 19Treatment of lupus (SLE) nephritis with sclerosis only ("scar" of kidney)No treatment
- 20Treatment of mild, early stage, nonproliferative lupus (SLE) nephritisSteroids
- 21Treatment of severe, advanced, proliferative lupus (SLE) nephritisMycophenolate mofetil and steroids
- 22Do not give ___ or ___ for TPP or HUSPlatelets or antibiotics
- 23Loss of more than 3.5 g per day of protein in the urine Decreased albumin levels in the blood Edema Hyperlipidemia ThrombosisNephrotic syndrome
- 24Mechanism of thrombosis in nephrotic syndromeLoss of antithrombin III, protein C, and protein S in the urine
- 25Hyperproteinuria Hypoproteinemia Hyperlipidemia EdemaNephrotic syndrome
- 26Nephrotic syndrome Adults, Cancer such as LymphomaMembranous
- 27Nephrotic syndrome Hepatitis CMembranoproliferative
- 28Reasons for transient mild proteinuriaCHF
Fever
Exercise
Infection - 29First step to confirm orthostatic proteinuriaSplit urine
Do a morning urine for protein and
then one in the afternoon - 30Steps for proteinuria evaluation:1. Repeat the UA.
2. Evaluate for orthostatic proteinuria.
3. Get a protein/creatinine ratio.
4. Perform a renal biopsy. - 31Elevated serum sodium always implies a ___?Free water deficit
- 32Hypervolemic causes of hyponatremia are the following:Congestive heart failure (CHF)
Nephrotic syndrome
Cirrhosis - 33Hypovolemic causes of hyponatremia are the following:Diuretics (urine sodium elevated)
GI loss of fluids (vomiting, diarrhea) (urine sodium low)
Skin loss of fluids (burns, sweating) (urine sodium low) - 34Causes of euvolemic (normal) hyponatremiaSIADH
Hypothyroidism
Psychogenic polydipsia
Hyperglycemia - 35Hyperglycemia causes an artificial drop in sodium by ___ points of sodium for each 100 points of glucose1.6
- 36Inappropriately high urine sodium (> 20 mEq/L) Inappropriately high urine osmolality (> 100 mOsm/kg) Low serum osmolality (< 290 mOsm/kg) Low serum uric acid Normal BUN, creatinine, and bicarbonateSIADH
- 37Treatment of moderate to severe hyponatremia (confused, seizures)Saline infusion with loop diuretics
Hypertonic (3%) saline
Check serum sodium frequently
ADH blockers (conivaptan, tolvaptan) - 38Treatment of chronic SIADH (as from malignancy)Demeclocycline blocks the effect of ADH at the kidney
Conivaptan and tolvaptan are inhibitors of ADH at the V2 receptor of the collecting duct - 39Mechanism of hyperkalemia with beta blocker useBeta blockers decrease the activity of the
sodium/potassium ATPase
Normal Na/K ATPase activity lowers blood potassium
Inhibit Na/K ATPase potassium levels can go up - 40Hyperkalemia changes on EKGFirst peaked T-waves occur, then loss of the P-wave, and then the widened QRS
complex occurs - 41Causes of hypokalemiaDietary insufficiency
Diuretics
High-aldosterone states (Conn syndrome)
Vomiting
Proximal and distal RTA
Amphotericin
Bartter syndrome - 42Avoid glucose-containing fluids in cases of hypokalemia because?They will increase insulin release and worsen the hypokalemia
- 43Leads to muscular weakness and loss of deep tendon reflexesHypermagnesemia
- 44Hypomagnesemia is caused by the following:Loop diuretics
Alcohol withdrawal, starvation
Gentamicin, amphotericin, diuretics
Cisplatin
Parathyroid surgery
Pancreatitis - 45Presents with hypocalcemia and cardiac arrhythmiasHypomagnesemia
- 46A ___ is the fastest single test to tell if a patient’s hyperglycemia is life threatening in DKALow serum bicarbonate
- 47—
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- Karteikarten am Nephrology - 1, erstellt von Vamsi Ahobila am 17/05/2017.
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