Lisa Nephro 2- Ucla 13

Front 1

list % of dehyd for mild, mod, severe for infant vs child?

Back 1

infant: 5, 10, 15%
child: 3,6,9 %

Front 2

poor skin turgor, sunken fontanel, lack of tears, lethargy, taccy ? how much dehyd?

Back 2

mild; infant: 5%; child 3%

Front 3

orthostatic hyptn, sign tacy, oliguria, deepeneing lethargy? how much dehyd

Back 3

moderate

Front 4

shock w/ dehyd; how much dehyd?

Back 4

severe

Front 5

FeNA < 1 % or (2.5% in NB) is what?

Back 5

dehydration; renal Na conservation;
-kidney compensates by reabsorbing Na

Front 6

% FeNa =

Back 6

urine Na/plasma Na // urine Cr / plasma Cr x 100
= urine na/plasma Na x plasma cr/ urine cr x 100

Front 7

? how much basal caloric expenditure for every degree > 37.8?

Back 7

add 12 % extra

Front 8

how calc fliuds in 24 hour?

Back 8

4/2/1:
10/10/next; then x 24 hours

Front 9

BSA: ? ml/m2/24 hours;
Na? mEq / m2 / 24 hrs
K ? meQ/ m2 / 24 hrs

Back 9

BSA: 1500 ml/m2/24 hours;
Na 30-50 mEq / m2 / 24 hrs
K 20-40 meQ/ m2 / 24 hrs

Front 10

? correction of deficits:

Back 10

bolus 20/kg
-mainteince + ongoing losses
-volume repletion: give first 50% in first 8 hrs, remainder in next 16 hrs

Front 11

ORS: for mild vs moderate? vs severe?

Back 11

5-10 cc q 5-10 min;
Mild: 50 cc/kg/ x 4 hrs;
Mod: 100 cc/kg over 4 hrs;
not effect in severe dehydration: shock, obtundation; > 10 cc/k/hr

Front 12

calc serum osmolality?

Back 12

N x 2 + K x 2 + glucse/18 + BUN/ 3;
NL ~ 290-300; serum Na major player

Front 13

head trauma, pituatary infarction/ tumors leads to ? that causes hypernatremia

Back 13

Central DI

Front 14

hypernetremia, boys; inheritance?

Back 14

nephrogenic DI; loss of V2 receptor activity

Front 15

low water intake, water los, inapp salt poison; leads to hi NA ~ also associated w/ other cause?

Back 15

inapp prepared formula

Front 16

hypernatremia in baby being Breast fed is due to what?

Back 16

CF in mom; mastitis

Front 17

Irritable, high pitched cry, doughy skin texture, convulsions; stupor paralysis, CNS damage;
-death

Back 17

signs of hypernatremia

Front 18

if Na < 170 , how fast correct vs > 170?

Back 18

< 170, correct over 48 hours;
> 170: correct over 3 days (reduce by 15 mEq/ day)

Front 19

kids look more hydrated; taccy, low BP may present w/ o w/o dehdyration
-Neuro: Ha, obtundation, coma, status, cerebral edema, herniation;

Back 19

hyponatremia;
-rapid correction: central pontene myelinolysis

Front 20

Na < 130; Posm < 280, urine that is not m aximally dilute U osm > P osm; but normal renal fxn
-? causes

Back 20

SIADH:
causes: cns diz, pulm diz, surgery, N/V/pain, stress

Front 21

Normal Urine osm

Back 21

nl urine osm >> 290; if

Front 22

SIADH tx?

Back 22

3 % saline if severe (Na < 120;
-otherwise fliud restriction

Front 23

? causes Hi ADH: drugs?

Back 23

cytoxan, vincristine

Front 24

6 yo w/ abd pain, vomiting, confused;
Lytes: 125/5/93/7 20/1/ gluc 900;
serum osm (317)
urine osm 600

Back 24

DM w/ Pseudohyponatremia;
-hi glucose can contribute to hypnoatremia

low na,

Front 25

6 yo w/ abd pain, vomiting, confused

122/3.6/93/22/10/0.6 glc 100
serum osm: 260; urine osm 350

Back 25

SIADH: vomiting or CNS process

Front 26

low aldo, hi K ; which type of RTA? ; -what meds also cause low aldo?

Back 26

type 4;
ACE I
-NSAIDS;

Front 27

normal or hi aldo w/ renal tubular unresponsive to mineralcorticoids

Back 27

obstructive uropathy, Sickle cell SLE

Front 28

? peaked T waves, long PR, wide QRS; ST depression due to what? treatment?

Back 28

hi K;
1) IV calcium gluconate (protect heart)
2); sodium bicarb: correct acidosis;
3)insulin, dextrose;
albuterol
Lasix: renal K wasting

Front 29

T wave flattening, constipation; weakness, cramps, rhabdo:

Back 29

hypokalemia;

Front 30

alkalosis and hypokalemia ~ ?

Back 30

vomiting

Front 31

hypokalemia and acidosis,

Back 31

diarrhea

Front 32

12 wt loss P 80/30;
bmp: 140/6/120/10/10/0.6:
next step?

Back 32

Adrenal insufficiency (addison's): no aldo--> hi renin: low BP, hi K
-next: serum renin (should be high and aldo should be low
-tan ( no melanin)

Front 33

12 yo wt loss, short, anemia, bp: 80/30
bmp: 140/6/120/10/75/5.2
cause?

Back 33

Chronic kidney disease: afects bone/blood

Front 34

1) low bicarb, low PcO2:
2) Hi bicarb, hi PCO2
3) hi pCO2, HI bicarb: causes?
4) low pCO2, low bicarb?

Back 34

1) met acidosis
2) met alkalosis: ~ hypokalemia; w/u: check Urin CL
3) resp acidosis
4) resp alkalosis

Front 35

urin Cl and BP: ? for metab alkalosis?

Back 35

Nl urine cl: (> 15);
1) - if urine cl < 15 w/ nL BP: Pyloric stenosis, CF;
2) urine cl > 15: renal cause or lasix;

Front 36

? hypercalciuria/nephorcalcinosis; hearing loss;
what's causes and acid/base disturbance

Back 36

loop duirteics; metab alkalosis

Front 37

polyhydramnios in utero; hypercalcuria; +/- hearing loss; hi urine cl

Back 37

barter's; looks like person on loop diuretics

Front 38

alkalotic, hypertensive, hi urine cL, ;
-low renin/low aldo:

Back 38

Liddle

Front 39

alkalotic, hypertensive, hi urine cL,
-ambig genitalia; ? most common kind and inheritence?

Back 39

CAH (11) ~ HTN; most common is 21

Front 40

hi renin/high aldo; alkalotic, hypertensive, hi urine cL,

Back 40

RAS

Front 41

cal AG?

Back 41

Na - (cl + HCO3)
NL 9-12

Front 42

name + AG met acidosis:
-what are most common?

Back 42

Methanol
Uremia
DKA***
Paraldehyde
Isoniazide/iron
lactic acidosis*** dehydration/sepsis an
ethylene glycol~ anti freeze
salicylates~ metabolic acidosis/resp alkalosis

Front 43

Most common cause of non-gap acidosis? *** boards

Back 43

GI losses - diarrhea, fistulas,
-RTA

Front 44

HTN, hi urine cl, low renin/high aldo?

Back 44

aldosterone escess

Front 45

5 wk, bp 70/30;
bmp: 128/2.8/82/35 10/0.6 glc 100;
BG: 7.5/45
urine Cl 75
Urine ca/cr: 1

Back 45

Barter's syndrome ( not CF - kidney would hold on Cl)
alkalotic; pcO2; hi bicarb: metabl alkalosis
hypokalemia; hi ur ca/cr ratio (nl < 0.2);
hi urine cl (nl 15)

Front 46

hyperchloremia
hypokalemia
Non gap acidosis
short,
nephrocalcinois + rickets

Back 46

RTA:

Front 47

? urine anion gap:?

Back 47

urine (na + K) - Cl;
type I: gap +
type II: gap neg

Front 48

proximal form, wasting bicarb in prox tubule; decreased threshold; distal tube can secrete H;
-aciditic urine; ; urine pH < 5.5; neg urine AG; low K
-

Back 48

type II

Front 49

low aldo: hihg K; urine Ph > 5.5

Back 49

type IV

Front 50

low K, urine pH > 5.5; urine AG: 0 to +

Back 50

distal I RTA

Front 51

sensorineural deafness, rickets, nephrocalcinosis/hi ur ca/cr ratio? RTA?

Back 51

type I distal hypkalemic

Front 52

which RTA ~ fanconi's syndrome, renal wasting phosphate, aa, bicarb; urate, glucose (cystinosis); rickets?

Back 52

type II (proximal)

Front 53

which RTA ~ hypoaldosteronism, addison's renal resistance to aldo; obstructive uropathy?

Back 53

type IV (distal hyperkalemic)