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15 Cards in this Set
- Front
- Back
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What are oxalate crystals?
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They are enveloped-shaped crystals that precipitate in the renal tubules when toxic dose of ethylene glycol, a component of antifreeze, is ingested.
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What is the most accurate test?
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The most specific test for ethylene glycol intoxication is to determine the blood level. Urine can be examined under a fluorescent Wood's light, however urinary fluorescence lasts only a few hours after ingestion. Because the oxalic acid precipitates with calcium, the blood level of calcium is often low.
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When is Ethylene glycole overdoase and oxalate crystals the answer?
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Answer when you see an elevated anion gap and metabolic acidosis. The questio most often describes a depressed patient with a possible attempted suicide. Hypocalcemia can lead to QT prolongation and cardiac arrhythmias. Oxalate crystals deposit in the renal tubules and cause acute tubular necrosis.
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What are Anti-Basement Membrane Antibodies?
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Anti-BM antibodies are indicative of Goodpasture's syndrome.
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When are Anti-Basement Membrane Antibodies the answer?
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Answer anti-BM antibodies when you are shown a patient with hematuria and hypertension, accompanied by cough, shortness of breath, and hemoptysis. Renal insufficiency and red cells or red cells casts in urine are characteristic.
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What is the most accurate diagnostic test for Anti-Basement Membrane Antibodies?
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The most accurate test for Goodpasture's syndrome is a lung or kidney biopsy.
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When do you answer CH50 (Total complement Level)?
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Complement deficiency leads to recurrent bacterial infections. CH50, or the total complement assay, is performed on a young patient with recurrent unexplained infections such as pneumonia, meningitis, sinusitis, etd., with encapsulated organisms such as Neisseria, S. pneumoniae, and H. influenzae. The patient will have normal lymphocyte and immunoglobulin levels. An abnormal CH50 assay indicates inherited or acquired complement deficiency.
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What is Urine Microalbumin?
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Microscopic urine albumin is a sensitive screening test for diabetic nephropathy.
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When do you answer urine microalbumin?
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Look for a case with diabetes for >5 years who have normal renal function and a negative urinalysis for protein. If the dipstick is already positive for albumin, there is no reason to look for microalbuminuria. Screening for microalbumin is done yearly in diabetic patients.
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What is the treatment for urine microalbumin?
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If the test is positive, you use ACE inhibitors or ARBs to prevent progression of the disease.
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What is a positive microalbumin test?
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A negative test for microalbumin is <30mg/day. Levels between 30 and 300 mg/day are called microalbuminuria. Levels above 300 mg would register as positive on the normal urinalysis.
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What is the most accurate test for urine microalbumin?
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The renal biopsy is the only test of the effect of diabetes on the kidney that is more sensitive than microalbuminuria.
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What is Water Deprivation test for?
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What deprivation test allows us to distinguish between teh causes of diabetes insipidus (DI) and to objectively assess patients with hypernatremia and high urine output.
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How is water deprivation test done?
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You restrict water intake for 12-24 hours wiht observation for the volume ofurine, urine osmolality, and change in body weight to evaluate whether the kidneys are conserving or excreting water properly. If the urine volume stays elevated after teh serum osmolality goes up, then it is DI. If there is a decrease in volume in response to giving vasopressin or ADH, then it is central DI. If there is no response, it is a nephrogenic DI.
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When is water deprivation test the answer?
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When you see a case of hypernatremia and high urine output, answer water deprivation test as the best initial test.
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