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Renal - Awesome

Urine studies, casts and other renal

QuestionAnswer
muddy brown casts acute tubular necrosis (necrotic so muddy and brown)
RBC casts glomerular damage
Urine Cl- < 10 mmol/l - what does this mean? Often associated with volume depletion (increased proximal tubular reabsorption of HCO3) Respond to saline infusion (replaces chloride and volume) Common causes: previous thiazide diuretic therapy, vomiting (90% of cases)
Urine Cl- > 20 mmol/l - what does this mean?
What should you be thinking when pts have high Cr and pelvic tumors or irradiation, congenital urinary abnormalities, kidney stones, genitourinary infections, procedures or surgeries, and prostatic enlargement - should increase suspicion for obstruction obstruction as cause of AKI - do kidney US
When should you NOT use FeNa with diuretic use or obstructive etiology
diffuse proliferative lupus nephritis - how to dx and how to treat Dx with kidney bx, tx with prednisone and IV cyclophosphamide for 6 months, followed by azathioprine or mycophenolate mofetil maintenance therapy, monitor with titers of anti-ds-DNA
when do you think of low phos? chronic alcohol use, critical illness, and malnutrition
fractional excretion of phosphate (FEPO4) less than 5% less than 5% suggests increased cellular uptake or extrarenal phosphate loss as the cause of the low serum phosphate
fractional excretion of phosphate value greater than 5% is consistent with renal phosphate wasting
in malnutrition, what should the fractional excretion of phosphate be? less than 5% - extrarenal
what do you see in primary HyperPTH high PTH, low phos, high Ca; no other proximal renal tubular abnormalities
true or false - hyperaldo is always associated with hypo K FALSE - Primary hyperaldosteronism is inconsistently associated with hypokalemia, and its absence in a patient with resistant hypertension should not influence the decision to screen for this condition
normal urine protein in 24h More than 95% of adults will excrete less than 130 mg/24 h of protein in the urine, and the normal value is defined as less than 150 mg/24 h
urine dipstick positivity for blood in the absence of hematuria rhabdo
Propylene glycol causes what kind of acid base abnormality in preparations of intravenous benzodiazepines (such as lorazepam and diazepam) - a lactic acidosis with an increased anion gap may occur
nephrotic syndrome - what is the amount of protein that defines it? what are the other symptoms of the syndrome? urine protein–creatinine ratio greater than 3.5 mg/mg, hypoalbuminemia, hyperlipidemia, lipiduria, edema, and hypercoagulability
new-onset hypertension accompanied by the development of proteinuria Preeclampsia
tx idiopathic hypercalciuria with what thiazide diuretic (HCTZ or cholorthalidone) which reabsorbs Ca
give what to alkalinize the urine K citrate
Created by: christinapham