• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/12

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

12 Cards in this Set

  • Front
  • Back
POM III - Renal - AIDS & the Kidney
POM III - Renal - AIDS & the Kidney
What are the 6 cond'ns we are going to talk about concerning AIDs & the Kidney?
1. HIV-assoc nephropathy
2. Coincidental renal disorders
3. Acute Renal Failure in HIV
4. Rhabdomyolysis
5. Glomerular Syndromes
6. Crystalluria Syndromes & HIV
AIDs & The Kidney -
HIV Assoc Nephropathy

1. What is the MC form of kidney dz found in HIV infected ppl?
A. Describe the pathogenesis of HIV AN?
1. HIV assoc nephropathy
A. Direct infxn of renal cells w/ HIV
AIDs & The Kidney -
HIV Assoc Nephropathy

1. Describe 3 aspects of the Hx & Sx of pts w/ HIV AN?

2. Describe 1 aspects of the PE in an HIV AN pt?

3. Labs & Imaging in an HIV AN pt:
A. Describe the lab value of PRO in HIV AN
B. How do you make a definitive Dx in HIV AN?
C. Describe the appearance of the kidneys in pts w/ HIV AN?
D. WHAT IS THE CHARACTERISTIC PATHOLOGIC FINDING IN HIV AN PTS?
E. Describe Ab findings in pts w/ HIV AN?
F. Describe the CD4 count in an HIV AN pt?
G. Describe the urinary sediment in an HIV AN pt?
1. HIV AN presents late in course of HIV;
HIV AN presents w/ significant renal dysfnctn;
HIV AN occurs in pts w/ poorly CTL'ed HIV

2. NO significant edema or HTN

3.
A. Nephrotic range PRO;
B. Biopsy
C. Large, echogenic kidneys
D. Collapsing focal segmental glomerular sclerosis w/ podocyte hypertrophy
E. False Positives for Auto-Abs:
ANA, RF, ANCA, anticardiolipin
F. Low CD-4 ct
G. Bland
AIDs & The Kidney -
HIV Assoc Nephropathy

1. HIVAN Epidemiology
A. HIVAN is found almost EXCLUSIVELY IN WHAT POPULATION!?!?!?!?
B. In one study, 71% of HIV pts had HIVAN if what?
C. For African Americans, HIVAN is the ________ of ESRD?!?!?!?!?
D. OK, so we've already established that HIVAN is much more likely to occur in young black men. But WHAT % OF ALL CASES OF ESRD DUE TO HIV OCCUR IN BLACKS!?!?!?!?
1.
A. African Americans!!!!!!!!
B. If they had > 1.5 gms urinary PRO
C. 3rd MCC of ESRD!?!?!?!?!?
D. 90%
AIDs & The Kidney -
HIV Assoc Nephropathy

1. Prognosis
A. Prior to HAART, HIV AN pts progressed to ESRD how quickly?
B. RF for bad prognosis in HIV AN?
C. What is associated w/ a Striking inc in mortality in HIVAN pts?
1.
A. wks to mos
B. Low CD4;
Inc SCr @ presentation;
HCV co-infxn;
High HIV (RNA) levels
C. Kidney dz
AIDs & The Kidney -
HIV Assoc Nephropathy

1. HIVAN Tx
A. What is 1st line tx for HIVAN?
B. What is a reasonable 1st line Rx fro HTN in HIVAN pts and why?
C. What is 2nd line tx for HIVAN pts who are failing HAART Tx and TF having deteriorating renal fnctn?
D. 2 Tx for ESRD in HIVAN pts?
1.
A. HAART
B. ACE-Inhibs, bc they may curb progression of the dz
C. Steroids
D. Dialysis & Kidney Transplant
AIDS & the Kidney -
Coincidental renal disorders -
Infxn & Infiltrative Lesions of the Kidney

1.
A. What types of pts usually get infxn & infiltrative lesions of the kidney?
B. Amyloidosis is assoc w/ what 3 pt pops who have HIV? In these pts what is found in the urine?
1.
A. AIDS, not HIV!
B. HIV +
Suppurative skin infxns,
Drug addicts who are skin poppers,
Secondary to Multiple Myeloma.
Massive PROteinuria
AIDS & the Kidney -
Coincidental renal disorders -
Infxn & Infiltrative Lesions of the Kidney

***NOTE: Their's a PPT slide w/ a chart on it -
But DeLeeuw said to focus on the infiltrative dz'es (but note, he's not writing the questions for this lecture)

Infiltrative lesions of the kidney that occur in HIV listed:
LYMPHOMA
AMYLOIDOSIS
Kaposi's Sarcoma
Kidney calcifications
Hypemephroma
Other maligs
AIDS & the Kidney -
Coincidental renal disorders -
Infxn & Infiltrative Lesions of the Kidney

***NOTE: Their's a PPT slide w/ a chart on it -
But DeLeeuw said to focus on the infiltrative dz'es (but note, he's not writing the questions for this lecture)

Infiltrative lesions of the kidney that occur in HIV listed:
LYMPHOMA
AMYLOIDOSIS
Kaposi's Sarcoma
Kidney calcifications
Hypemephroma
Other maligs
AIDS & the Kidney -
Coincidental renal disorders -
HYPO-natremia

1. How common is HYPO-natremia in AIDs pts?

2. Hyponatremia in AIDs pts is usually due to volume depletion from what 2 things?

3. 3 anti-microbials that can cause hyponatremia in HIV pts?

4. NOTE: HYPO-natremia in HIV pts could also be from salt wasting, TIN

5. Hyponatremia in HIV pts could also be from SIADH resulting from what drug?

6. 1 endocrine cause of hyponatremia in HIV pts?

7. Hyponatremia in an HIV pt may signify a serious infxn w/ what 2 organisms?

8. Hyponatremia in an HIV pt is correlated w/ an inc what?
1. MC electrolyte abnormality in AIDs pts

2. GI losses & sweating

3. Amphotericin B; Bactrim; Ketoconazole

4.

5. Ketoconazole

6. Adrenal Insufficiency

7. OCO, CMV

8. Morbidity and Mortality
AIDS & the Kidney -
Coincidental renal disorders -
Various other electrolyte disturbances

1. Hypernatremia
A. Hypernatremia in AIDs pts usually has 1 of what 2 causes?

2. Hypokalemia
A. Hypokalemia in AIDs pts is usually secondary to what?
B. 2 other causes of hypokalemia in AIDs pts is what?

3. Hyperkalemia
A. 2 endocrine causes of Hyperkelemia in AIDs pts?
B. 3 Rx that can cause Hyperkalemia in AIDs pts?
a) MOA of Ketoconazole --> Hyperkalemia?
1.
A. Dehydration
Nephrogenic DI from Foscarnet

2.
A. Vomiting & Diarrhea
B. Renal K+ wasting & RTA

3.
A. Primary AND Secondary adrenal insufficiency
B. Bactrim;
Pentamidine;
Ketoconazole
a) Inhibs adrenal steroid synth -->
acute adrenal insufficiency
See printed PPT bc realized it doesn't make sense to sum this lecture anymore....
See printed PPT bc realized it doesn't make sense to sum this lecture anymore....