Ipapburke Gu Test 1- Renal Vascular Disease

Front 1

What is the usual cause of RAS?

Back 1

atherosclerotic occlusive disease

Front 2

This condition AKA "spillover" aortic disease

Back 2

RAS

Front 3

2 general problems in RAS

Back 3

renovascular hypertension and ischemic nephropathy

Front 4

Clues to diagnosis of RAS

Back 4

refractory HTN, new onset HTN in older pt, pulm edema w/ poorly controlled BP, and acute renal failure when pt. starts an ARB

Front 5

Common PE finding in RAS

Back 5

renal bruit

Front 6

What can labs show in RAS?

Back 6

increased BUN and serum creatinine

Front 7

What can abdominal US show in RAS?

Back 7

asymmetric kidney size if one is worse than the other

Front 8

Risk Factors for Atherosclerosis

Back 8

smoking, DM, obesity, HTN, metabolic syndrome, high LDL, low HDL, high TG, high CRP, family hx

Front 9

Non invasive study used to diagnosis RAS

Back 9

MRA with or without contrast

Front 10

Gold standard for diagnosis of RAS

Back 10

renal angiography

Front 11

What imaging study used for Raps is contraindicated in pregnancy?

Back 11

renal angiography so use MRA

Front 12

Options for RAS tx

Back 12

tobacco cessation, medical management of BP and lipids, interventional angiography/angioplasty/stent, surgical bypass

Front 13

What is the goal of RAS treatment?

Back 13

prevent end organ damage, disease, and renal failure

Front 14

This is hardening of the kidney due to overgrowth and contraction of interstitial connective tissue

Back 14

Nephrosclerosis

Front 15

Causes of nephrosclerosis

Back 15

DM, HTN

Front 16

Characteristics of nephrosclerosis

Back 16

HTN, edema, HA, retinal hemorrhage

Front 17

What will labs in nephrosclerosis show?

Back 17

low level proteinuria, increased BUN and creatinine

Front 18

Usual course of nephrosclerosis

Back 18

chronic and progresses to ESRD

Front 19

Treatment of nephrosclerosis

Back 19

treat the underlying condition- DM and HTN

Front 20

#1 cause of chronic renal disease

Back 20

DM

Front 21

What causes renal infarction?

Back 21

arterial occlusion

Front 22

What happens to the function f the kidney

Front 23

Major Causes of renal infarction

Back 23

sub acute infective endocarditis, atrial or ventricular thrombi, art

Front 24

Lab value that you should think off in renal infarct

Back 24

epitheluria (sloughing of renal tubular epithelial cells)

Front 25

Imaging that makes the definitive diagnosis of renal infarct

Back 25

renal angiography or CT

Front 26

Tx for renal infarct

Back 26

anticoagulation with infusion of streptokinase and IV heparin, control HTN, and surgical revascularization

Front 27

After tx of renal infraction, what should happen

Back 27

renal function should return to normal

Front 28

What syndrome is renal vein thrombosis usually associated with?

Back 28

nephrotic syndrome, esp. membranous nephropathy

Front 29

Patients with renal vein thrombosis are also at risk for _______ and _______ (related).

Back 29

DVT and PE

Front 30

RVT can be also caused by invasion of _________ by tumor or retroperitoneal disease, or secondary to acute trauma.

Back 30

renal vein

Front 31

Symptoms in renal infarction.

Back 31

acute onset flank pain, nausea, fever

Front 32

What conditions do patients with renal infarction present with (2)?

Back 32

HTN or renal insufficiency

Front 33

Lab values in Renal Infarction

Back 33

hematuria, proteinuria, epitheluria; leukocytosis on CBC, increased LDH

Front 34

What is epitheluria?

Back 34

sloughing of renal tubular epithelial cells

Front 35

Rat can mimic what condition.

Back 35

nephrolithiasis

Front 36

How do patients with RVT present?

Back 36

flank pain that is unilateral and insidious onset, hematuria

Front 37

Labs in RVT

Back 37

urinary albumin, thrombocytopenia on CBC, decreased serum albumin

Front 38

What is the best test to diagnose RVT?

Back 38

renal venogram

Front 39

Tx for RVT

Back 39

ACE (decrease protienuria), Heparin followed by Coumadin long term, catheter thrombectomy, nephrectomy

Front 40

Purpose of ACE in RVT

Back 40

decrease protienuria