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Renal Block 2

Clinical Medcine

Acute Tubular Necrosis is cause by what drug? Gentamycin, Aminogylcosides
Acute Nephritic Syndrome is assoc w/ what type of HTN? Malignant HTN
Azotemia is? AUCTE RENAL FAILURE. Increase in both Blood Creatine and BUN but still INncrease BUN:Creat. Blood flow is bypassing the Nephron and nothing is filtering through therefore all blood levels go up and urine output drops ie Na Urine drops.
Causes of Acute Renal Failure? MC- Decr Volume d/t diuretics or Decr Flow d/t poor pump ie CHF. Obstruction
Hyaline Clast are indicative of? Kidney Damage
MC cause of Nepthrotic Syndrome in Peds? Minimal Change Disease.
Minimal Change Dz urine findings? Proteinuria, Maltesecrosses
Tubular Renal Failure is caused by? Caused by hypoperfusion to the kidney. MC Blood loss d/t Surgey, Shock, Trauma
Large Muddy Brown Casts hallmark of? Acute Tubular Necrosis (pos. d/t gentamycin)
Acute Interstitial Nephritis is d/t ? Drug Induced. MC Abx (bactrim, methicillin), NSAIDS
Proximal, Descending, Ascending, Distal Tubules, Collecting Duct absorbs/effected by? Ascending- Gluc Na, Cl. Descending reabsorbs H20 (water falls down) to follow solute. Ascending Na Cl (remaining solutes follow water). Distal effected by Aldosterone. Collecting duct affected by ADH
earlist sign of chorinc kidney disease Proteinuria
ACE-I work how on the kideny dilates efferent arteriole and decrease GFR. Therefor in renal artery stenosis GFR is droped twice as much with an ACE-I (too much)
Gluc Level of what leads to glucosuria? >180
Unilateral small kidney on u/s ->? Renal artery stenosis- atrophy of one leads to hypertrophy of the other
Thiazide effect on Ca and K reabsorbs Ca and Excretes K
How do you distinguish b/w Acute and Chronic Renal Failure? In Chronic K rises as GFR Starts to decrease
MC and 2nd MC cause of Chronic Renal Failure? 1st Diabetes, 2nd HTN
Glomerulonephritis classic u/a findings? RBC Casts
Pathognomonic for Nephrotic Syndrome (MCD)? Fat Oval Bodies
MC inherited disorder in humans? Polycystic Kidney Disease
Cystitis 1st and 2nd line Therapy? Pregnancy? 1st-Bactrim. 2nd Cipro. Prego-Nitrofurantoin
Renal Cell Cancer Shows what type of Anemia? Normochromic/ Normocystic Anemia
Age line and Pathogen diff in urethritis/ prostatitis/epidiymitis and tx? <35 yo Chlamydia and Gonorrhoeae (ceft and doxy). >35 yo E. Coli and Pseudomonas (cipro)
Orchitis is associated with what viral infection? Mumps. MC unilateral orchitis presents
At what size will kidney stones need surgical help? 5mm or greater (flomax 4 women maybe approp)
Risk Factor for Testicular Torsion? Bell Clapper Deformity. inappropriately high attachment of the tunica vaginalis ->free rotation. 6hr window b4 salvage rate drops
Hyrdoceles occur how? Associated with ? defect in the tinica vaginalis of the scrotom leads to collection of serous fluid. (Transluminates) Assoc w/ Hernias
Varicocele is assoc with what? 40 % of infertile males
First second and third line drug for pain in kidney stones? 1 Toradol. 2 Morphine sulfate. 3 Demerol
HTN and Generalized Weakness what condition should you consider? Renal Artery Stenosis on an ACE-I
MC cause of nephrotic syndrome in adults? DM
What blood findings are elev in dehydration and what are low? K is high, Creatine is High, GFR is low
Urea Nitrogen (BUN) nml values? BUN: 7 - 18 mg/dL;
BUN/Creatinine Ratio nml values? BUN:Creatine 5 - 35
Creatine nml values? 0.6 - 1.2 mg/dL
GFR nml values? 120±25 mls/min
K diff in acute and chronic renal failure? acute-Incr K, chronic-Decr K
Acute Tubular Necrosis is d/t what drug? Gentamycin, Aminoglycosides
prostatic massage is contraindicated in? acute bacterial prostatitis -> septecemia
Small echogenic kidneys bilaterally? Chronic kidney failure. <10cm
Hyrdonephrosis MC pathology? Stones blocking collecting ducts
What type of anemia is assoc c/ CHRONIC renal dz? Anemia of CHRONIC dz
Chronic Renal Dz presents with what Ca and Phos Levels and acidosis or alkalosis? hypocalcemia, hyperphosphatemia, and metabolic acidosis.
smoking and presents with painless hematuria? Bladder Ca
When and how does IgA Nephropathy typically occur? After an upper respiratory tract infection and presents with hematuria and proteinuria.
Restricted diet of what will decr incidence of Kidney Stones? Sodium and Protein. Advise in pt w/ recurrent stones
Incr consumption of what will decrease Renal Stones? Fluids, Bran
Coffen Lids on U/A and Staghorn calculus on KUB, Proteus patho in UTI? Struvite Stone
Intervention for Struvite Stones? Percutaneous Nephyrolithotomy
Laser Lithotripsy is indicated when? Stones 5mm-3cm
What dietary changes need to occur with Uric Acid Stones? Low Purine Diet (drop meats)
In Persistent Nocturia what drug will alleviates symptoms but is not currative? Desmopressin (DDAVP, ADH)
Should Asymptomatic bacteriuria be treated in pregnancy ? Yes. Nitrofurantoin. To prevent development of complications, such as premature labor, fetal morbidity, and premature mortality.
In Terminal hematuria, blood at the end of the urinary stream where anatomically is the source of the blood? bladder neck or prostatic urethral source.
Presence of blood at the beginning of the urinary stream suggests what location of bleed? an anterior (penile)urethral source.
Total hematuria, blood throughout the urinary stream, suggests what location of bleed? a bladder or upper urinary tract source.
squamous epithelial cells on u/a indicates what? contaminated specimen
solid renal mass, hematuria, flank pain. what is your dx? Renal Ca. Radical Nephrectomy w/o radio or chemo if no sign of metastasis
When is Radiation therapy indicated in Renal Ca? Never. It is not effective in the treatment of renal cell cancer and may lead to damage of the surrounding vital organs.
What is the pathology behind urge incontinence and in who is it seen the most? Detrusor overactivity. Elderly
s/sx of urge incont and tx? urge to urinate but leakage before making it to bathroom. Oxybutynin
What is the pathology behind stress incont? s/sx? tx? Relaxed pelvic muscles. leakage upon coughing/sneezing ect. Kegel exercises. Estrogen cream is used when evidence of atrophic vag or urethra is assoc.
What should be given when a potassium level of 6.5-7 in the blood is reached? IV Calcium gluconate. This stimulates K to enter the cells and be excreted out. Ca chases K out of the system. K also follow insulin and glucose.
What is given to correct HyperCalcemia? Bisphosphonates ie Zometa, Zolendrenic Acid.
Ischemia ->Acute tubular necrosis and Drug Rxn are causes of pre, intrinsic, or post renal azotemia? Intrinsic
Postrenal azotemia mc cause? obstruction
PreRenal azotemia mc cause? hypotension
+ Phren's Sign ? Epididimitis.
In pyelonephritis when can you switch from IV abx to PO abx? 24 hrs after becoming afebrile
cola-colored urine, oliguria, and edema of the face and eyes in the morning. Glomerulonephritis. can occur 1-3 wks post strep infection
Created by: duanea00