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Renal Block 2
Clinical Medcine
| Question | Answer |
|---|---|
| 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
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