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40 Cards in this Set
- Front
- Back
What is the usual cause of RAS?
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atherosclerotic occlusive disease
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This condition AKA "spillover" aortic disease
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RAS
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2 general problems in RAS
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renovascular hypertension and ischemic nephropathy
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Clues to diagnosis of RAS
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refractory HTN, new onset HTN in older pt, pulm edema w/ poorly controlled BP, and acute renal failure when pt. starts an ARB
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Common PE finding in RAS
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renal bruit
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What can labs show in RAS?
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increased BUN and serum creatinine
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What can abdominal US show in RAS?
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asymmetric kidney size if one is worse than the other
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Risk Factors for Atherosclerosis
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smoking, DM, obesity, HTN, metabolic syndrome, high LDL, low HDL, high TG, high CRP, family hx
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Non invasive study used to diagnosis RAS
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MRA with or without contrast
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Gold standard for diagnosis of RAS
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renal angiography
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What imaging study used for Raps is contraindicated in pregnancy?
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renal angiography so use MRA
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Options for RAS tx
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tobacco cessation, medical management of BP and lipids, interventional angiography/angioplasty/stent, surgical bypass
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What is the goal of RAS treatment?
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prevent end organ damage, disease, and renal failure
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This is hardening of the kidney due to overgrowth and contraction of interstitial connective tissue
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Nephrosclerosis
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Causes of nephrosclerosis
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DM, HTN
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Characteristics of nephrosclerosis
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HTN, edema, HA, retinal hemorrhage
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What will labs in nephrosclerosis show?
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low level proteinuria, increased BUN and creatinine
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Usual course of nephrosclerosis
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chronic and progresses to ESRD
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Treatment of nephrosclerosis
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treat the underlying condition- DM and HTN
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#1 cause of chronic renal disease
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DM
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What causes renal infarction?
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arterial occlusion
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What happens to the function f the kidney
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Major Causes of renal infarction
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sub acute infective endocarditis, atrial or ventricular thrombi, art
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Lab value that you should think off in renal infarct
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epitheluria (sloughing of renal tubular epithelial cells)
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Imaging that makes the definitive diagnosis of renal infarct
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renal angiography or CT
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Tx for renal infarct
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anticoagulation with infusion of streptokinase and IV heparin, control HTN, and surgical revascularization
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After tx of renal infraction, what should happen
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renal function should return to normal
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What syndrome is renal vein thrombosis usually associated with?
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nephrotic syndrome, esp. membranous nephropathy
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Patients with renal vein thrombosis are also at risk for _______ and _______ (related).
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DVT and PE
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RVT can be also caused by invasion of _________ by tumor or retroperitoneal disease, or secondary to acute trauma.
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renal vein
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Symptoms in renal infarction.
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acute onset flank pain, nausea, fever
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What conditions do patients with renal infarction present with (2)?
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HTN or renal insufficiency
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Lab values in Renal Infarction
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hematuria, proteinuria, epitheluria; leukocytosis on CBC, increased LDH
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What is epitheluria?
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sloughing of renal tubular epithelial cells
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Rat can mimic what condition.
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nephrolithiasis
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How do patients with RVT present?
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flank pain that is unilateral and insidious onset, hematuria
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Labs in RVT
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urinary albumin, thrombocytopenia on CBC, decreased serum albumin
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What is the best test to diagnose RVT?
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renal venogram
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Tx for RVT
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ACE (decrease protienuria), Heparin followed by Coumadin long term, catheter thrombectomy, nephrectomy
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Purpose of ACE in RVT
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decrease protienuria
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