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53 Cards in this Set

  • Front
  • Back
What drugs cause decreased K secretion?
– trimethoprim, NSAIDS
What drugs cause extracellular shifts
– succinilcholine, digitalis, arginine, B-blockers
Hyperkalemia Sx
– intestinal colic, poor reflexes, weakness
Hyperkalemia EKG
– peaked Ts, long PR and QRS, loss of P
– can progress to sine waves and Vfib
Hypokalemia EKG
– flat T and u waves
– ST depression can lead to AV block
Hypercalcemia and Hypocalcemia EKG
– short QT and long QT
Hypercalcemia Tx
– IV hydration, then furosemide
What can cause hypomagnesemia
– diuretics, hypercalcemia
– amphotercin
– DKA, pancreatitis
What can cause normal anion gap acidosis
– Glue sniffing and hyperchloremia
What can cause metabolic alkaosis
– diuretics (loop and thiazide), antacids, and hyperALD
White cells and eos on urinalysis
– atheroembolic and allergic interstitial
IgA nephropothy
– aka berger’s disease
– young men w/ episodic hematuria
– steroids or ACEI’s (if proteinuria)
– 20% to ESRD
PSGN immuno
– lumpy bumpy w/ low compliment level
Wegener’s
– pauci-immune and c-ANCA
– systemic stuff and more UR stuff, but no asthma like goodpastures
– give high dose steroids and cytotoxic
Goodpastures
– linear deposits and anemia
– do plasma exchange and pulsed steroids
Alport’s syndrome
– boys 5-20 w/ ASx hematuria
– nerve deafness and eye disorders
– need transplant
FSGN
– HIV, IV drugs, and obesity
– young black male w/ uncontrolled hypotension
What nephritic syndromes don’t need steroids and cytotoxic stuff
– diabetic, amyloidosis, and minimal change (just steroids)
Membranous nephropathy
– 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
Lupus nephritis deposition
– subendothelial
Renal amyloidosis
– 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
MPGN
– HCV, lupus, and SBE
– progresses to renal failure w/ tram track
– low serum C3 (only other one besides PSGN
Calcium kidney stones
– alkaline urine
– do hydration and thiazides
Uric Acid kidney stones
– Acidic urine so alkalize w/ citrate or bicarb
– only one radiolucent
Cysteine kidney stones
– COLA cystein, ornithine, lyseine and arginine
– Acidic urine so alkalinize
– can also do hydration and penicillamine
PCKD associations
– diverticulitis, MVP
Type 1 RTA dx and tx
– distal w/ H secretion
– alkaline pH (>5.3)
– tx w/ K citrate
– you worry about stones
Type 2 RTA dx and tx
– proximal HCO3 reabsorption w/ low K
– acidic urine
– tx w/ K citrate
– you worry about rickets and osteomalacia
Type 4 RTA dx and tx
– Distal Ald deficiency w/ acidic urine (rennin is low too!)
– Tx w/ lasix, cortisone, and low K diet
– you worry about hyperkalemia
Type 1 RTA associations
– Amphotercin, chirrhosis, sickle cell, lithium, autoimmune
Type 2 RTA associations
– CA inhibitors, fanconi’s, and MM
Type 4 RTA associations
– DM, HTN, and HIV
What drug besides LI can cause nephrogenic CI
– demeclocycline (so it can be used in SIADH)
Nonseminomatous germ cell testicular cancers
– Pt based therapy
Best way to dx kidney stones
– non-contrast CT
Alkalotic pregnant patient
– if resp, think PE
– if metabolic, think hyperemesis
Winter’s formula
– PaCO2 + 1/5(bicarb) + 8 is how much bicarb should decrease
Who don’t you give metformin to
– renal or hepatic failure, or in sepsis
Hypernatremia tx
– mild gets D5 ½ NS
– severe gets NS
Analgesia nephropathy
– requires several years of abuse
– hematuria from papillary necrosis
When do you do surgery for hyperparathyroidism?
– if < 50, Ca more than 1 over ULN, RF, or osteoporosis
Cl sensitive vs. Cl resistant metabolic alkalosis
– 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
How do NRTI’s cause lactic acidosis
– they mess w/ DNA so mito cant deliver O2 to cells
Hypocalcemia post op
– can occur if lots of transfusions
– will see hyperreflexia
Cyclosporine SE’s
– neprhotox w/ increased K, HTN, gum hypertrophy, hirsutism, and tremor
Tacrolimus SE’s
– same as cyclosporine but no gum hypertrophy or hirsutism
Azathiprine SE’s
– diarrhea, liver tox, and leucopenia
Mycophenolate SE’s
– marrow suppression
How do you help prevent contrast nephropathy
– hydration, isotonic bicarb, and acetylcysteine
Rhabdomyololysis
– RF’s are EtOH, cocaine, low K and P
– Creatinine will be increased way more than BUN
– positive blood but no RBCs
Elderly w/ irrative voiding sx and negative UA
– get cytology and cystoscopy
Medullary cystic disease
– adults w/ recurrent UTI’s or stones
– cysts fill on IVP
Interstitial nephritis drugs
– cephalosporins and penicillins, sulfa, NSIADS, rifampin