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Renal - clin med 2
Clinical Medcine
| Question | Answer |
|---|---|
| The kidney maintains pH balance by _________ bicarb, generating new bicarb, and _________ H+. | Retaining, secreting |
| If pH drops, you ________ ventilation & __________ rate of H+ secretion by the kidneys. | increase, increase |
| If pH increases, you _________ ventilation, __________ H+ secretion, & ________ bicarb secretion in kidneys. | decrease, decrease, increase |
| ABG: pH 7.49, PCO2 28, HCO3 24. Diagnosis? | Respiratory Alkalosis |
| ABG: pH 7.31, PCO2 50, HCO3 25. Diagnosis? | Respiratory Acidosis |
| ABG: pH 7.55, PCO2 50, HCO3 30. Diagnosis? | Metabolic Alkalosis |
| ABG: pH 7.33, PCO2 25, HCO3 12. Diagnosis? | Metabolic Acidosis |
| List causes of non-anion gap metabolic acidosis (FUSEDCARS) | Fistula (pancreatic) Uretero-enterostomy Saline administration Endocrine (hyperparathyroid) Diarrhea Carbonic Anhydrase Inhibitors Ammonium Chloride RTA Spironolactone |
| List the causes of anion gap metabolic acidosis (GOLDMARK) | Glycols Oxoproline L-lactate D-lactate Methanol Aspirin Renal failure Ketoacidosis |
| List the causes of Cl responsive metabolic alkalosis (VCEED) | Volume depletion Cystic Fibrosis Emesis Exogenous alkali Diuretics |
| List the causes of Cl unresponsive metabolic alkalosis with a high BP (DHLH) | Diuretics Hyperaldosteronism Liddle Syndrome Hydroxylase deficiencies (11 beta or 17 alpha) |
| List the causes of Cl unresponsive metabolic alkalosis with normal/low BP (HBAGH) | Hypokalemia Bartter Syndrome Alkalotic agents Gitelman Syndrome Hypomagnesia |
| Respiratory acidosis is due to _____ventilation | hypO (COPD, CNS depression, restrictive lung dz, etc) |
| Respiratory alkalosis is due to ____ventilation. | HypER (anxiety, SAH, meningitis, drugs, altitude sickness, fever, pregnancy, etc) |
| Equation for calculating anion gap? | (Na + K) - (Cl + HCO3) |
| Causes of a low anion gap? | Multiple myeloma & hypoalbuminemia |
| _________ >10 mOsm/L suggests the presence of ethanol, ethylene glycol, methanol, acetone, isopropyl ethanol, or propylene glycol. | Osmolar gap |
| If high anion gap, calculate _______. | Osmolar gap |
| If non-anion gap metabolic acidosis, calculate ________. | Urine anion gap |
| A negative urine anion gap suggests __________. | diarrhea (GI loss of bicarb) |
| A positive urine anion gap suggests _______. | RTA (impaired renal acidification) |
| List the etiologies of hypokalemia (EIII) | Extrarenal losses Increased renal excretion Intracellular shift Inadequate intake |
| EKG: Inverted T waves, prominent U waves, ST depression. Diagnosis? | Hypokalemia |
| Patient with 4 day history of vomiting and diarrhea presents complaining of weakness & paralysis. EKG shows abnormalities. Diagnosis? | Hypokalemia |
| First test to order in hypokalemic patients to determine source of K+ loss? | Urine K+ (<20 = extra renal, >20=renal) |
| Tx for severe hypokalemia? | PO KCl |
| List the etiologies of hyperkalemia (DCH) | Decreased renal fxn Cell leakage (or transcellular shifts) High potassium intake |
| EKG: Tall, peaked T waves, flat P waves, QRS widening. Diagnosis? | Hyperkalemia |
| Patient presents to ER with crush injury to forearm from MVA. Complains of general weakness and paralysis. EKG shows peaked T-waves. Dx? 1st step of Tx? | Hyperkalemia, Calcium gluconate |
| Calcium gluconate, regular insulin+D50, nebulized albuterol, sodium bicarb, & IV loop diuretics are all part of the treatment for? | Hyperkalemia |
| Last resort treatment for hyperkalemia if nothing else works? | dialysis |
| Metabolic acidosis leads to _____kalemia. | hypER |
| Causes of chronic hyperkalemia? | Aldosterone deficiency & renal failure |
| Aldosterone excess leads to _____kalemia. | hypO |
| Aldosterone deficiency leads to _____kalemia. | HypER |
| Drug class that can be used concomitantly with diuretics to treat diuretic-induced hypokalemia? | Potassium sparing diuretics |
| Fraction of total body water that's extracellular? | 1/3 |
| Fraction of total body water that's intracelluar? | 2/3 |
| TBW in women calculation | 0.5 x body weight (kg) |
| TBW in men calculation | 0.6 x body weight (kg) |
| Intracellular fluid makes up __% of body weight. | 40 |
| Extracellular fluid makes up __% of body weight. | 20 |
| Extracellular fluid is further divided into _______ & ________ fluid. | intravascular, interstitial |
| A water deficit should be calculated in patients that have ________ to determine treatment. | hypernatremia |
| Equation to calculate serum osmolality? | 2 x Na +(Glu/18) + (BUN/2.8) |
| Cell shrinkage is ? | Dehydration |
| Decrease in extracellular fluid volume is ? | Volume depletion |
| Cause of hypertonic hyponatremia? | Hyperglycemia |
| Causes of isotonic hyponatremia? | Hyperlipidemia, hyperproteinemia |
| Causes of this type of hyponatremia include diuretics, RTA, interstitial nephritis, CKD, volume replacement with hypotonic fluid, N/V/D, enteric fistulas, & 3rd space losses | Hypovolemic Hypotonic Hyponatremia |
| #1 cause of euvolemic hypotonic hyponatremia? | SIADH |
| Causes of this type of hyponatremia include TBW overload, edematous states like nephrotic syndrome, cirrhosis, CHF, or renal failure. | Hypervolemic hypotonic hyponatremia |
| Treatment for mild/asymptomatic hyponatremia? | Water restriction |
| Tx of critical hyponatremia? | 3% NaCl |
| List the etiologies of hypernatremia (NOC) | Nephrogenic diabetes insipidus Osmotic diuresis Central diabetes insipidus |
| 90 year old female presents with lethargy. Caregiver reports inadequate water intake. Dx? Tx? | Hypernatremia, D5W |
| If unsure of cause of hypernatremia, which tests should you order? | Urine osmolarity (>300=osmotic diuresis; <150= DI) ADH test (if responsive- CDI; not responsive - NDI) |
| ADH secreted independently of body's need to conserve water. Diagnosis? | SIADH |
| There's a risk for _______ _______ if D5W is administered too quickly. | Cerebral edema |
| Patient with a hx of DM presents with N/V, polydipsia, polyuria, & abd pain. On exam - Kussmaul respirations, tachycardic. Dx? | DKA |
| Temporary incontinence is? | Acute urinary incontinence |
| List the causes of acute urinary incontinence (DIAPPERS): | Delirium (normal pressure hydrocephalus) Infection (UTI) Atrophic Vaginitis Pharmaceuticals Psych (depression) Endocrine (DM, DI) Restricted mobility Stool Impaction |
| Involuntary loss of urine accompanied by or immediately preceded by sudden urge? | Urge Incontinence |
| Risks for this type of incontinence are: bladder inflammation, chronic bladder outlet obstruction, post-menopausal status, & CNS disorders | Urge Incontinence |
| Most common etiology of urge incontinence? | Idiopathic |
| Treatment options for this type of incontinence include behavior modification, Kegel exercises, estrogen, anticholinergics, Botox, & surgery | Urge Incontinence |
| Most common type of incontinence in men? | Urge incontinence |
| Incontinence associated with increased abd pressure, change in position, or sexual intercourse? | Stress Incontinence |
| Most common type of incontinence in women? | Stress incontinence |
| Etiologies of this type of incontinence include: Urethral hypermobility, intrinsic sphincter deficiency, urinary retention, detrusor overactivity, post-prostate surgery or after prostate radiation. | Stress incontinence |
| Treatment for this type of incontinence includes: Behavior modification, Kegel exercises, peri-urethral bulking agents, suspension/sling procedures, or artificial urinary sphincters | Stress Incontinence |
| Cough test is best to diagnose which type of incontinence? | Stress |
| Incontinence due to incomplete emptying from impaired detrusor muscle contractility or bladder outlet obstruction. AKA "false incontinence" | Overflow Incontinence |
| Incontinence commonly seen in Alzheimer's, Parkinson's, & severe arthritis. Due to impaired mobility &/or cognition. | Functional Incontinence |
| Cotton swab test is used to evaluate? | Urethral mobility |
| BPH is due to increase in the # of epithelial & stromal cells in the __________ gland of the prostate. | Periurethral |
| Decreased force & caliber of stream, hesitancy, post-void dribbling, & sensation of incomplete emptying are what type of BPH sx? | Obstructive |
| Dysuria, urinary frequency, urgency, & nocturia are what type of BPH sx? | Irritative |
| What labs should you order if you suspect BPH? | UA, SCr, PSA |
| Drugs used to treat BPH? (3 classes?) | Alpha blockers, 5-alpha reductase inhibitors, PDE-5 inhibitors |
| Gold standard for BPH surgical treatment? | TURP (Transurethral Resection of Prostate) |
| Male presents with acute onset of perineal/low back pain, fever, chills, N/V, sensation of incomplete emptying, & dysuria. DRE shows a hot, boggy, & tender prostate. Diagnosis is? What is expected on CBC? | Acute bacterial prostatitis, elevated WBC with left shift |
| Acute bacterial prostatitis is typically caused by gram ______ organisms and should be treated with ______ or ______ x30 days. | negative, FQ, bactrim |
| Male presents complaining of recurrent UTIs, between which he is asymptomatic. Normal prostate exam. Diagnosis? Treatment? | Chronic bacterial prostatitis, acute abx followed by suppressive abx |
| Male presents complaining of persistent perineal, low back pain with LUTS sx. He is afebrile & non-toxic. His hx is pertinent for anxiety/depression. Diagnosis? Treatment? | Nonbacterial Prostatosis, counseling/physical therapy |
| Older AA male presents for yearly physical, complains of mild obstructive urinary sx. Worry about? | Prostate carcinoma |
| Most prostate CA is found in the ________ zone. | Peripheral |
| Which prostate carcinoma treatment has a lower risk of ED & incontinence? | Radiation |
| Surgery to remove prostate in prostate carcinoma is associated with side effects of _____ & __________. | ED, incontinence |
| Greatest benefit of PSA screening is between ages ___-____ | 55-69 |
| 14 year old male presents with acute onset of scrotal pain following a soccer game. On exam, testis is swollen and tender and cremasteric reflex is absent. - Phren's sign. Diagnosis? | Testicular Torsion |
| Definitive diagnosis of testicular torsion is by? | Scrotal exploration |
| Bell clapper deformity is associated with increased risk for? | Testicular Torsion |
| Male patient presents complaining of painful testicular swelling. He was diagnosed with Mumps 7 days ago. Likely diagnosis? Orders? | Orchitis, scrotal US & UA |
| Male patient presents complaining of a dull ache in his testis, with pain radiating into the ipsilateral inguinal canal. Reports he recently had a Foley catheterization. On exam, + cremasteric reflex & Phren's sign. Likely diagnosis? | Epididymitis |
| Treatment for epididymitis? | Rest, scrotal support, abx, NSAIDs |
| Male patient presents complaining of vague testicular pain that worsens with valsalva. On exam - dilated, tortuous veins of spermatic cord of L testis. Diagnosis? Tx? | Varicocele, NSAIDs & scrotal support (ligation or embolization if severe) |
| Male patient presents for yearly physical. On GU exam, small cyst on superior pole of epididymis. Transilluminates on exam. Diagnosis? Tx? | Spermatocele, None (unless continued enlargement or pain) |
| Male patient presents complaining of painless testicular swelling that's worse after standing long periods of time. On exam, there is an accumulation of fluid in the tunica vaginalis that transilluminates. Diagnosis? Orders? | Hydrocele, scrotal US (to r/o CA) |
| 25 year old male presents complaining of "heaviness in testis" & gynecomastia. He reports a hx of cryptorchidism. Likely diagnosis? | Testicular carcinoma |
| Most commonly enlarged lymph nodes in testicular carcinoma? | Pelvic |
| Testicular tumors often produce _______ which can lead to gynecomastia. | beta HCG |
| 22 year old male presents complaining of dysuria and scant clear urethral discharge. + leukocytes, - culture on urine. Diagnosis? Order? Tx? | Nongonococcal urethritis, urethral swab, Tetracycline/Doxycycline |
| 19 year old male presents complaining of dysuria, copious urethral discharge and is uncircumcised. + leukocytes, - urine culture. Diagnosis? Order? Tx? | Gonococcal Urethritis, urethral swab, Rocephin & Azithromycin |
| Nongonococcal urethritis is usually caused by what organism? | Chlamydia |
| Envelope crystals on urine microscopy = what type of stone? | Calcium |
| Type of stone that forms with hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia, low urine volume, and changes to pH | Calcium |
| Foods like spinach, beans, nuts, soy, chocolate, & coffee are high in ________ and should be ________ in patients that have kidney stones. | oxalate, avoided |
| Foods like bananas, melons, citrus, salmon, tuna, & cereals are high in ________ and should be _______ in patients with kidney stones. | Citrate, increased |
| Foods like organ meats, tuna, & beer are high in _________ and should be __________ in patients with kidney stones. | Purines, avoided |
| Coffin lid crystals on urine microscopy suggest which type of stone? | Struvite |
| Women are more at risk for which type of stone? | Struvite |
| Stone that forms due to presence of urease producing bacteriae? | Struvite |
| Most severe type of stone? | Struvite |
| Rosebud, Rhomboid, and Needle crystals seen on urine microscopy suggest which type of stone? | Uric Acid |
| Which type of stone is common in patients that have metabolic syndrome (including gout)? | Uric Acid |
| Benzene ring crystals seen on urine microscopy suggest which type of stone? | Cystine |
| Stone associated with rare autosomal recessive disorder that typically presents in childhood? | Cystine |
| 40 year old male presents complaining unilateral flank pain radiating into groin with associated n/v and hematuria. Diagnosis? | Kidney Stone |
| Gold standard for diagnosis of kidney stone? | Thin cut spiral CT |
| More accessible, cheaper imaging for diagnosing stones? | KUB |
| Initial imaging done when kidney stone suspected during pregnancy? | Renal US |
| Type of stone that's undetectable on KUB? | Uric Acid |
| General treatment for all symptomatic kidney stones? | Hydrate, Toradol, Zofran, Flomax |
| Treatment for a struvite stone? | PCNL (percutaneous nephrolithotomy) & abx |
| Stones greater than __mm are unlikely to pass on their own. | 5 |
| Older male presents complaining of recent onset of anuria and exhibits symptoms of metabolic acidosis. Cr & K+ levels are increased. Hydronephrosis on renal US. No hx of CKD. Suspect? | Complete urinary obstruction |
| 30 year old female presents complaining of dysuria, frequency, urgency, and suprapubic pain. Likely diagnosis? | UTI |
| A pregnant women has asymptomatic bacteruria. Do you treat her? | Yes |
| Pyuria and nitrite on UA suggest what diagnosis? | lower UTI |
| Most common pathogen that causes UTIs? | E. Coli |
| Gold standard for diagnosis of UTI? | Urine culture and sensitivity |
| Two most common abx used to treat uncomplicated lower UTI? | Macrobid & Bactrim |
| Patient presents within 2 weeks of being treated for a UTI with another UTI, that's caused by the same pathogen. What type of UTI is this? | Relapse |
| Patient presents 3 weeks after being treated for a UTI with a UTI caused by a different pathogen. What kind of UTI is this? | Reinfection (95% of recurrent UTIs!) |
| 32 year old female presents complaining of fever, chills, flank pain, and dysuria. Diagnosis? Labs to order? | Pyelonephritis, UA, urine culture, & CBC |
| Women that have __ or more symptomatic UTIs within 6 months or ___ or more over 12 months should get prophylaxis. | 2, 3 |
| How long should continuous prophylaxis for UTIs be done? | 3-6 months |
| Usage of spermicide containing products _______ the risk of UTIs. | increases |
| Topical estrogen therapy in postmenopausal women _________ the risk of UTIs. | Decreases |
| Increased muscle mass, eating cooked meats, and kidney disease all do what to the serum creatinine? | Increase |
| Increased age, low protein diet, malnutrition, and liver disease all do what to the serum creatinine? | Decrease |
| Obesity causes a decrease in SCr? T/F? | False (no change) |
| Renin is secreted when there's a _______ in renal perfusion. | Decrease |
| Aldosterone causes Na+ and Cl- ________, K+_________, and water _______. | Reabsorption, excretion, retention |
| Which BP drug blocks reabsorption of Na & Cl in the DCT? | Thiazides |
| Which BP drug blocks reabsorption of Na+, K+, & Cl- in the ascending limb of the loop of Henle? | Loop diuretics |
| Which BP drug prevents Na+ reabsorption & K+ secretion? | Potassium Sparring Diuretics |
| Which BP drug prevents reabsorption of HCO3 in the PCT causing indirect inhibition of Na+ resorption? | Carbonic Anhydrase Inhibitors |
| Kidney damage or a decreased GFR of <60 mL/min for 3 months or more | Renal Insufficiency |
| GFR <15 mL/min or on dialysis | Renal failure |
| Sx resulting from loss of kidney fxn? | Uremia |
| Patient presents complaining of progressive loss of energy, decreased appetite, N/V, & confusion. Pericarditis found on imaging. Etiology of these sx? | Uremia |
| "Nitrogen in the blood"; elevated BUN, Cr? | Azotemia |
| Alterations in handling of substances that occurs with CKD: Water ______, _____ potassium and phosphorus excretion, and _______ calcium reabsorption. | Retention, decreased, decreased. |
| What do NSAIDs, aminoglycosides, radioopaque contrast, penicillin, Gold, penicillamine, nitrofurantoin, nalidixic acid, & tetracycline all have in common? | Avoid in renal failure |
| Most common genetic cause of renal failure in adults (10%)? | Polycystic kidney disease (PCKD) |
| Patient with acute abd/back pain, hematuria, UTI, HTN, palpable kidneys, and a ruptured berry aneurysm likely has?? | Polycystic Kidney Disease |
| Patients with these disease should avoid contact sports and instrumentation on GU tract, stay well hydrated, and be screened for cerebral aneurysms. | Polycystic Kidney Disease |
| Adult PCKD is autosomal _______, while childhood PCKD is autosomal ________. | dominant, recessive |
| A patient presents with hyperkalemia, metabolic acidosis, salt & water handling abnormalities, anemia, mineral & bone disease, and sexual dysfunction. They likely have? | CKD |
| Kidney damage with nl or increased GFR (>90) is classified as what stage of CKD? | Stage I |
| A GFR of 60-89 is classified as what stage of CKD? | Stage II |
| A GFR of 30-59 is classified as which stage of CKD? | Stage III |
| A GFR of 15-29 is classified as which stage of CKD? | Stage IV |
| A GFR of <15 or being on dialysis is classified as which stage of CKD? | Stage V |
| Most specific diagnostic tool for diagnosing CKD? | Renal Biopsy |
| Which dose is adjusted in renal insufficiency, loading or maintenance? | Maintenance (also adjust dosing intervals) |
| Treatment for this disease may include protein restriction, statins, smoking cessation, ACEI/ARB, low K+ diet, sodium bicarb/citrate, EPO stimulating agents, Ca/Vit D supplementation, & phosphate binders | CKD |
| Tx for patients that have an uncontrolled volume, uremic sx that can't be managed, failure to thrive, pericarditis, DM with GFR<15, or non-DM with GFR<10? | Dialysis |
| Abrupt deterioration in kidney function, manifested by an increase in SCr with or without a reduced urine output | Acute Kidney Injury |
| A creatinine >/= 26 within 24hrs or an increase >/= 1.5-1.9x the reference SCr is indicative of what stage of AKI? | Stage I |
| An increase >/=2-2.9x the reference SCr signifies which stage of AKI? | Stage II |
| An increase >/= 3x the reference SCr or an increase >/=354, or on dialysis signifies which stage of AKI? | Stage III |
| Stage I AKI can be defined as <0.5 mL urine/kg/hr for >___ hours. | 6 |
| Stage II AKI can be defined as <0.5 mL urine/kg/hr for >___ hours | 12 |
| Stage III AKI can be defined as<0.3 mL urine/kg/hr for >____hours or anuria for____hours. | 24, 12 |
| Etiologies of this class of AKI include: Hypovolemia, reduced effective circulating volume, drugs, and renal artery stenosis | Pre-Renal AKI |
| Etiologies of this class of AKI include: GN, tubular obstruction & dysfunction (ATN), drugs, myeloma, or sarcoidosis | Intrinsic AKI |
| Etiologies of this class of AKI include: renal papillary necrosis, kidney stones, retroperitoneal fibrosis, carcinoma of the cervix, BPH, prostate CA, or urethral strictures. | Post renal AKI |
| BUN-Cr ratio >20:1, FENa < 1%, urine sp gravity >1.020, & hydraline casts suggest? | Pre-renal AKI |
| BUN-Cr ratio 10:1-20:1, FENa>1, urine sp gravity 1.010-1.020, tubular or granular casts, hematuria, and proteinuria is associated with? | Intrinsic AKI |
| US showing hydronephrosis in an elderly person. This is most likely? | Post-renal AKI |
| Approach to ______ AKI tx is hydration, eliminating toxins, treating causes, and giving diuresis if overloaded. | Pre-renal |
| Approach to ______ AKI treatment is ordering CBC, ESR, consulting nephrology for biopsy, eliminating toxins, and treating causes | Intrinsic AKI |
| Approach to _______ AKI treatment is to order CT without contrast, get Foley, & consider urology consult | Post-renal |
| AEIOU indications for dialysis? | Acid Base problems Electrolyte problems Intoxications Overload (fluid) Uremia sx |
| HTN, proteinuria, & RBC casts = ??? | GN |
| Can be characterized by scrotal/peri-orbital edema, HTN, proteinuria <3g/24 hrs, hematuria (dysmorphic RBCs), edema, elevated Cr, & decreased GFR | Nephritic Spectrum GN |
| Post-infection GN, Berger's Dz, Hep C, and SLE are part of the ________ spectrum of GN. | Nephritic |
| Can be characterized by proteinuria >3g/24 hours, edema, HTN, hypoalbuminemia, hyperlipidemia, hematuria, & oval fat bodies | Nephrotic Spectrum GN |
| Minimal change disease, diabetic nephropathy, membranous nephropathy, & amyloidosis are part of the ________spectrum of GN | Nephrotic |
| Microscopic or macroscopic hematuria with or without proteinuria & generally asymptomatic suggests? | Asymptomatic Glomerular Hematuria |
| AKI, proteinuria<3g/24 hrs, hematuria, RBC casts, edema, & HTN suggests? | Nephritic Syndrome |
| AKI, proteinuria <3g/24 hrs, hematuria, RBC casts, HTN, decreased GFR(50% in <3 months), increased ESR/CRP, +ANCA, & crescent formations on biopsy suggests? | RPGN |
| MC in children;>3g protein/24 hrs, hematuria, edema, hypoalbuminemia, HTN, hyperlipidemia, & oval fat bodies on UA suggests? | Minimal Change Disease |
| Hx of DM, albuminuria, end organ damage suggests? | Diabetic Nephropathy |
| Membranous nephropathy is caused by? | Lymphoma |
| Proteinuria 300mg-10g/24hrs, no RBCs or casts, "bland urine" suggests? | Asymptomatic Proteinuria |
| Proteinuria >3g/24 hrs, HTN, hypoalbuminemia, hyperlipidemia, RBCs & oval fat bodies on UA suggests? | Nephrotic Syndrome |
| Recent sore throat, low complement levels, and +anti-streptolysin O titer suggest? | post-strep GN |
| Gold standard for diagnosing GN? | Renal Biopsy |
| 29 year old male presents to ER post trauma complaining of muscle pain, weakness, & red-brown urine. CK levels are elevated.Diagnosis? Complication if left untreated? | Rhabdomyolysis, AKI |
| RTA type that is caused by defect in distal tubule leading to failure of H+ secretion, severe acidosis, & hypokalemia. | Type 1 |
| RTA that occurs mostly in children that have Fanconi's syndrome. May also occur in chemo pts, use of acetazolamide, or outdated tetracycline. Causes failed HCO3 reabsorption in proximal tubules. Acidosis & hypokalemia on labs. | Type 2 |
| RTA that is a combination of type 1 & 2 | Type 3 |
| RTA in which the transport of electrolytes is impaired & results in high levels of potassium. Due to aldosterone deficiency or resistance. | Type 4 |
| A low urine specific gravity (<1.009) is due to? | Excess H2o |
| A high urine specific gravity (>1.020) is due to ? | H2O restriction (dehydration) |
| How do you estimate urine osmolality from specific gravity? | Last 2 digits of specific gravity x 35 |
| Leukocytes on UA indicate? | inflammation or infection |
| Nitrite on UA? | Gram- bacteria (& some gram +) |
| Bilirubin on dipstick indicates abnormal ________ function. | hepatobiliary |
| Urobilinogen indicates ________ parenchymal damage. | hepatic |
| If _______ are present in urine, may be due to DM, ETOH ingestion, vomiting, starvation, high protein diet, or acute febrile illness. | Ketones |
| Glucose on UA usually signifies DM, but can also suggest? | Hyperthyroidism, Cushing's, Fanconi's syndrome, pain, excitement, asphyxia, shock, anesthesia, pancreatic d/o, CNS d/o |
| Casts that are associated with exercise, heat exposure, pyelonephritis, or chronic renal disease. | Hyaline |
| Casts that can be granular, fatty, waxy, epithelial, RBCs or WBCs | Cellular |
| Cellular cast seen with nephrotic syndrome, lipiduria, & hypothyroidism. | Fatty casts |
| The glomerular basement membrane, slit diaphragm of epithelial podocysts, & renal tubular cell reabsorption are all _______to the development of proteinuria | barriers |
| Normal daily protein excretion? | <150 mg/24 hours |
| Categories of non-nephrotic proteinuria? | Transient, intermittent, persistent, non-isolated (microalbuminuria) |
| Subclasses of persistent proteinuria? | Orthostatic, constant |
| Subclasses of constant persistent proteinruia | Glomerular, Tubulointerstitial, Overflow |
| Etiologies of this type of proteinuria include fever, strenuous exercise, cold exposure, CHF exacerbation, seizure, high renin states, & pancreatitis. | Transient |
| Type of proteinuria that occurs only when in upright posture? | Orthostatic |
| Etiologies of hematuria? (TICS) | Trauma, infections, Calculi, Surgery |
| 20% of people with gross hematuria have? | Cancer |
| Normal GFR in males? | 100-125 |
| Normal GFR in females? | 80-105 |
| BUN-Cr ratio of 15-20:1 signifies? | Dehydration |
| BUN-Cr ratio of >15:1 signifies? | Pre-renal/post-renal azotemia |
| BUN-Cr ratio <10:1 signifies? | Renal Disease |
| Diagnostic study best for dx of cysts, tumors, PCKD, obstruction, & scarring in chronic pyelonephritis | Renal US |
| Diagnostic study that can reveal stones, obstructions & show kidney size, shape, and calyceal anatomy. | Intravenous Pyelogram |
| Diagnostic study that best for identifying calcified stones, & calcified renal artery aneurysm. Shadows may help determine kidney size & shape. | KUB |
| Diagnostic study used for evaluating chronic UTIs (esp in children). Can detect vesicoureteral reflux. | Voiding cystourethrogram |
| Diagnostic study used to visualize bladder stones, bladder diverticula, BPH, bladder/urethral tumors, interstitial cystitis, & urethral strictures. Good for working up hematuria. | Cystourethroscopy |
| Diagnostic study used to visualize renal vessels to evaluate for secondary HTN, CKD, kidney masses, trauma, or complications post-transplant. Being replaced by CTA. | Renal angiography |
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