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21 Cards in this Set
- Front
- Back
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What electrolyte abnormalities are created by NSAIDs?
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hyperkalemia
hyponatremia |
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Normal anion gap is 3-12. What might you suspect if anion gap is unusually low?
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hypoalbuminemia;
"Albumin is a negatively charged protein and its loss from the serum results in the retention of other negatively charged ions such as Chloride and Bicarbonate. As bicarbonate and chloride anions are used to calculate the anion gap, there is a subsequent decrease in the gap." also, multiple myeloma |
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Patient has postobstructive diuresis after a foley is placed, and becomes dehydrated. How do you replace fluids?
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Go slow, and use half normal saline (normal saline will worsen the Na overload that the diuresis is going to cause).
Replace only 2/3 of urinary volume loss per day. |
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Patient has renal failure after eating tainted beef. What should you suspect?
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HUS caused by E coli 0157
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What is the mnemonic for clinical signs of TTP? What about HUS?
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"FAT RN" = TTP
fever, anemia, thrombocytopenia renal failure neurologic signs HUS has the middle letters: ATR (no fever, no neurologic signs) just anemia, thrombocytopenis, renal failure |
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What is the pathophysiology of Bartter's syndrome?
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tubule pathology causes Na loss
this leads to volume loss this causes the R-A-A response, so renin and aldosterone are elevated and there is HYPOkalemia. However, because of the ongoing salt/volume loss, there is no elevation in BP which normally accompanies high renin and aldosterone. |
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What is the acid-base status of Bartter's?
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metabolic alkalosis, chloride resistant
(losing Na+ due to tubule pathology, and losing K+ due to R-A-A activation, so alkalosis) (chloride resistant is not intuitive) |
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How do you diagnose multiple myeloma?
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UPEP - URINE electrophoresis shows IgM spikes
dipstick doesn't detect light chains! a 24 hour protein collection will show high protein though, like 5 grams |
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What blood dyscrasia do you worry about with proteinuria?
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clotting b/c of loss of antithrombin III
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Besides berry aneurysms, what is associated with polycystic kidney disease?
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hepatic cysts
mitral valve prolapse elevated hematocrit |
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Criteria for a MAJOR workup of nephrolithiasis
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1. family hx of stones
2. patient is <25 or >60 3. recurrent stones (>2) |
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What are criteria for referring nephrolithiasis patient to a urologist?
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1. Stone is larger than 5 mm
2. stone hasn't passed in 24 hours |
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Most common type of renal stone
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calcium oxalate
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What size renal and ureteral stone should be treated by lithotripsy?
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5 to10mm - 1cm for ureteral stone
larger than 1 cm, consider percutaneous nephrolithotomy 5 to 10 mm - 2 cm for renal stone larger than 2 cm, consider percutaneous nephrolithotomy 5-10 mm is gray zone, can watch or do lithotripsy |
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What is the #1 cause of GN?
What is the treatment? |
IgA nephropathy
no proven treatment |
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Patient has GN following a URI. How do you know if it's post-strep, or IgA nephropathy?
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timing:
post-strep usually takes 10 days to show up after strep throat, and 21 days after impetigo. IgA nephropathy shows up sooner, 3-5 days after a URI or GI infection. |
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How dangerous is an SLE flair during pregnancy?
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25% fetal mortality
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Mnemonic: indications for dialysis
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AEIOU
acidosis electrolyte abnormalities INTOXICATION --salicylate or glycol poisoning, etc. OVERLOAD (fluid) UREMIA |
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Mnemonic: causes of hyperkalemia
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RHABDO
rhabdo hemolysis Addison's (aldosterone normally retains Na and pees out K) "BAD KIDNEYS" DRUGS (ACEI, K-sparing diuretics) "O" for "hypO" : hyporenin, hypo-aldo |
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In nearly all cases, hypernatremia is due to ? and hyponatremia is due to ?
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hypernatremia: dehydration
hyponatremia: fluid overload |
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Usual treatment of hyponatremia
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fluid restriction if euvolemic or hypervolemic
if HYPOvolemic, use NORMAL SALINE if patient is ASYMPTOMATIC HYPERTONIC saline if patient is SYMPTOMATIC |
