Clin Med 5

Front 1

3 or more RBC per high power field
Chromagen stick turns green

Back 1

hematuria

Front 2

Hematuria False positives

Back 2

Myoglobin
Menses
Povidone
Peroxidase
Dehydration
Vitamin C

Front 3

Hematuria False negatives

Back 3

pH < 5.1
Air exposure to dipstick

Front 4

Glomerular causes of hematuria?

Back 4

Ig A nephpropathy
NSAID induced

Front 5

Non-glomerular causes of hematuria?

Back 5

BPH,UTI,Papillary necrosis
Urothelial tumors/stones

Front 6

Found on PE of hematuria pt?

Back 6

HTN,Afib
BP enlargement
Bruits, swelling, masses
Occupational toxicity
Nitrates
UTIs
APCs
Shistosomiasis

Front 7

If Isomorphic RBC or WBC clots are found in urinalysis then?

Back 7

Repeat, if positive = treat
if negative = screening exams

Front 8

What screening exams are used post urinalysis?

Back 8

CBC, electrolyte, PT/PTT
BUN/Creatinine

Front 9

If screening tests are negative then?

Back 9

IVP-asseses anatomy and fxn

Front 10

Risks of IVP usage?

Back 10

Cardiac, renal failures
Allergies
Dehydration
IHOCM reaction
Renal insufficiency

Front 11

If screening labs are positive then?

Back 11

Treat abnormality

Front 12

If IVP finds mass?

Back 12

Ultrasound
Simple cyst = watch
Complex cyst = CT

Front 13

If IVP is negative, contraindicative, or obstruction?

Back 13

Retrograde pyelography if negative BX
positive CT

Front 14

W/u for glomerular dz is?

Back 14

Renal bx

Front 15

2 special considerations for hematuria

Back 15

Coumadin- anticoag
Extreme exercise

Front 16

NL specific gravity level

Back 16

1.007-1.010

Front 17

SG <1.007
Hydrated state
DI

Back 17

Hypothenuria

Front 18

SG fixed at 1.010
Problems with renal tubules

Back 18

Isothenuria

Front 19

SG > 1.010
SG 1.007-1.0010

Back 19

Dehydration
Renal failure

Front 20

SG > 1.035

Back 20

contamination
glucose
dyes

Front 21

NL protein level

Back 21

150

Front 22

3 types of cells seen in proteinuria

Back 22

Bence jones
Albumin
Tamm-Horsfall

Front 23

BJ protien
M-proteins
Inc'd Scalcium
Hyperurcicemia
Recurrent infxn
Rouleax formation

Back 23

Multiple Myeloma

Front 24

NL glucose level
False +
False -

Back 24

130
air exposure
vitamin C

Front 25

Present in ketoacidosis,starvation,ASA toxicity
False -

Back 25

Ketones
Exlax,Ldopa

Front 26

Help detect UTI

Back 26

nitrates

Front 27

Positive with WBC, pyurea

Back 27

Leukocyte esterase

Front 28

Examined under Microscopic urinalysis?

Back 28

WBC,RBC,Lipiduria,Epithelial cells

Front 29

Cast seen in high concentrations, febrile disease

Back 29

Hyaline

Front 30

Cast seen in glomerulonephritis?

Back 30

RBC

Front 31

Cast seen in acute pyelonephritis?

Back 31

WBC

Front 32

Broad, waxy casts are indicative of?

Back 32

CRF

Front 33

Sns of glomerular damage? (5)

Back 33

Dec'd GFr
Protein/hematuria
Edema
HTN

Front 34

Abnl cellular proliferation w.in glomerulus?

Back 34

Proliferative Glomerular DZ

Front 35

Inc'd Glomerular matrix?

Back 35

Mesangial cell glom. dz

Front 36

Membrane thickens and cellular proliferation?

Back 36

Combination glomerular dz

Front 37

1. ONly few glomeruli effected
2. All glomeruli affected
3. Part of glomerulus affected
4. Entire glomerulus affected

Back 37

Focal
Diffuse
Segmental
Global

Front 38

5 clinical presentations of Glomerular DZ?

Back 38

1. asymptomatic
2. acute GN
3. Chronic GN
4. RPGN
5. Nephrotic syndrome

Front 39

Children age 2-6
Nephrotic
Atopic disease
Presents with URI
EM shows foot processes of BM
What?
Tx?

Back 39

Minimal change disease
Steroids
Immunosuppressant(cyclosporine)

Front 40

Adult nephrotic syndrome
Deposition of immunoglobins
Some FP on BM, HIV assoc.
What?
Tx?

Back 40

Focal Segmental GN
Cyclosporine,cyclophosphamide
Transplant

Front 41

Cast seen in acute pyelonephritis?

Back 41

WBC

Front 42

Broad, waxy casts are indicative of?

Back 42

CRF

Front 43

Sns of glomerular damage? (5)

Back 43

Dec'd GFr
Protein/hematuria
Edema
HTN

Front 44

Abnl cellular proliferation w.in glomerulus?

Back 44

Proliferative Glomerular DZ

Front 45

Inc'd Glomerular matrix?

Back 45

Mesangial cell glom. dz

Front 46

Membrane thickens and cellular proliferation?

Back 46

Combination glomerular dz

Front 47

1. ONly few glomeruli effected
2. All glomeruli affected
3. Part of glomerulus affected
4. Entire glomerulus affected

Back 47

Focal
Diffuse
Segmental
Global

Front 48

5 clinical presentations of Glomerular DZ?

Back 48

1. asymptomatic
2. acute GN
3. Chronic GN
4. RPGN
5. Nephrotic syndrome

Front 49

Children age 2-6
Nephrotic
Atopic disease
Presents with URI
EM shows foot processes of BM
What?
Tx?

Back 49

Minimal change disease
Steroids
Immunosuppressant(cyclosporine)

Front 50

Adult nephrotic syndrome
Deposition of immunoglobins
Some FP on BM, HIV assoc.
What?
Tx?

Back 50

Focal Segmental GN
Cyclosporine,cyclophosphamide
Transplant

Front 51

Most common nephrotic in adults.
40-50 y/o males
idiopathic or secondary to infxn, SLE,neoplasm,drugs.
"moth eaten,swiss cheese" BM.
Proteinuria,micro hematuria.
What?
Tx?

Back 51

Membranous GN
Steroids,cytotoxic agents
50% --> ESRD

Front 52

Adult nephrotic.
Young females.
Follows URI
Associated with SLE and cryoglobulinemia
What?
Tx?

Back 52

MEmbranoproliferative GN
Glucocorticoids,cytotoxics

Front 53

Dx: ANA,anti-dsDNA present.
becomes focal/diffuse lupus nephritis.
malar rash.

Back 53

Membranoproliferative GN with SLE association

Front 54

Most common GN
Young men, macro. hematuria.
IgA deposition.
What?
Tx?

Back 54

IgA nephropathy
ESRD, transplant, but transplant will get ig A

Front 55

School aged children.
Post Group B hemolytic strep infxn or CMV
Deposition of C3.
What?
Tx?

Back 55

Diffuse proliferative GN
Treat HTN,fluid overload

Front 56

Dx: ASO titer
CH50,CH3 measures low

Back 56

Diffuse proliferatie GN

Front 57

Major Causes of SBE

Back 57

1. native (congential,rheumatic fever, calcinosis)mitral valve prolase
2. prosthetic
3. IV drug users

Front 58

Bacterial causes of SBE

Back 58

Staph aureus, Strep viridins, Staph epidermis

Front 59

Endogenous routes to get SBE

Back 59

Tooth work, GI endoscopies,GU(TURP), catheters

Front 60

Sns of SBE

Back 60

night sweat, anorexia,fatigue,weight loss
Inc'd ESR,WBC
RF factor

Front 61

Tx:SBE

Back 61

abiotics
nafcillin and aminoglycoside

Front 62

DX:SBE

Back 62

Blood culture

Front 63

Middle age men
Triad of Dyspnea,Illness,Glomerulonephritis.
Nasal perforation.
Granulomas in kidney by necrotizing vasculitis.
What?
Tx?

Back 63

Wegners Granulomatosis
Steroids(prednisone)
Cyclophosphamide

Front 64

Dx: ANCA

Back 64

Wegners Granulomatosis

Front 65

Children under 10
Pinpoint purpuric rash
Nephrotic sns
What?
Tx?

Back 65

Henoch-Schonlein
Self-limited

Front 66

Dx: renal biopsy looks like Ig A nephropathy

Back 66

Henoch schonlein

Front 67

Crescent shaped macrophages accumulate.
Affects lungs = hemoptysis,dyspnea.
W/u includes chest xray,PFT,pulse ox,bx.
What?
TX?

Back 67

Goodpastures/Crescentric GN
Plasmapheresis
Steroids, immunosuppressant

Front 68

Dx: anti-GBM

Back 68

Goodpastures

Front 69

Precipates in cold weather.
Purpuric rash, Hep c. associateion.
Peripheral neuropathy.
What>
Tx?

Back 69

Cryoglobulinemia
Plasmapharesis

Front 70

Crescentric macrophage build up.
L/t alveoli hemorrhages.
Antibodies against kidney and lung, reacts against basement membrane.
Hemoptysis
What?
Tx?

Back 70

Goodpastures
Plasmapheresis
Steroids,cyclosporine

Front 71

Dx:Anti-GBM

Back 71

Goodpastures

Front 72

Peripheral neuropathy
Arthralgia
Purpuric vascular rash
What?
Tx?

Back 72

Cryoglobulinemia
Plasmapheresis

Front 73

Pt post surgery,trauma,burn,or drug toxicity.
Sns:oliguria,sudden dec'd GFR
What?
Tx?

Back 73

ARF
Tx underlying,electrolyte balance, volume stats, monitor CO, Hg, ventilation,caloric intake.

Front 74

Most common cause of ARF

Back 74

Pre-renal

Front 75

Associated with Pre-renal causes of ARF

Back 75

dec'd volume
(GI/blood loss,dehydration,diuresis)
inc'd vasodilation (sepsis,anti-htn)
inc'd renal resistance(surgery)
cardiac conditions
prostaglandin inhibition

Front 76

Associated with Post-renal causes of ARF

Back 76

Obstructions

Front 77

Associated with Intrinisic causes of ARF?

Back 77

NSAIDS,HUS, TTP

Front 78

Most common cause of ARF in children
E.coli associated with diarrhea/UTI.
Eating undercooked meat.
Shistocytes,
WHAT?>
Tx?

Back 78

Hemolytic uremic syndrome
hydration,plasma exchange

Front 79

Adult cause of ARF.
Associated with platlet congregation and causing microthrombi.
Shistocytes.
What?
Tx?

Back 79

Thrombocytopenia purpura
Hydration,plasma exchange

Front 80

Tests for ARF:

Back 80

Blood,Urine,U/s,doppler,immuno, bx

Front 81

Pt has gross hematura and oliguria.

Back 81

GN

Front 82

Pt has hemoptysis and ARF

Back 82

Good pastures

Front 83

Throat infxn and ARF

Back 83

Post-infectious GN

Front 84

Pt with urinary freq, noctura,poor urinary stream, hesistancy in urination, dribbling.

Back 84

BPH = post renal disease

Front 85

Hematuria with ARF

Back 85

Rhabdomyolysis

Front 86

Loss of nephrons = ESRD

Back 86

Chronic renal failure

Front 87

35-50% dec'd GFR(60)
S/s underlying disease

Back 87

Stage 1 CRF

Front 88

30-35% dec'd GFR (20-50)
Bun>20
Creatinine > 1.5
PCP finds
Renal insufficiency

Back 88

Stage 2 CRF

Front 89

20-25% dec'd GFR (20)
Bun > 20
Creatinine > 5
Renal failure
Metabolic acidosis, everything associated with renal failure

Back 89

Stage 3 CRF

Front 90

<20% dec'd GFR (<20)
Creatinine>8
Uremia,ESRD
Dialysis/transplant

Back 90

Stage 4 CRF

Front 91

Hypocalemia,dec'd Vit.D
Hyperphosphatemia
Fluid overload - edema
Metabolic acidosis
N/v, anemia,anorexia
Polyuria
Concentrated urine

Back 91

Stage3 and 4 CRF

Front 92

UOsm - >500
UNa - <10
FEna- <1
Cast - Hyaline

Back 92

Pre-renal failure

Front 93

Uosm < 250
Una - >20
Fena >1
Cast - Brown,granular

Back 93

Post-renal failure

Front 94

Cardiac Rub
Uremic Frost
Asterexis
Uremic factor

Back 94

Uremic syndrome

Front 95

Most common cause of Uremia

Back 95

Diabetes

Front 96

Restricted diet
Hypervolemia
Control BP
Erythropoeitin inj.
Monitor albumin
Dialysis
Transplant - best

Back 96

Control/Tx CRF

Front 97

Autosomal dominant
Multiple cysts in kidney
Inc'd ICp
C/o pain in flank area with hematuria
MGA used to DX

Back 97

Polycystic kidney
TX:dialysis/transplant

Front 98

Microalbuminurea
What?;
Tx:

Back 98

diabetes associated kidney disease
ACE-I
control sugar levels

Front 99

REgulated by ADH.
Control of sodium excretion.
Angiotensin 2,ADH,renin, work together with feedback to control fluids.

Back 99

Electroylytes control

Front 100

Lo NA level.
Edema,delerium,muscle cramps,dec'd DTR,seizures
Seen in burn pts.
What?

Back 100

Hyponatremia
REstrict fluids
Sodium replacement if needed

Front 101

High Na
water level low, DI
Aldosterone mechanisms
Pt is irritable, twitching, spastic
What?
Tx:

Back 101

Hypernatremia
Water replacement

Front 102

Low K
Loss from gut
Hyperaldosterone,loop diuretics
Vomiting
MI
Insulin overdose,Mg depletion,digitalis tox.
Pt has muscle weakness,contstipation.
What?
TX:

Back 102

Hypokalemia
Oral K or Iv KCL

Front 103

Inc'd K
Diabetic ketoacidosis,rhabdomyolysis,metabolic syndrome, low aldosterone
What?.
Tx:

Back 103

Hyperkalemia
Insulin,diuretics,hydration

Front 104

Sns:right testicular enlargement,hematuria,lose weight,nightsweats, anemia,myosisitis, polyneuritis.

Back 104

Renal cancer

Front 105

CHildhood cancer
Abdominal mass
Genitourinary malformation.
Mental retardation.
What?
Tx?

Back 105

Wilms tumor
Nephrectomy, chemo