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20 Cards in this Set
- Front
- Back
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What are the three Cs of nephrotoxicity?
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cisplatin: causes RTA type 4, or ATN
cyclophosphamide: hemorrhagic cystitis cyclosporine: causes hypertension, hyperkalemia, hyperuricemia, RTA type 4 |
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Nephritic syndrome signs
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HEMATURIA
proteinuria RBC casts |
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Nephrotic syndrome signs
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high proteinuria
edema (from protein loss) HYPERLIPIDEMIA |
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Patient has proteinuria. What is workup?
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1. 24 hour protein (or protein/Cr ratio)?
--this is to see if it's nephrotic 2. if < 3 g, check UPEP. 3. if > 3 g, look for cause in history (infx, drugs, allergic rxn, neoplasm, renal dz) -- if no cause, get renal biopsy |
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general formula for renal clearance of something
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urine x / plasma x
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When would you expect contrast nephropathy to show?
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24-48 hours after injection, peaks at 3-5 days
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Risk factors for NSAID induced ARF
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pre-existing renal insufficiency (duh)
volume depletion, watch hypotension, diuretics relative volume depletion (CHF, cirrhosis, nephrosis) ADVANCED AGE generally |
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Risk factors for contrast induced ARF
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NSAID risk factors, + 4 others
NSAID: pre-existing renal insufficiency (duh) volume depletion, watch hypotension, diuretics relative volume depletion (CHF, cirrhosis, nephrosis) ADVANCED AGE generally 3 others: DM, esp with azotemia large contrast load, including multiple exposures MULTIPLE MYELOMA with dehydration |
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What is the colony count for bacteriuria?
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1,000 for UNCOMPLICATED UTI or acute pyelo
100,000 for asymp. bacteriuria or COMPLICATED UTI |
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Uncomplicated UTIs are usually treated for ? days
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3
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Complicated UTIs are usually treated for ? days
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7-14
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UTI in pregnant or diabetic woman is treated for ? days
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7
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Suppose patient is oliguric, urine sodium is > 20 and FeNa is < 1. What should you consider?
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renal ultrasound to rule out obstructive
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Phospate levels < 1. What should you do?
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Panic! This is a life-threatening emergency because muscle weakness can lead to respiratory failure or heart failure. Hemolysis or rhabdo, thus ARF, can also develop.
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Supplements to consider in CRF
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BCDE
bicarbonate calcium vitamin D ERYTHROPOETIN |
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RBC casts can be caused by acute GN or ?
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malignant HTN
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WBC casts can be caused by pyelo or ?
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interstitial nephritis
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Fatty casts might be found in ?
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nephrotic syndrome
oval fat bodies, "Maltese cross" |
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Waxy casts might be found in ?
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Chronic renal failure
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Patient has WBC casts on UA. How would you distinguish interstitial nephritis from pyelo with more labs?
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1. urine eosinophils - IN
2. WBCs as well as casts - IN |
