Im Renal Crf, Rta, Stones Usmle 2

Front 1

Retention of what (3) things causes anion gap increase w/ CRF?

Back 1

Phosphates

H+

Sulfates

Hint 1

PHS

Front 2

what does the ultrasound show w/:
1. CRF
2. Diabetes
3. Amyloidosis
4. Poylcyctic Kidney Dz

Back 2

1. shrunken kidneys

2 - 4. Enlarged kidneys

Front 3

What (3) endocrine functions are lost w/ CRF?

what is the result of each on the patient?

Back 3

Synthesis of:
1. Vitamin D - hypocalcemia;

2. Ammonia - anion-gap met acidosis;

3. Erythropoietin - anemia

Front 4

Tx for Chronic renal failure
(3)

Back 4

ACEi;

low-protein diet;

Dialysis

Front 5

Dx:
pale complexion, wasting, purpura, N/V, itching, tubular casts in urine

Back 5

Uremic syndrome

Front 6

Waxy casts in urine

Back 6

Chronic Renal Failure

Front 7

CNS problems from Uremia
(5)

Back 7

Foot drop;
Carpal tunnel;
Clonus;
Asterixis;
Seziures

Front 8

Cardiac / Pulmonary problems from Uremia
(5)

Back 8

HTN;
Pericarditis;
Valve calcification;
Pulmonary edema;
Pulmonary effusions

Front 9

Hematologic problems from Uremia
(3)

Back 9

Normochromic, normocytic anemia;
Low platelet function (prolonged bleeding time);
low WBC - increased infections

Front 10

(2) metabolic problems from Uremia

Back 10

High triglyerides;

Insulin resistance

Front 11

Dx:
Inability for kidney to concentrate urine
(stays fixed w/ specific gravity = 1.010)

Back 11

Isostheuria

Front 12

Dx:
enlarged kidneys w/ multiple cysts presenting in mid 30's to 40's w/ flank pain

what can it lead to?

Back 12

ADPKD

Berry aneurysms

Front 13

Dx:
Metabolic acidosis w/ normal anion gap

Back 13

Renal Tubular Acidosis

Front 14

Renal Tubular Acidosis Type I:
1. Defect
2. bicarb level
3. Urine pH
4. Plasma K
5. where in kidney

Back 14

1. H+ secretion causing Acidosis
2. Low
3. pH > 5.3
4. Low
5. DT defect

Front 15

Renal Tubular Acidosis Type II:
1. Defect
2. bicarb level
3. Urine pH
4. Plasma K
5. where in kidney

Back 15

1. Dec. Bicarb reabsorp
2. 12 - 20
3. pH > 5.3
4. Low - normal
5. PCT defect

Front 16

Renal Tubular Acidosis Type IV:
1. Defect
2. bicarb level
3. Urine pH
4. Plasma K
5. where in kidney

Back 16

1. Decreased Aldosterone
2. > 17
3. pH < 5.3*
4. High*
5. DT

Front 17

Etiology of Renal Tubular Acidosis Type I
(4)

Back 17

Lithium;

Amphotericin B;

SLE;

Sarcoidosis

Hint 17

LASS

Front 18

Etiology of Renal Tubular Acidosis Type II
(3)

Back 18

Heavy Metals;

Acetazolamide;

Multiple myeloma

Hint 18

HAM

Front 19

Etiology of Renal Tubular Acidosis Type IV
(3)

Back 19

Renal transplant;

Obstructive uropathy;

Diabetic nephropathy;

Hint 19

causes a 4" ROD

Front 20

Dx:
Radiopaque stone seen in inflammatory bowel diseases, decreased citrate & uricourea

Tx?

Back 20

Calcium Oxalate stone

Tx:
Thiazides

Front 21

Dx:
moderately readiopaque stone common in Proteus or staph Saprophyticus UTI due to high urinary pH

Tx?

Back 21

Struvite (ammonium, magnesium, phosphate) stone

Tx:
lower urine pH

Front 22

Dx:
Radiolucent stone caused by myeloproliferative diseases and gout

Tx?

Back 22

Uric Acid stone

Tx:
raise urine pH

Front 23

Dx:
moderately radiopague stone that has hexagonal crystals and is positively birefringent
What congenital disorder is cause?

Tx?

Back 23

Cystine Stones

Disorder:
Cystinuria

Tx:
raise urine pH

Front 24

Dx:
39-yo man w/ severe back pain and hematuria, nausea and unable to find a comfortable position.

Back 24

Renal stone
(Urolithiasis)

Front 25

Dx:
sudden HTN w/ low K+

How do you do a screening Dx?

Tx?

Back 25

Renal artery stenosis

give oral captopril to induce increase of renin

Tx: surgery or angioplasty

Front 26

Etiology of renal artery stenosis
(2)

Back 26

Plaque

Fibromuscular dysplasia

Front 27

Dx:
hematuria, palpable mass, flank pain, fever, secondary polycythemia

Back 27

Renal Cell Tumor

Front 28

MC person to get Renal cell CA

Where does it disseminate to?

Tx? (2)

Back 28

50-70 yo Male smoker

moves to:
Renal veins and Vena cava

Tx:
resection
IL-2 immunotherapy

Front 29

(3) causes of Ketones in the urine

Back 29

1. DKA

2. Alcohol intox

3. starvation

Hint 29

SAD

Front 30

What does Nitrite in urine indicate?

Back 30

Gram negative rods

Front 31

What does a positive Leukocyte esterase in urine indicate?

Back 31

White cells and infection

Front 32

What do eosinophils in the urine indicate?

Back 32

Allergic Interstitial Nephritis

Front 33

What do Squamous cells in the urine indicate?

Back 33

contaminated specimen

Front 34

What does Bilirubin in the urine indicate?

Back 34

Extravascular hemolysis

Front 35

What does Hemoglobin in the urine indicate?

Back 35

Intravascular hemolysis

Front 36

What do Hyaline casts in the urine indicate?

Back 36

Pre-renal azotemia