Step III - Renal 1
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Hyaline casts, urine osm >500, FeNa <1%, urine Na <20 | Pre-renal
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| What are the causes of pre-renal azotemia | HYPO-volemia, HYPO-tn (<90), CHF, constrictive cardx, low onc pressure, renal aa stenosis
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| Causes of post-renal | Strictures, stones, CA bladder/prostate/cervix, neurogenic bladder
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| Muddy brown/granular casts | ATN
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| Hyaline casts | Pre-renal
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| What are the common causes of ATN | Toxic injury and HYPOperfusion
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| MCC toxin induced renal insufficiency | Aminoglycosides, amphotericin, chemo (cisplatin), IV contrast dye
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| What lab test can help in evalx ATN from contrast | Mg
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| Fever, Rash, Eosinophilia/uria, WBC casts. Exposure to drug or infection | AIN
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| What is the FeNa and urine Osm in AIN | FENa >2%, Dilute urine (Osm < 350)
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| h/o Abx (PCN, ceph, NSAIDs, phenytoin, diuretics, sulfa, quinolones) a/w what type intrarenal renal failure | AIN
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| h/o infection/autoimmune (SS, SLE, sarcoidosis) a/w what type intrarenal renal failure | AIN
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| What is the best initial test for AIN and what does it show | UA showing WBCs
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| Most accurate test for AIN | Wright stain OR Hansel’s stain of urine showing eosinophils
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| Tx for AIN | None; resolves on own
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| What drug causes hemorrhagic cystitis and NOT renal failure | Cyclophosphamide
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| What are some causes of rhabdo that lead to intrarenal failure | Seizures, crush injury, immobility in intoxicated pt, low K+ causing muscle necrosis, pt on statin
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| What is the best initial test for rhabdo induced intrarenal failure | UA showing large amounts RBCs but no cells
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| Most accurate test for rhabdo induced intrarenal failure | Urine myoglobin
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| Decreased bicarb, low Ca2+, incr K+ labs seen in what type of renal failure | rhabdo induced intrarenal failure
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| Tx for rhabdo induced intrarenal failure | Bolus nL saline, mannitol diuresis, alkalinization of urine
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| Pt in case has rhabdomyolysis. Most URGENT step in management and why | EKG; rhabdo causes HYPER-kalemia which is risk for arrthymia
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| Pt intoxicated from suicide attempt w/ antifreeze. What kind of renal failure | Crystal induced
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| What type of crystals are seen in ethylene glycol renal failure and what is the shape | Oxalate “envelope” crystals
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| What is the best initial test for crystal uropathy | UA
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| What is the best initial tx for crystal uropathy | Ethanol OR fomepazole w/ dialysis
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| What kind of crystals are seen in tumor lysis syndrome | Urate
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| Tx for urate crystal renal failure | Hydration and allopurinol
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| What can you give a pt that has DM/HTN who absolutely needs contrast dye | Hydrate w/ nL saline + bicarb/N-acetylcysteine
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| What are some kidney insults resulting from NSAIDs | ATN, AIN, nephrotic syndrome, afferent aa vasoconstrx
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| Red blood cells, red cell casts, proteinuria <2g in 24, edema | Glomerulonephritis
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| Most accurate test for glomerulonephrx | Kidney bx
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DrINFJ
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