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55 Cards in this Set

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Drugs that cause Hyperkalemia
dec excretion: ACEIs, NSAIDs, TMP, spironolactone, triamterene

cellular shifts: BBs, succinylcholine, arginine, digitalis
EKG findings for Hyperkalemia
Tall peaked T waves
PR prolongation
QT prolongation
loss of P waves
Drugs that cause Hypokalemia
cellular shifts: Beta agonists, insulin,

Renal losses: Gentamicin, amphotericin
EKG findings for Hypokalemia
T-wave flattening
U waves
ST depression
Causes of Hypercalcemia
CHIMPANZEES

Calcium supplements
HyperPTH**
Iatrogenic/immobility
Milk-alkali syn
Paget's dz
Addisons dz
Neoplasm** (breast, sq cell, mult. myel)
Zollinger-Ellison
Excssive A
Excssive D
Sarcoidosis/ granulomatous dz
EKG findings for Hypercalcemia
short QT interval
Hypomagnesemia causes...
Hypokalemia
Hypocalcemia
Alkalosis causes...
Hypokalemia
Acidosis causes...
Hyperkalemia
Hypertriglyceridemia or hyperglycemia can cause...
Hyponatremia
EKG findings for Hypercalcemia
prolonged QT
Hypomagnesemia is defined by a level
<1.5 mEQ/L
Hypomagnesemia is caused by
Hypercalcemia
amphotericin
alcoholism
DKA
pancreatitis
EKG findings of Hypomagnesemia
Prolonged PR
Prlonged QT
Normal Anion Gap is...
8-12 mEq/L
ASA intoxication causes...
Respiratory Alkalosis (early)
Anion Gap Metabolic Acidosis (late)
Causes of Normal Anion Gap Metabolic Acidosis
Diarrhea
Glue Sniffing
Renal Tubular Acidosis
Hyperchloremia
Causes of Metabolic Alkalosis
Vomiting
Diuretics
Antacids
inc Aldosterone.
Symptoms of Uremia
fatigue
malaise
oliguria
confusion
anorexia
nausea
**Pericardial Friction rub
** Asterixis
**encephalopathy
**pruritis
Sx of Prerenal ARF
Thirst, orthostatic hypotension, tachycardia, other s/sx of hypovolemia
Sx of Intrinsic RF
Drug exposure- aminoglycosides, NSAIDs
Toxins- myoglobin, myeloma protien
Sx of Acute Interstitial Nephritis
Fever
Arthlagias
Pruritic erythematous rash

**Associated with METHICILLIN**
Sx of Atheroemboli
Subcutaneous nodules
Livedo reticularis
Digital ischemia
Sx of Glomerulonephritis
Oliguria
Edema
HTN
FeNA < 1%, UNa <20, sp. gravity >1.020

OR

BUN/Cr ration >20

suggests....
Prerenal Etiology

FeNa < 1% shows kidneys are trying to preserve sodium.
Indications for Dialysis
AEIOU

Acidosis
Electrolyte abnormalies (inc K)
Ingestions (salicylates, theophylline, barbiturates, Lithium, ethlyene glycol, methanol)
Uremic sx
Side Effects of Loop Diuretics
Otoxicity
Sulfa Allergy
Pts who are Diaysis dependant are at an increased risk of
CAD
Symptoms of Nephritic Syndrome
Oliguria
HTN
Hematuria
periorbital edema
inc GFR c dec BUN/Cr
Side Effects of Carbonic Anhydrase Inhibitors
Hyperchloremic Metabolic Acidosis
Sulfa Allergy
Side Effects of Osmotic Diuretics
Pulmonary Edema
Side Effects of Thiazides
Pancreatitis
Sulfa Allergy
Pts with Nephrotic Syndrome are at an inreased risk of which 3 things?
1) Infections
2) Thromboembolism
3) Infections with S. Pneumo.
Treatment of Nephritic Syndrome
Salt and water restriction
diuretics
corticosteriods
Treatment of Nephrotic Syndrome
PROTEIN and Salt restriction
antihyperlipiemics
diuretics
ACEIs
PPV23
Lab findings of PSGN
Low C3
Increased ASO titer

"lumpy-bumpy immunofluorescence
S/Sx of IgA Nepropathy/ Berger's Disease
Normal C3

episodic gross hematuria vs. persistant microscopic hematuria

ass c URI and GI infections and HSP

*can progress to ESRD*

tx c glucocoricoids or ACEIs
S/Sx of Wegener's Granulomatosis
granulomatous inflamm of resp tract & kidney c necrotizing vasculitis

sx- fever, hematuria, hearing dist, weight loss, hemoptysis, sinus probs

** C-ANCA**

segmental necrotizing GN on bx c few IG deposits

tx: high dose corticosteroids & cytoxic agents
Lab/Histo of Goodpasture's
Linear anti-GBM deposits on IF

Fe defic anemia

hemosiderin filled macros in sputum

pulm infilatrates

tx- plasma exchabge

** can lead to ESRD**
Sx of Alport's Syndrome
asx hematuria c nerve deafness and eye d/o

BM splitting on EM

can lead to ESRD can can have probs after transplant.
Kids with Minimal Change Disease are prone to...
Infections
Thromboembolic events

** see lipid-laden renal cortices**

tx c steroids--> good px
What should you suspect when you see:

Young black male with uncontrolled HTN and sclerosis in capillary tufts?
Focal Segmental Glomerular Sclerosis

tx c prednisone and cytotoxic therapy
Membranous Nephropathy is associated with...
HBV
Gold
Malaria
Syphilis
Hisologic Appearance of Membranous Nephropathy
"Spike and Dome" b/c of IgG and C3 @ BM.
What are the 2 type of Diabetic Nephropathy
1) Diffuse Hyalinization
2) Nodular Glomerulosclerosis (kimmelsteil-Wilson lesions)

** see thickened BM c inc mesangial matrix**
Histologic appearance of Lupus Nephritis
Mesangial prolferation
subendothelial immune complex deposition
Renal amyloidosis is associated with
Multiple myeloma
chronic inflammatory disease
Membranoproliferative nephropathy is associated with
HCV, cryoglobulinemia, lupus, SBE,
Histologic appearance of Membranoproliferative nephropathy
"tram-track" double layered BM

type I-> subendothelial deposits and mesangial deposits

low C3
s/p colectomy/ileostomy predisposes you to what?
Nephrolithiasis- especially with Calcium oxalate
How does Autosomal Recessive Polycystic Kidney Disease present?
In children: renal failure, liver fibrosis, and portal HTN
PCKD is associate with what?
Hepatic cysts
cerebral berry aneurysms
mitral valve prolapse.
Where does ADH come from?
Posterior Pituitary
What drugs cause Nephrogenic DI?
Lithium
demeclocycline
S/Sx of DI
Polyuria
Polydypsia
dilute urine
HyperNa+
dehydration