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Step III

Step III - Renal 4

If protein:creatinine elevated then next step Bx
Under what renal failure conditions would dialysis be warranted K+, MA, toxins eg ASA, lithium, ethylene glycol, uremia w/ enceph, fluid overload, uremia w/ pericardx
Pee a lot, Drink a lot, Urine dilute, Na+ in blood. Given desmopressin and urine osm ↑ Central DI
Pee a lot, Drink a lot, Na+ in blood. Desmopressin given but NO response in urine osm Nephrogenic DI
Pee a lot, Drink a lot, Na+ in blood. DDAVP given and urine volume drops Central DI
Pee a lot, Drink a lot, Na+ in blood. DDAVP given and urine volume unchanged Nephro DI
What are the causes of NDI Low K+, lithium tox,  Ca2+
What will happen to urine osm if pt is water deprived No change in urine Osm
Best initial tx CDI Give DDAVP/vasopressin
Best initial tx NDI Correct low K+ or  Ca2+; give HCTZ
What are the causes of HYPERvolemic hyponatremia CHF, nephrotic syndrome, cirrhosis
DONE 10/13
What are the causes of HYPOvolemic hyponatremia Diuretics, GI loss (vomiting/diarrhea), skin loss (burns/sweating)
Hyponatermia from insufficient aldosterone = Addison’s
Low Na+,  K+, MA, hypovolemic pt Addison’s
Tx for Addison’s fludrocortisone
What are the causes of euvolemic hyponatremia SIADH, polydipsia, hypothyroidism
Initial tx for HTN Lifestyle modification
First line Rx tx for HTN HCTZ
First line Rx tx for DM HTN ACE/ARB
HCTZ fails to control HTN then next tx Add β(-) / ARB / ACEI / CCB
Rx for HTN in CAD β(-)
Rx for HTN in CHF β(-) / ARB / ACEI
Rx for HTN in migraine CCB / β(-)
Rx for HTN in HYPERthyroid β(-)
Rx for HTN in osteoporosis thiazide
Rx for HTN in depression NO β (-)
Rx for HTN in asthma NO β (-)
Rx for HTN in pregnancy α methyl dopa
Rx for HTN in BPH α (-)
Male pt w/ hx BPH presents w/ recurrent UTI Bladder diverticulum
most efficient and reliable method of detection for bladder diverticula VCUG (Voiding cystourethrography)
What do U waves indicate on EKG HYPOkalemia
What are the S/S of HYPOkalemia Abdominal cramps, nausea, vomiting, muscle weakness, polyuria, and polydipsia
Drug induced renal failure a/w penicillins, cephalosporins, rifampin, sulfa drugs, quinolones, NSAIDs, diuretics, allopurinol, and phenytoin AIN
Initial tx for AIN Stop offending drug and observe
Next step tx for AIN if initial does not work Steroids
Is Churg Strauss the only renal dz to present w/ eosinophilia NO, AIN can as well
Eosinophiluria, eosinophilia, low grade fevers, mild proteinuria, and arthralgias, in the setting of exposure to medication AIN
What does MUDPILES stand for MUDPILES (Methanol, Uremia, Diabetic ketoacidosis, Paraldehyde, Iron, Isoniazid, Lactic acid, Ethanol, Ethylene glycol, and Salicylates)
Created by: DrINFJ