Renal Ck

isolis's version from 2016-07-27 20:59


Question Answer
• Indications for urgent dialysis?AEIOU, acidosis, electrolyte abnormalities, Ingestion, Overload(volume) and Uremia causing pericarditis, encephalopathy or bleeding
• Palpable purpura, proteinuria, hematuria and non specific systemic sx (arthralgia, peripheral neuropathy, hypocomplement) with underlying hep C infectionmixed cryoglobulinemia
• If you have to give contrast to somebody with renal issues (from diabetes for example) then what do you do first? What can you give to decrease risk of contrast nephropathy?hydrate them first. Acetylscysteine and bicarb my decrease that risk
• Sore throat then low back pain and hematuria 5 days laterIgA nephropathy, if 10-15 days later it would be PSGN (also has low levels of C3)
• Treatment for lithium induced nephrogenic DI?discontinue lithium and salt restriction
• Winter's formula to calculate respiratory compensation for metabolic acidosisPaCo2 = 1.5 * Bicarb + 8 +/- 2
• Treatment for minimal change disease?prednisone. Biopsy not required for diagnosis, highly responsive to steroids
• Effect if Angiotensin II on efferent renal arterioles?constricts them to increase GFR
• Palpable purpura on lower extremities, abdominal pain, renal disease, what is this?HSP - henoch-schonlein purpura, IgA mediated vasculitis of the small vessels, common in children.
• These antibiotics are nephrotoxic and used to treat serious gram negative infectionsaminoglycosides (gentamicin and amikacin)
• Hypertonic saline is indicated to treat hyponatremia when?if it's below 120 and symptomatic (eg confusion, lethargy) until it's above 120
• Most common nephrotic syndrome associated with cancer? What about in hodgkin lymphoma? Multiple myeloma?membranous nephropathy, minimal change disease, amyloidosis
• Which nephrotic syndrome is associated with hep B, C?membranoproliferative glomerulonephritis
• Initial hematuria? Terminal hematuria? Total hematuria (the whole time)?urethral damage, bladder damage or prostate damage, kidney or ureter damage
• What should you do if you have to give a patient contrast with renal disease? What can you give to high risk patients?hydrate them, can give acetylcysteine and bicarb to decrease risk of nephropathy
• Chronic normal anion gap metabolic acidosis, if in kids presents as failure to thrive. What is this and how do you treat it?RTA, treat with oral bicarbonate replacement
• Recurrent renal stone formation with family history. Radio opaque hexagonal crystals. Urinary cyanide nitroprusside test is a screening measurecystinuria
• Can't concentrage urine well, hx of sickle cell disease in family, what is this?hyposthenuria.
• Antiglomerular basement membrane antibodies causing linear immunofluorescence on biopsy? Hemoptysis, SOB and renal failure. What is this and how do you treat?this is goodpastures, treat with steroids and cyclophosphamide
• Nasal involvement, hemoptysis, pleurisy, renal disease, ANCA positive, what is this and how do you treat?this is wegener's, same treatment as goodpastures, steroids and cyclophosphamide or methotrexate is an alternative
• Indications for dialysis?uremic encephalopathy, pericarditis, severe metabolic acidosis (7.25), heart failure, hyperkalemia severe enough to cause arrhythmia
• Treatment for minimal change disease?steroids. Usually follows an infection
• Polycystic kidney disease and bad headache?berry aneurysms causing subarachnoid hemorrhage
• Anemia with CKD?b/c of lack of EPO, give EPO to correct
• Most common causes of UTIs in children? How do you evaluate?vesicoureteral reflux and posterior urethral valves. Evaluate with an ultrasound and voiding cystourethrogram or radionuclide cystogram in any child < 2 years old with first UTI. Recommendations for imaging in older kids aren't clear cut
• Who do you treat asymptomatic bacteuria in? with what?pregnant patients, pencillins
• Diarrhea then hemolysis?HUS
• URI then hematuria and purpura?HSP
• Treatment for ITP?steroids, IVIG if platelets <30,000 and with sx, splenectomy if drugs fail.
• Repeat stone forming patient?think homocystinuria > increased risk of DVTs.
• How do you prevent hyperuric acid stones?give allopurinol and IV hydration before chemo
• First stem in management of severe symptomatic hypercalcemia?vigorous hydration
• Tuberculosis patient with an acid base disturbance, what is most likely?TB causing primary adrenal insufficiency and therefore not enough aldo, so retaining K and H, so non anion gap metabolic acidosis
• If you suspect obstructive AKI (post renal) what do you do first and why?renal ultrasound to evaluate for hydronephrosis and worsening kidney function
• Imaging modality of choice to confirm kidney stone diagnosis?ultrasound or noncontrast spiral CT scan of the abdomen and pelvis
• Left sided varicoceles that fail to empty. What do you think of?obstruction of venous flow, commonly due to RCC
• ADPKD, first sign prior to decline in renal functionhypertension.
• Dense intramembranous deposits that stain for C3membranoproliferative glomerulonephritis, type II. Due to IgG antibody directed against C3 convertase in alternative complement pathway. Persistent activation
• Renal vein thrombosis is a complication associated with which nephrotic syndrome?membranous glomerulopathy. Loss of antithrombin III in the urine increases thrombosis risk.
• Accelerated atherosclerosis due to hyperlipidemia. Also higher risk of thrombosis ue to loss of AT IIInephrotic syndrome
• Non anion gap metabolic acidosis but preserved kidney function. This type is common in poorly controlled diabetesrenal tubular acidosis (RTA), type 4 (hyperkalemic) is most common with diabetics
• These drugs cause crystal induced kidney injuryacyclovir, ethylene glycol, methotrexate, sulfonamides, protease-i.
• Treatment for platelet dysfunction due to chronic renal failureDDAVP, increases factor 8 release from endothelial storage sites