Boards Renal

Front 1

What drugs cause decreased K secretion?

Back 1

– trimethoprim, NSAIDS

Front 2

What drugs cause extracellular shifts

Back 2

– succinilcholine, digitalis, arginine, B-blockers

Front 3

Hyperkalemia Sx

Back 3

– intestinal colic, poor reflexes, weakness

Front 4

Hyperkalemia EKG

Back 4

– peaked Ts, long PR and QRS, loss of P
– can progress to sine waves and Vfib

Front 5

Hypokalemia EKG

Back 5

– flat T and u waves
– ST depression can lead to AV block

Front 6

Hypercalcemia and Hypocalcemia EKG

Back 6

– short QT and long QT

Front 7

Hypercalcemia Tx

Back 7

– IV hydration, then furosemide

Front 8

What can cause hypomagnesemia

Back 8

– diuretics, hypercalcemia
– amphotercin
– DKA, pancreatitis

Front 9

What can cause normal anion gap acidosis

Back 9

– Glue sniffing and hyperchloremia

Front 10

What can cause metabolic alkaosis

Back 10

– diuretics (loop and thiazide), antacids, and hyperALD

Front 11

White cells and eos on urinalysis

Back 11

– atheroembolic and allergic interstitial

Front 12

IgA nephropothy

Back 12

– aka berger’s disease
– young men w/ episodic hematuria
– steroids or ACEI’s (if proteinuria)
– 20% to ESRD

Front 13

PSGN immuno

Back 13

– lumpy bumpy w/ low compliment level

Front 14

Wegener’s

Back 14

– pauci-immune and c-ANCA
– systemic stuff and more UR stuff, but no asthma like goodpastures
– give high dose steroids and cytotoxic

Front 15

Goodpastures

Back 15

– linear deposits and anemia
– do plasma exchange and pulsed steroids

Front 16

Alport’s syndrome

Back 16

– boys 5-20 w/ ASx hematuria
– nerve deafness and eye disorders
– need transplant

Front 17

FSGN

Back 17

– HIV, IV drugs, and obesity
– young black male w/ uncontrolled hypotension

Front 18

What nephritic syndromes don’t need steroids and cytotoxic stuff

Back 18

– diabetic, amyloidosis, and minimal change (just steroids)

Front 19

Membranous nephropathy

Back 19

– most common, think of tumor if > 60
– HBV, syphilis, malaria, and gold
– can lead to renal vein thrombosis w/ sudden ab pain, fever, and hematuria
– spike and dome immuno

Front 20

Lupus nephritis deposition

Back 20

– subendothelial

Front 21

Renal amyloidosis

Back 21

– 1o is from plasma cells and 2o from infection or inflammation
– RA and TB
– need fat pad bx
– give prednisone and melphalan
– BMT for MM

Front 22

MPGN

Back 22

– HCV, lupus, and SBE
– progresses to renal failure w/ tram track
– low serum C3 (only other one besides PSGN

Front 23

Calcium kidney stones

Back 23

– alkaline urine
– do hydration and thiazides

Front 24

Uric Acid kidney stones

Back 24

– Acidic urine so alkalize w/ citrate or bicarb
– only one radiolucent

Front 25

Cysteine kidney stones

Back 25

– COLA cystein, ornithine, lyseine and arginine
– Acidic urine so alkalinize
– can also do hydration and penicillamine

Front 26

PCKD associations

Back 26

– diverticulitis, MVP

Front 27

Type 1 RTA dx and tx

Back 27

– distal w/ H secretion
– alkaline pH (>5.3)
– tx w/ K citrate
– you worry about stones

Front 28

Type 2 RTA dx and tx

Back 28

– proximal HCO3 reabsorption w/ low K
– acidic urine
– tx w/ K citrate
– you worry about rickets and osteomalacia

Front 29

Type 4 RTA dx and tx

Back 29

– Distal Ald deficiency w/ acidic urine (rennin is low too!)
– Tx w/ lasix, cortisone, and low K diet
– you worry about hyperkalemia

Front 30

Type 1 RTA associations

Back 30

– Amphotercin, chirrhosis, sickle cell, lithium, autoimmune

Front 31

Type 2 RTA associations

Back 31

– CA inhibitors, fanconi’s, and MM

Front 32

Type 4 RTA associations

Back 32

– DM, HTN, and HIV

Front 33

What drug besides LI can cause nephrogenic CI

Back 33

– demeclocycline (so it can be used in SIADH)

Front 34

Nonseminomatous germ cell testicular cancers

Back 34

– Pt based therapy

Front 35

Best way to dx kidney stones

Back 35

– non-contrast CT

Front 36

Alkalotic pregnant patient

Back 36

– if resp, think PE
– if metabolic, think hyperemesis

Front 37

Winter’s formula

Back 37

– PaCO2 + 1/5(bicarb) + 8 is how much bicarb should decrease

Front 38

Who don’t you give metformin to

Back 38

– renal or hepatic failure, or in sepsis

Front 39

Hypernatremia tx

Back 39

– mild gets D5 ½ NS
– severe gets NS

Front 40

Analgesia nephropathy

Back 40

– requires several years of abuse
– hematuria from papillary necrosis

Front 41

When do you do surgery for hyperparathyroidism?

Back 41

– if < 50, Ca more than 1 over ULN, RF, or osteoporosis

Front 42

Cl sensitive vs. Cl resistant metabolic alkalosis

Back 42

– sensitive is w/ urine Cl < 20 and decreased ECFV and is from vomiting or diuretics
– Cl resistant is w/ increased ECFV and is from 1o hyperALD, Barters, and licorice

Front 43

How do NRTI’s cause lactic acidosis

Back 43

– they mess w/ DNA so mito cant deliver O2 to cells

Front 44

Hypocalcemia post op

Back 44

– can occur if lots of transfusions
– will see hyperreflexia

Front 45

Cyclosporine SE’s

Back 45

– neprhotox w/ increased K, HTN, gum hypertrophy, hirsutism, and tremor

Front 46

Tacrolimus SE’s

Back 46

– same as cyclosporine but no gum hypertrophy or hirsutism

Front 47

Azathiprine SE’s

Back 47

– diarrhea, liver tox, and leucopenia

Front 48

Mycophenolate SE’s

Back 48

– marrow suppression

Front 49

How do you help prevent contrast nephropathy

Back 49

– hydration, isotonic bicarb, and acetylcysteine

Front 50

Rhabdomyololysis

Back 50

– RF’s are EtOH, cocaine, low K and P
– Creatinine will be increased way more than BUN
– positive blood but no RBCs

Front 51

Elderly w/ irrative voiding sx and negative UA

Back 51

– get cytology and cystoscopy

Front 52

Medullary cystic disease

Back 52

– adults w/ recurrent UTI’s or stones
– cysts fill on IVP

Front 53

Interstitial nephritis drugs

Back 53

– cephalosporins and penicillins, sulfa, NSIADS, rifampin