Reading...
Play button
Play button
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;
65 Cards in this Set
- Front
- Back
|
Hypernatremia Tx
|
replace water-free deficit w/ hypotonic saline, D4W or water depending on volume satus
|
|
|
Hypovolemic hyponatremia
|
renal failure
nephrotic syndrome cirrhosis CHF hypothyroidism 2nd or 3rd adrenal insufficiency |
|
|
Euvolemic hyponatremia
|
SIADH - most common and extravascular
Drugs Psychogenic polydipsia Oxytocin use |
|
|
Hypovolemic hyponatremia
|
Diuretics
vomiting diarrhea bleeding third spacing |
|
|
Treatment of Hyperkalemia
|
C BIG K
Calcium gluconate - cardioprotective Bicarbonate Insulin Glucose Kayexalate |
|
|
Hypokalemia Tx
|
Treat underlying disorder
Oral and/or IV potassium repletion Replace Magnesium Monitor ECG and potassium levels frequently |
|
|
Hypercalcemia Signs
|
> 10.2 mg/dL
Stones, bones, groans, moans osteopenia, fractures kidney stones anorexia, constipation psychiatric overtones |
|
|
Hypercalcemia Tx
|
IV hydration
Furosemide Calcitonin and biphosphonates for severe AVOID THIAZIDES (increases calcium) |
|
|
Hypocalcemia
|
< 8.5 mg/dL
Abdominal cramps, tetany facial spasm from tapping facial nerve (Chvostek's sign) carpal spasm after arterial occlusion by a BP cuff (Trousseau's sign) prolonged QT interval |
|
|
Hypocalcemia
|
Treat underlying disorder
Magnesium repletion Oral calcium (IV calcium for severe) |
|
|
Type IV Renal Tubular Acidosis
|
Most common
Aldosterone deficiency or resistance, leading to defects in sodium reabsorption and H and K excretion Serum potassium High Serum pH low urine pH low |
|
|
Type IV Renal Tubular Acidosis Tx
|
1. Furosemide
2. Mineralocorticoid and glucocorticoid replacement 3. low potassium diet |
|
|
Type II Renal Tubular Acidosis
|
Defect in bicarb reabsorption
Serum potassium low Serum pH low Urine pH low Can be caused by carbonic anyhydrace inhibitors |
|
|
Type II Renal Tubular Acidosis Tx
|
Potassium citrate
|
|
|
Type I Renal Tubular Acidosis
|
Defect in distal H+ secretion
Serum potassium low Urine pH high Caused by cirrhosis, SLE, Sjogren's sickle cell, lithium, amphotericin |
|
|
Type I Renal Tubular Acidosis Tx
|
Potassium Citrate
|
|
|
Indications for urgent dialysis
|
AEIOU
Acidosis Electrolyte abnormalities (hyperkalemia) Ingestions (salicylates, theophylline, methanol, barbiturates, lithium, ethylene glycol) Overload (fluid) Uremic symptoms (pericarditis, encephalopathy, bleeding, nausea, pruritus, myoclonus) |
|
|
Carbonic Anhydrase Inhibitors
|
Acetazolamide
Acts on proximal convuluted tubule Inhibits carbonic anhydrase, increasing hydrogen reabsorption May lead to metabolic acidosis |
|
|
Loop diuretics
|
Furosemide, ethacrynic acid, bumetanide, torsemide
Inhibit Na/K/2Cl transporter at ascending loop ofhenle Leads to hypokalemia and hypocalcemia |
|
|
Which loop diuretic is best for patients w/ sulfur allergies?
|
Ethacrynic acid
|
|
|
Thiazide Diuretics
|
Hydrochlorothiazide, chlorothiazide
Inhibit Na/Cl transporter at distal convuluted tubule Decrease sodium, decrease potassium Hyperglycemia, hypercalcemia, hyerlipidemia, hyperuricemia |
|
|
Potassium Sparing Diuretics
|
Spironolactone - aldosterone receptor antagonist
Triamterine, amiloride - block sodium channel Use in situations of hypokalemia Leads to gyneco |
|
|
Postinfectious glomerulonephritis
|
Can be seen 2-6 weeks after strep infection
|
|
|
Postinfectious glomerulonephritis Hx
|
oliguria, edema, htn, tea colored urine
|
|
|
Postinfectious glomerulonephritis labs
|
Low serum C3, Increased ASO titer
Lump-bumpy immunofluorescence |
|
|
Postinfectious glomerulonephritis tx
|
Tx: most resolve on own
|
|
|
IgA nephropathy
|
Berger's disease
Associated w/ upper respiratory or GI infections Commonly seen in young males |
|
|
IgA nephropathy hx
|
episodic gross hematuria or persistent microscopic hematuria
|
|
|
IgA nephropathy labs
|
normal C3
|
|
|
IgA nephropathy treatment
|
Glucocorticoids for some patients
ACEI for patients w/ proteinuria |
|
|
Wegener's granulomatosis
|
graunlomatous inflammation of respiratory tract and kidney
|
|
|
Wegener's granulomatosis hx
|
cavitary pulmonary lesions
hemoptysis hematuria respiratory and sinus symptoms |
|
|
Wegener's labs
|
c-ANCA
segmental necrotizing glomerulonephritis few immunoglobulin deposits on immunofluorescence |
|
|
Wegener's Tx
|
steroids and cytotoxic agents
|
|
|
Goodpasture's syndrome
|
rapidly progressing glomerulonephritis w/ pulmonary hemorrhage
|
|
|
Goodpasture's syndrome hx
|
male in mid 20's w/ hemoptysis, dyspnea
|
|
|
Goodpasture's syndrome Labs
|
linear anti-GBM
iron deficiency anemai pulmonary infiltrates on cxr |
|
|
Goodpasture's syndrome tx
|
plasma exchange
pulsed steroids |
|
|
Alport's syndrome
|
Hereditary glomerulonephritis in boys 5-20 years old
|
|
|
Alport's syndrome hx
|
hematuria, nerve deafness, eye disorders Progresses to renal failure
|
|
|
Alport's syndrome labs
|
GBM splitting on electron microscopy
|
|
|
Minimal change disease
|
most common cause of nephrotic syndrome in children
|
|
|
Minimal change disease hx
|
tendency towards infections and thrombotic events
|
|
|
Minimal change disease labs
|
normal on light microscopy
electron microscopy: fusion of epithelial foot processes |
|
|
Minimal change disease tx
|
steroids
good prognosis |
|
|
Focal segmental glomerulosclerosis
|
Associated w/ HIV, obesity, IV drug abuse
|
|
|
Focal segmental glomerulosclerosis Hx
|
Typically a young AA male w/ uncontrolled hypertension
|
|
|
Focal segmental glomerulosclerosis Labs
|
Microscopic hematuria, biopsy w/ sclerosis in capillary tufts
|
|
|
Focal segmental glomerulosclerosis Tx
|
Prednisone, cytoxic therapy
ACEI to decrease proteinuria |
|
|
Membranous nephropathy
|
most common nephropathy in Caucasian adults
2ndary to tumor malignancies |
|
|
Membranous nephropathy Hx
|
Associated w/ HBV, symphilis, malaria, and gold
|
|
|
Membranous nephropathy labs
|
spike and dome appearance
IgG and C3 deposits at basement membrane |
|
|
Membranous nephropathy tx
|
Prednisone and cytotoxic therapy for severe disease
|
|
|
Diabetic nephropathy
|
Thickened GBM, thickened mesangial matrix
|
|
|
Diabetic nephropathy tx
|
tighten blood sugar
ACEI for type I DM and ARBs for type 2 DM |
|
|
Lupus nephritis
|
Both nephrotic and nephritic
|
|
|
Lupus nephritis hx
|
proteinuria or RBC's on UA may be found during evaluation of SLE patients
|
|
|
Lupus nephritis labs
|
Mesangiel proliferation
Subendothelial and subepithelial immune complex deposition |
|
|
Lupus nephritis Tx
|
Prednisone and cytoxic therapy
|
|
|
Renal Amyloidosis Hx
|
patients w/ multiple myeloma or chronic inflammatory disease (rheumatoid arthritis or TB)
|
|
|
Renal Amyloidosis Labs
|
Nodular sclerosis, apple-green birefringence on Congo red stain
|
|
|
Renal Amyloidosis Tx
|
Prednisone and melphalan
|
|
|
Membranoproliferative nephropathy
|
Type I associated w/ HCV, cryoglobulinemia, SLE, subacute endotherlial endocarditis
Seen in patients 8-30 years old |
|
|
Membranoproliferative nephropathy Labs
|
Tram-tracked basement membrane
Low C3 |
|
|
Membranoproliferative nephropathy Tx
|
Corticosteroids and cytoxic agents
|
