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Renal - ABIM

Renal tubular acidosis

QuestionAnswer
What is the mnemonic to remember renal tubular acidosis? Stones I, bones II, aldosterone IV
What is the order of the renal tubular acidosis in the order that it shows up in the kidneys ? What does this order also denote? 241–bones (proximal), aldosterone (distal), Stones (distal) bones (low K), aldosterone (high K), stones (low K) bones(high urine pH >5.5), aldosterone (low pH <5.5), stones (high pH>5.5)
What is the tubular defect in RTA type II? The body can't reabsorb bicarb HCO3- (like acetazolamide)
What is the tubular defect in RTA type IV? The body can't excrete H+ and K+
What is the tubular defect in RTA type I? The body can't excrete H+
Which RTA has low bicarb, Low potassium, low phosphorus? RTA type II
Which RTA has high H and high K? RTA type IV
Which RTA has high H and low K? RTA type I
Which RTA has calcium phosphate stones? RTA type I
Which RTA is associated with autoimmune diseases such as Sjogren's and lupus? RTA type I
Which RTA is associated with renal obstruction? RTA type I
Which RTA is associated with hypo aldosterone? RTA type IV
Which RTA is associated with diabetes? RTA type IV
Which RTA is associated with osteomalacia? RTA type II
Which RTA is associated with multiple myeloma? RTA type II
Which RTA is associated with fanconi's syndrome? RTA type II
What drugs are associated with RTA type II? topiramate, tanofovir, cycloPHOSphamide, iPHOSphamide (RTA II has low phos)
What is the characteristic of urine pH in RTA type II? Early pH > 5.5 because a lot bicarbonate in the urine. Late pH < 5.5 because the body compensates by excreting more H+ into the urine.
What is the characteristic of urine pH in RTA type IV? Urine pH less than 5.5 because there is increased chloride in the urine, which makes the urine acidic
What is the characteristic of urine pH in RTA type I? Urine pH is greater than 5.5 because there is no chloride in the urine.
How do we assess the kidneys response to hypokalemia? Urine potassium/ urine creatinine x 100. If the result is less than 15, then potassium loss is extra renal. If the result is greater than 20, then the kidney is wasting potassium.
In a nonAG metabolic acidosis, how do we differentiate between a kidney problem versus a GI problem Calculate urine anion gap: urine Na + urine K - urine Cl. neg means GI losses. pos means kidney losses.
What are the three things you would see in Fanconi's syndrome? Glucosuria with normoglycemia, proteinuria, hypophosphatemia
Which RTA has calcium oxalate kidney stones? RTA II when induced by drugs such as acetazolamide (Can't reabsorb HCO3–) or zonisamide
Created by: christinapham