nephrology.txt

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dewarsb
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215406
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nephrology.txt
Updated:
2013-04-23 20:54:46
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dewarsb Boardreview nephrology
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Nephrology Board review
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  1. 4 methods to measure tubular function
    • fractional excretion or reabsorpitve percentages
    • osmolality (concentration)
    • urine protein electrophoresis (low-molecular weight proteins)
    • direct measurement of substances not normally found in urine (glucose, amino acids)
  2. 3 transient causes of proteinuria
    • fever
    • illness
    • exercise
  3. 9 further studies to evaluate proteinuria
    • CMP
    • C3/C4
    • ANA
    • anit dsDNA
    • HBVsAg
    • HCVAb
    • CMV/EBV IgM, IgG
    • HIV
    • renal US
  4. edema
    hypoalbunimemia
    normal complement
    nephrotic range proteinuria
    2-12 years of age
    no gross hematuria, HTN or renal insufficiency
    Minimal change disease
  5. 5 findings c/w urologic bleeding pRBCs
    • Pain
    • Round RBCs in urine
    • Bright red blood
    • Clots
    • Stream variation in color
  6. 7 findings c/w glomerular hematuria
    CD PHAGE
    • Casts
    • Deformed RBCs on micro
    • Proteinuria
    • Hypertension
    • Anemia
    • GFR changes
    • Edema
  7. Causes of anion-gap metabolic acidosis
    MUDPILES
    • Methanol
    • Uremia
    • Diabetic ketoacidosis
    • Paraldehyde
    • INH, Iron
    • Lactic acidosis
    • Ethylene glycol
    • Salicylate
  8. Causes of non-anion-gap acidosis
    ACCRUED
    • Acid loading
    • Carbonic anhydrase inhibitor
    • Compensation for respiratory alkalosis
    • TRA
    • Ureteral diversion
    • Extra alimentation TPN
    • Diarrhea
  9. impaired acidification of urine in distal tubule
    nephrocalcinosis
    alkaline urine with serum acidosis
    low potassium
    Type I (distal) RTA
  10. impaired proximal tubule reabsorption of base
    can be secondary to systemic disease
    proteinuria, glucosuria, aminoaciduria
    Type II (proximal) RTA
  11. resistance to aldosterone
    may associated with obstructive uropathy
    high potassium
    Type IV (hypoaldosteronism) RTA
  12. overly rapid correction of hyponatremia
    central pontine myelinolysis
  13. euvolemia
    hyponatremia
    low serum osmolality
    high urine osmolality
    SIADH
  14. overly rapid correction of hypernatremia
    cerebral edema
  15. thirst
    hypernatremia
    high serum osmolality
    low urine osmolality
    DI
  16. 5 EKG findings of hyperkalemia
    • peaked T waves
    • shortened QT
    • ST segment depression
    • increased PR interval
    • widening of the QRS
  17. 5 steps in the treatment of hyperkalemia
    • IV calcium, stabilizes myocardial membrane
    • insulin, glucose, bicarbonate infusion to drive K into cells
    • Kayexalate
    • inhaled albuterol
    • dialysis
  18. 3 Findings of hypocalcemia
    • weakness/tetany
    • Chvostek's sign
    • widened QTc interval
  19. 3 findings in nephrotic syndrome
    • edema
    • hypoalbuminemia
    • severe proteinuria
  20. 5 glomerulonephritides presenting with only hematuria
    • postinfectious glomerulonephritis
    • IgA nephropathy
    • thin basement membrane disease
    • HSP
    • Alport's syndrome
  21. 4 glomerulonephritides presenting with only proteinuria
    • minimal change nephrotic syndrome
    • congenital nephrotic syndrome
    • focal segmental glomerulosclerosis
    • membranous nephropathy
  22. 3 glomerulonephritides presenting with hematuria and proteinuria
    • lupus nephropathy
    • membranoproliferative glomerulonephritis
    • anti-glomerular basement membrane disease
  23. normal C3
    normal C4
    normal CH50
    • minimal change disease
    • membranous nephropathy
    • IgAnephropathy
  24. low C3
    normal or low C4
    low CH50
    C3 nephritic factor postive
    immune deposits
    membranoproliferative glomerulonephritis
  25. low C3
    normal C4
    low CH50
    elevated ASO
    postinfectious glomerulonephritis
  26. low C3
    low C4
    low CH50
    anti-ds DNA antibody positive
    lupus nephritis
  27. congenital nephrotic syndrome
    Wilms' tumor
    ambiguous genitalia
    Denys-Drash syndrome
  28. hearing loss
    microscopic glomerula hematuria
    genetic abnormality of collagen
    Alport syndrome
  29. 8 conditions associated with a diagnosis of sickle cell nephropathy
    HIP PINCH
    • Hyposthenuria
    • Infarction
    • Papillary necrosis
    • Pyelonephritis
    • Insufficiency
    • Nephrotic syndrome
    • Carcinoma
    • Hematuria
  30. congenital anomaly
    lack of abdominal musculature
    undescended testicles
    renal dysplasia
    Eagle-Barrett (Prune-Belly) syndrome
  31. progressive cystic enlargement of the kideys
    CNS, GU, GI involvement
    presents in adulthood
    AD Polycystic Kidney Disease
  32. cystic disease of kidneys
    hepatic fibrosis
    presents in neonatal period
    AR Polycystic Kidney Disease
  33. chronic inherited sclerosing tubulointerstitial disease
    Juvenile nephronophthisis/Medullary Cystic disease
  34. AR blond, fair-skinned individuals
    Northern Europeans
    disorder of cysteine metabolism
    cystinosis

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