Renal Cat Review

Front 1

What is the osmolarity of NS, LR,

Back 1

Isotonic

Front 2

What is the osmolarity of 3%NS, D5W 1/2NS, D5W LR?

Back 2

Hypertonic

Front 3

What is the osmolarity 1/2 NS and D5W

1/2 NS and D5W

Back 3

Hypotonic

Front 4

What is the normal range of serum osmolarity?tt

Back 4

280-300 mOsm/kg

Front 5

What condition does normal saline causes?

Back 5

Hyperclorimic acidosis, which is associated with AKI and Inc mortality

Front 6

What does the patient's osmolality tell you?

Back 6

Whether they are dehydrated, has excess water in serum or have access or deficiency in sodium, glucose and urea

Front 7

What is the normal range of serium sodium?

Back 7

135-145

Front 8

Associated with briard range of neurological manifestation

Back 8

Hyponatremia

Front 9

Hyponatremia diagnostic labs

Back 9

BMP, serum osmolality, plasma osmolality, triglycerides, TSH, urine sodium, urine osmolality

Front 10

Isotonic hyponatremia

Back 10

Lab error-toomuch protein or triglyceride

Front 11

Hypertonic hyponatremia

Back 11

Hyperglycemia, mannitol, sorbitol, glycerol, Maltese and radioconstrast agents

Front 12

Treatment for hypertonic hyponatremia?

Back 12

Trest the underlying issue ( give fluid, insulin in DKA pts)

Front 13

Pts comes into the hospital with diabetic ketoacidosis. You check a blood sugar and it come back 600, and the sodium BMP comes back at 126

Back 13

Hypertonic hyponatremia

Hint 13

How do you treat-give insulin

Front 14

Hypotonic hyponatremia hypervolemic

Back 14

Congestive HF, liver disease, Arenal failure

Front 15

Hypotonic hyponatremia hypovolemic

Back 15

Dehydration, vomit, diarrhea, sweat and renal salt loss (diuretics, ace inhibitors, nephropathy, sodium wasting syndrome, mineralocorticoid deficiency)

Front 16

Low urine sodium concentration <10-20 meq/L

Back 16

Nonmetallic cause- dehydration, vomiting, diarrhea and sweat

Front 17

High urine sodium >20 meq/L

Back 17

Renal cause ( diuretic mc thiazides, Ace inhibitors)

Front 18

Euvolemic hypotonic hyponatremia

Back 18

Problem with ADH ( SIADH) MC

Front 19

Inc. ADH ( inappropriately concentrated urine >100

Back 19

MC cause is SIADH, hypothyroidism, postoperative hyponatremia

Front 20

Decreased ADH (diluted urine with urine osmolality <100

Back 20

MC Primary polydipsia. Beer potomania (alcohol inhibits ADH)

Front 21

Treatment for hypotonic hyponatremia

Back 21

Acutely-hypertonic saline (3%NS)

Chronic-sodium chloride tablets and fluid restriction, NS

Front 22

Fast rate correction can lead to what condition?

Back 22

Osmotic demyelination syndrome (ODS)

Front 23

Back 23

Front 24

What labs do you want for hypernatremia?

Back 24

BMP, serum osmolality, urine osmolality and urine electrolytes

Front 25

Hypernatremia

Back 25

Too much salt, diabetes insipid, mineralocorticois excess ( hyperaldosteroism, Cushing disease)

Front 26

Treatment for hypernatremia

Back 26

Goal is to replace free water deficit ( isotonic fluid)

Front 27

Normal potassium range?

Back 27

3.5-5 meq/L

Front 28

What are the most common way to lose potassium (hypokalemia)?

Back 28

1. Not enough intake (alcoholic patient), or too much loss through kidney and gut

2.K+ shift from blood to cells

3. Hyperalosteronism (rare)

Front 29

What cause K+ to shift from blood to cells

Back 29

Insulin, beta adrenergic activity, alkalosis, Elevated PH in the cells

Front 30

What are drugs that inc K+ excretion?

Back 30

Steroid, diuretic

Front 31

Drugs that push K+ into the cells?

Back 31

Insulin administration and beta agonist (IV or nebulized)

Front 32

What are the causes of hyperkalemia?

Back 32

Inc K+ release from cells, renal impairment, medication

( insulin deficiency, beta blockers, metabolic or respiratory acidosis)

Front 33

Seroius manifestation of hyperkalemia

Back 33

>7meq/L. Muscle weakness of paralysis, cardiac manifestation, reduced urinary acid excretion-metabiloc acidosis

Front 34

Hyperkalemia treatment?

Back 34

IV calcium gluconate ( stabilize ecg), insulin and beta agonist, diuretics and prevention

Front 35

Ekg findings in hypokalemia

Back 35

St segment depression, flattened T wave and U wave

Front 36

Ekg finding in hyperkalemia

Back 36

Peaked T wave, prolong PR intervals, ST depression, widened QRS

Front 37

Normal calcium

Back 37

8.5-10.5

Front 38

Hypercalcemia cause

Back 38

Malignancy and hyperparathyroidism

Front 39

Hypercalcemia symptoms

Back 39

Bones, stones, groans (constipation), moans (peptic ulcer, pancreatitis)pancreatic, overtones ( depression, confusion)

Front 40

Hypercalcemia treatment

Back 40

Isotonic saline, IV loop diuretics,

Calcitonjn, IV bisphosphonates (in cancer pts), glucocorticoids

Front 41

Causes of hypocalcemia

Back 41

Low PTH, vitamin D deficiency, low magnesium, tissue consumption of calcium

Front 42

Hypocalcemia manifestation

Back 42

Tetanus, papilledema, and seizures

Front 43

Treatment for hypocalcemia

Back 43

Iv or oral calcium

Front 44

Treatment for hypophosphatemia

Back 44

Milk or oral phosphorous ( can jnduce diarrhea)

Front 45

Causes of hypophosphatemia

Back 45

Dec intake, inc renal wasting, fluid shift from cells to blood

Front 46

Treatment for hyperphosphatemia

Back 46

Restrict dietary intake, phosphate binders, inc dialysis

Front 47

Normal phosphate

Back 47

4.5

Front 48

CKD definition

Back 48

-presence of kidney damage for 3 months: albuminuria= ACR >30, abnormalities, kidney transplant

-GFR <60

Front 49

Acute prostatitis treatment for non sexual active men

Back 49

Bacterium or fluoroquinolone for 4-6 weeks

Front 50

Acute prostatitis for sexual active men

Back 50

Cetriaxone and doxy for 4-6 weeks

Front 51

Firm and tender prostate, constitutional symtoms

Back 51

Acute bacterial prostatitis

Front 52

Painless hematuria, urothelial carcinoma, cigarette smoking MC risk factor

Back 52

Bladder cancer

Front 53

Renal cell carcinoma triad

Back 53

Flank pain, hematuria, palpable abdominal renal mass

Front 54

Gleason is a 60 year old AA men who present with back pain, LUTS. What is the lost likely dx?

Back 54

Prostate cancer

Front 55

Flank pain radiating to groin, patient can't lie still, hematuria, noncontract CT is definitive dx

Back 55

Nephrolithiasis

<5mm pass, >5 (medication tamsulosin), >10 urology consult

Hint 55

Calcium oxalate MC

Struvite-proteus infection

Uric acid- gout and radiolucent xray

Cistine-FH

Front 56

Painless swelling of the testicle, crytochidism MC risk factor

Labs: elevated beta hcg, AFP or LDH

Back 56

Testicular cancer

Front 57

Dilated and tortuous veins of the scrotum, heavy sensation, swelling decrease with supine position. left side>right. Infertility

Back 57

Varicocele

Hint 57

Bag of worm

Front 58

Abdominal, flank and back pain, hematuria, bilateral enlarged kidney, autosomal dominant

Back 58

Polycystic kidney disease

Hint 58

Tx: BP control, hydration, sodium restriction diet, Tolvaptan

Front 59

Peritoneal fluid, translluminates, painless, children, increase in size with Valhalla maneuver

Back 59

Hydrocele

Front 60

WBC cast

Back 60

Pyelonephritis, interstitial nephritis

Front 61

RBC cast

Back 61

Glomerulonephritis

Front 62

Fatty cast

Back 62

Nephrotic syndrome, minimal change syndrome

Front 63

Muddy brown casts

Back 63

Acute Tubularnephritis

Front 64

Renal stenosis

Back 64

Inc aldosterone, ADH and angiotensin

Front 65

Abdominal bruit, refractory hypertension

Back 65

Renal stenosis

Front 66

Low C3 comp, cola color urine, post strep/impetigo,

Back 66

PSGN

Hint 66

Positive ASO titer, supportive care

Front 67

E coli 0157h7, shiga toxin, bloody diarrhea, petechial rash, thrombocytopenia

Back 67

Hus

Hint 67

School age

Front 68

Chronic sinusitis, saddle deformity, skin rash,

Back 68

Wegners

Hint 68

+C-ANCA

Front 69

Good pastures

Back 69

Anti GBM, hemoptysis, hematuria, steroid

Front 70

Gross hematuria, post URI or GI, young men

Back 70

IgA

Hint 70

Control bp

Front 71

Acute prostatitis risk factors

Back 71

Catheters, instrumentation, prostate bx

Hint 71

Tx for 6 weeks

Front 72

Twist score for torsion

Back 72

Hard testis, swelling testis, negative crematorium reflex, high riding testis, N/V

Front 73

Mc acite scrotal pain in Prepubescent boys, blue dot spot, supportive care

Back 73

Appendix torsion

Front 74

Failure to produce ADH, resulting in inc extracellular fluid osmolaity-> vasopresin challenge Dec urine volume and Inc urine osmolality

Back 74

Central diabetes insipidus

Front 75

High ADH, no change in using volume or osmolality

Back 75

Nephrogenic diabetes insipidus

Hint 75

Drug: lithium, demeclocycline, amphotericin B

Front 76

MC inherited cause of kidney disease, mutation in pkd1

Back 76

Polycystic kidney disiease

Front 77

When to dialyse

Back 77

Acidosis, electrolytes, ingestion (SLIME), overload, uremia, gfr<15

Front 78

Cause of anion gab metabolic acidosis

Back 78

Cardia output, Methanol, Uremix, Dka, Ethylene glycol, Salicylate (asapirin),

Front 79

SIADH

Back 79

Hyponatremia

Front 80

Trousseau, chvostek sign

Back 80

Hypocalcemia

Front 81

Hyperparathyroid, malignancy

Back 81

Hypercalcemia

Front 82

Treatment for hyperkalemia

Back 82

Insulin, Calcium, Bicarbonate,

Kayexalate, xation exchange resins

Front 83

Inulin, urea, glucose, acid and K+

Back 83

Filtration only, filtration and partial reabsorption, filtration ND complete reabsorption, filtration and secretion

Front 84

Mc solid tumor in men 15-35

Back 84

Testicular cancer

Front 85

Hydronephrosis on US

Back 85

Kidney stones

Front 86

AKI pre renal cause and values

Back 86

Dehydration and hypoperfususion

Bun/Cr=20:1

U NA= <20

FeNA= <1

SG= >1.010

Hint 86

High urine osmolality

Front 87

AKI renal cause and values

Back 87

Glomerular, tubular and interstitial

Bun/Cr = 15:1

U NA >40

FeNA <2

SG normal

Urine osmolality is low