Mksap 16 Nephro Part 01

Front 1

When to consider evaluating for secondary causes of HTN? (6)

Back 1

young age, no family history, no risk factors, rapid onset, abrupt change, endocrine abnormality

Front 2

Indications for rasburicase (being that it is more expensive) (2)

Back 2

high risk for tumor lysis syndrome or very high UA levels in chemo

Front 3

NOTE: Plain AXR has no role in

Back 3

the acute diagnosis of kidney stones.

Front 4

NOTE: There is no role for the routine measurement of

Back 4

EPO in CKD.

Front 5

How does GFR relate to creatinine?

Back 5

inversely proportional; 50% reduction in GFR = doubling of serum crea

Front 6

medications that block tubular secretion of creatinine (resulting in higher crea without change in GFR)

Back 6

TMP, cimetidine

Front 7

alternative marker of GFR that is less influenced by age, gender, muscle mass, and body weight compared with serum creatinine

Back 7

cystatin C

Front 8

high urinalysis pH

Back 8

strict vegetarians, distal RTA, urease-splitting organisms (Proteus and Pseudomonas)

Front 9

urine dipstick reads negative or trace for protein but shows increased positivity for protein by the SSA test

Back 9

consider multiple myeloma - presence of urine light chains or Ig not detected by urine dipstick

Front 10

at what serum glucose does glucosuria occur?

Back 10

180-200 mg/dL

Front 11

differential diagnosis for (+) ketones

Back 11

DKA, starvation / alcoholic ketoacidosis; salicylate toxicity, isopropyl alcohol poisoning

Front 12

ketones detected by urinalysis

Back 12

acetoacetate, not B-OH

Front 13

confirms myoglobinuria

Back 13

urine myoglobin levels

Front 14

when is nitrites (+)?

Back 14

GN UTI (Kleb, E. coli, Proteus, Pseudomonas)

Front 15

differentials for (+) urobilinogen in urinalysis

Back 15

hemolytic anemia or hepatic necrosis (NOT obstructive causes)

Front 16

differentials for (+) bilirubin in urinalsysi

Back 16

severe liver disease or obstructive jaundice

Front 17

sterile pyuria differentials

Back 17

M. tuberculosis, AIN, kidney stones, kidney transplant rejection

Front 18

common causes of AIN

Back 18

antibiotics, NSAIDs, PPI

Front 19

differentials for urine eosinophil (+) in urinalysis

Back 19

allergic reaction, atheroembolic disease, RPGN, small vessel vasculitis, UTI, prostatic disease, parasitic infections

Front 20

blood in urine: isomorphic RBCs

Back 20

tumor, stone or infection

Front 21

blood inurine: acanthocytes and RBC casts

Back 21

GN, severe interstitial nephritis, ATN

Front 22

casts in urinalysis

Back 22

hyaline casts - hypovolemia; pigmented granular (muddy brown) casts - tubular injury; RBC casts - GN; WBC casts - tubulointersitial inflammation of kidney, pyelonephritis

Front 23

urine crystal shapes

Back 23

envelope / dumbell / needle (calcium oxalate); prism, needle, star-like clumps (calcium phos); rhomboid / needle / rosette (uric acid); coffin lid (struvite / magnesium ammonium phos); hexagonal - cystine

Front 24

Nephrotic-range proteinuria

Back 24

protein–creatinine ratio greater than 3.5 mg/mg

Front 25

ADA recommendation: when to check urine albumin-crea ratio in DM?

Back 25

typ1DM x 5 years; all type 2 DM at time of diagnosis

Front 26

ADA definition of microalbuminuria

Back 26

urine albumin–creatinine ratio of 30 to 300 mg/g; two of three random samples over 6 months

Front 27

transient proteinuria differentials

Back 27

fever, rigorous exercise

Front 28

proteinuria increases during the day and decreases at night when the patient is recumbent

Back 28

orthostatic proteinuria

Front 29

diagnostic test for orthostatic proteinuria

Back 29

split urine collection

Front 30

imaging used in the evaluation of hematuria

Back 30

CT urography, MR urography, US, IVP

Front 31

which urinary tract imaging to choose in hematuria

Back 31

CT uro for high-risk patients with preserved GFR; MR uro when GFR 30-60; US in <40y/o with no RF for urologic malignancy; noncontrast abd CT if stones suspected; IVP no longer recommended

Front 32

hematuria ffd by negative evaluation of upper urinary tract, next step

Back 32

cystoscopy; assess for lower ureteral, bladder or urethral causes