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34 Cards in this Set

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Best initial test in nephrology
-Urianalysis
and others
Blood urea
Creatinine
long-term microalbuminuria the to worsening
renal function
Test to detect eosinophils in the urine, for allergic interstial nephritis
Wrigth and Hansel tests
Are Bence-Jones detectable on urine dipstick?
No, use immunoelectrophoresis
Most accurate test for renal stones?
Renal CT
What you should think when you see "dysmorphic" red cells?
Glomerolonephritis
When is Cytoscopy the answer?
-Hematuria without infection or prior trauma.
-Renal US or CT doesn't show an etiology.
-Bladder sonography shows a mass for possible biopsy
Red cell Cast
White cell
Eosipnophil
Hyaline
Glomerulonephritis
Pyelonephritis
Acute allergic interstitial nephritis
Dehydration
Broad, waxy cast
Granular "muddy-brown"
Chronic renal disease
Acute tubular necrosis
Acute Kidney Injury
Best initial test?
Best initial imaging test?
1-BUN and Creatinine
2-Renal Sonogram
Tests for AKI of unclear Etiology?
-Urianalysis
-Urine SOdium(UNa)
-Fractional excretion of Na(FeNA)
-Urine osmolalty
"always go with urianalysis first"
Best initial test to confirm Rhabdomyolysis?
The most specific test?
Electrolytes abnormality?
Treatment?
-Uroanalysis
-Urine test for myoglobulin
-Hypocalcemia, Hyperkalimia
-Saline, Mannitol, Bicarbonate
Why doesn't hemolysis cause hyperurecemia?
RBC's have no nuclei
When Dialysis is the answer in ATN?
Fluid Overload
Encephalopathy
Pericarditis
Metabolic Acidosis
Hyperkalemia
Hepatorenal Syndrome treatment?
Lab values fit with?
ALbumin
Midodrine
Octreotide

-Prerenal Azotemia
Atheroemboli
Definition?
Most accurate test?
1-Cholesterol emboli lodge in the kidney leading AKI(during catheter procedures)
2- Biopsy of one of the purplish skin lesion(Cholesterol crystals)
Acute Allergic Interstial Nephritis
Presentation?
Most Accurate Test?
1- Fever, Rash, Asthralgias, Eosinophilia(80%).
2- Hansel or Wright stain
Papillary Necrosis
Best initial test?
The Most accurate test?
Urianalysis
CT scan
Goodpasture Syndrome
Best initial test?
Most Accurate test?
Treatment?
1- Antigloemrular basement membrane antibodies.
2- Lung or Kidney biopsy
3- Plasmapheresis and steroids
IgA Nephropathy(berguer DIsease)
Most common cause of?
Most accurate test?
Protein levels correspond with what?
Tx?
1- Acute glomerulonephritis
2- Kidney biopsy
3- Severity of disease and likehood of progression( more proteinuria= worse progression)
4-Severe proteinuria tx with ACEi and stereoids
Postinfectious Glomerulonephritis
Inital test?
Most accurate?
1- Uroanalysis
2- Biopsy(should not rutenely do, because the blood is enough).
Polyarteritis Nodosa
Test?
Most accurate tests?
1- ANgiogrpahy of the renal , mesenteric or hepatic artery showing anuerismal dilation.
2- biopsy of a symptomatic site such as skin, nerves, or muscles.
Lupus Nephritis
Most accurate test?
treatment?
Biopsy, is indiscipable in determining therapy.
Mild: Glucocorticoids
Severe: Glucocorticoids+ cyclophosphamide or mycophenolate
Amyloidosis
MAT?
Tx?
-Biopsy(green birefringend with Congo red staining)
-Melphalan and Prednisone
Nephrotic syndrome
BIT?
MAT?
Tx?
1-UA(maltesse corsses lipid deposists)
2- Renal biopsy
3-Glucocorticoids, Cyclophosphamaide(if not), ACEi( control proteuniria)
Statins(hyperlipidemia)
What you have to avoid in TTP or HUS?
Plaletler transfusions
Hypernatremia etiology?
Sweating
Burns
Fever
Hyperventilation
Diarrhea
Diuretics
Hyponatremia etiology?
Hypervolemic state:
CHF
Nephrotic syndrome
Cirrhosis
Hypovolemia( if there is chronic replacemnt with free water(no Na))
Sweating
Burns
Fever
Pneumonia
DIarrhea
Causes of pseudohyperkalemia?
Hemolysis
Repeated fist cleching with tourniquet in place
Thrombocytocytosis or leukocytosis( will leak out on labs)
Causes of hyperkalemia?
Renal failure
Aldosterone decrease
ACEi
Tissue destriction
Heparin
Most urgent test in severe hyperkalemia?
an EKG
When there is hyperkalemia and anormal EKG, the Most appropiate next step?
Calcium chloride or gluconate
Hypokalemia GI ways?
Vomiting
Diarrhea
Laxative
Also hypomagnesimia causes
Best initial therapy in HTN?
Thiazide diuretics