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36 Cards in this Set
- Front
- Back
- 3rd side (hint)
Retention of what (3) things causes anion gap increase w/ CRF?
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Phosphates
H+ Sulfates |
PHS
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what does the ultrasound show w/:
1. CRF 2. Diabetes 3. Amyloidosis 4. Poylcyctic Kidney Dz |
1. shrunken kidneys
2 - 4. Enlarged kidneys |
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What (3) endocrine functions are lost w/ CRF?
what is the result of each on the patient? |
Synthesis of:
1. Vitamin D - hypocalcemia; 2. Ammonia - anion-gap met acidosis; 3. Erythropoietin - anemia |
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Tx for Chronic renal failure
(3) |
ACEi;
low-protein diet; Dialysis |
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Dx:
pale complexion, wasting, purpura, N/V, itching, tubular casts in urine |
Uremic syndrome
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Waxy casts in urine
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Chronic Renal Failure
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CNS problems from Uremia
(5) |
Foot drop;
Carpal tunnel; Clonus; Asterixis; Seziures |
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Cardiac / Pulmonary problems from Uremia
(5) |
HTN;
Pericarditis; Valve calcification; Pulmonary edema; Pulmonary effusions |
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Hematologic problems from Uremia
(3) |
Normochromic, normocytic anemia;
Low platelet function (prolonged bleeding time); low WBC - increased infections |
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(2) metabolic problems from Uremia
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High triglyerides;
Insulin resistance |
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Dx:
Inability for kidney to concentrate urine (stays fixed w/ specific gravity = 1.010) |
Isostheuria
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Dx:
enlarged kidneys w/ multiple cysts presenting in mid 30's to 40's w/ flank pain what can it lead to? |
ADPKD
Berry aneurysms |
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Dx:
Metabolic acidosis w/ normal anion gap |
Renal Tubular Acidosis
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Renal Tubular Acidosis Type I:
1. Defect 2. bicarb level 3. Urine pH 4. Plasma K 5. where in kidney |
1. H+ secretion causing Acidosis
2. Low 3. pH > 5.3 4. Low 5. DT defect |
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Renal Tubular Acidosis Type II:
1. Defect 2. bicarb level 3. Urine pH 4. Plasma K 5. where in kidney |
1. Dec. Bicarb reabsorp
2. 12 - 20 3. pH > 5.3 4. Low - normal 5. PCT defect |
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Renal Tubular Acidosis Type IV:
1. Defect 2. bicarb level 3. Urine pH 4. Plasma K 5. where in kidney |
1. Decreased Aldosterone
2. > 17 3. pH < 5.3* 4. High* 5. DT |
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Etiology of Renal Tubular Acidosis Type I
(4) |
Lithium;
Amphotericin B; SLE; Sarcoidosis |
LASS
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Etiology of Renal Tubular Acidosis Type II
(3) |
Heavy Metals;
Acetazolamide; Multiple myeloma |
HAM
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Etiology of Renal Tubular Acidosis Type IV
(3) |
Renal transplant;
Obstructive uropathy; Diabetic nephropathy; |
causes a 4" ROD
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Dx:
Radiopaque stone seen in inflammatory bowel diseases, decreased citrate & uricourea Tx? |
Calcium Oxalate stone
Tx: Thiazides |
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Dx:
moderately readiopaque stone common in Proteus or staph Saprophyticus UTI due to high urinary pH Tx? |
Struvite (ammonium, magnesium, phosphate) stone
Tx: lower urine pH |
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Dx:
Radiolucent stone caused by myeloproliferative diseases and gout Tx? |
Uric Acid stone
Tx: raise urine pH |
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Dx:
moderately radiopague stone that has hexagonal crystals and is positively birefringent What congenital disorder is cause? Tx? |
Cystine Stones
Disorder: Cystinuria Tx: raise urine pH |
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Dx:
39-yo man w/ severe back pain and hematuria, nausea and unable to find a comfortable position. |
Renal stone
(Urolithiasis) |
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Dx:
sudden HTN w/ low K+ How do you do a screening Dx? Tx? |
Renal artery stenosis
give oral captopril to induce increase of renin Tx: surgery or angioplasty |
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Etiology of renal artery stenosis
(2) |
Plaque
Fibromuscular dysplasia |
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Dx:
hematuria, palpable mass, flank pain, fever, secondary polycythemia |
Renal Cell Tumor
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MC person to get Renal cell CA
Where does it disseminate to? Tx? (2) |
50-70 yo Male smoker
moves to: Renal veins and Vena cava Tx: resection IL-2 immunotherapy |
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(3) causes of Ketones in the urine
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1. DKA
2. Alcohol intox 3. starvation |
SAD
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What does Nitrite in urine indicate?
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Gram negative rods
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What does a positive Leukocyte esterase in urine indicate?
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White cells and infection
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What do eosinophils in the urine indicate?
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Allergic Interstitial Nephritis
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What do Squamous cells in the urine indicate?
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contaminated specimen
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What does Bilirubin in the urine indicate?
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Extravascular hemolysis
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What does Hemoglobin in the urine indicate?
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Intravascular hemolysis
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What do Hyaline casts in the urine indicate?
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Pre-renal azotemia
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