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Old people get ______ renal failure very easily from dehydration pre-renal
the 2 weird labs that imply pre-renal azotemia? BUN:Cr is >20 (i.e. BUN is 20x more than Cr). FeNa is <1% [FeNa= (urineNa/serumNa)/(urineCr/serumCr)]
Uremic symptoms like NAV, pericarditis, GI bleed...imply? CHRONIC renal failure (i.e. >90% of kidneys are not functioning)
what does Urine OSM = Serum OSM imply? it implies that kidney f***** SUCKS because it can't concentrate urine. (CRF)
Renal Failure causes platelet coagulopathy. (low Plt's; high BT). treatment? DDAVP
#1 treatment for CRF? When do you not give ACEi? stop smoking! Don't give ACEi if K+ already raised (due to renal failure)...it can exacerbate the hyperkalemia
MCC of death in CRF? heart failure/disease
indications for dialysis: ____ K+ levels, ______pericarditis, metabolic _____osis, fluid overload, BUN >___ or Cr >_____ hyperK+, uremic pericarditis, met acidosis, BUN >100, Cr >12
muddy/granular casts? ATN
fatty casts nephrotic
Hyaline casts pre-renal azotemia
broad/waxy casts CRF
RTA I, II, IV: causes? I: H+ retention (causes raised Ald). II: low HCO3 reabsorption. IV: aldosterone deficiency
RTA II is ass'd with what dz? RTA IV? II: Fanconi anemia, MM, Wilsons dz. IV: diabetes mellitus
Why is pH of urine greater in RTA I than II? cuz I has no H+ in urine...and pH is determined by H+ levels, not HCO3 levels!
MUDPILES (AG acidosis) methanol, uremia, DKA, Paraldehyde, INH/Iron, Lactic acidosis, Ethanol/Ethylene glycol, Salicylate
HyperNa+ treatment: for pt who is hypovolemic (which is usually the case)? pt who is euvolemic or hypervolemic (rarely the case)? hypovolemic: NS. eu/hypervolemic: 5%D
treatment for the 3 DI's: central, nephro, lithium? central: DDAVP (ADH analogue). nephro: HCTZ (indomethacin if refractory). lithium: amiloride
H2O deprivation test for DI diagnosis. How does it work? [note: NOT DONE IN HYPOVOLEMIC PT!]. deprive water for 2-3h, then give ADH...see how urine OSM changes after ADH administration
Rx of hypoNa+? same as hyperNa+ (NS). You can give 3%NS if it is very acute hypoNa+, but correction shouldnt exceed 0.5/h or 12/day
SIADH pulmonary cause? small cell CA or pneumonia
SIADH has ____ urine osm? raised (because urine volume is low, so it is very concentrated)
SIADH Rx? fluid restriction first!, then TTCs or loops
B blockers cause (K+ extracellular/intracellular) extracellular
acidosis causes K+ to (enter/exit) cells exit
First step if hyperK+? EKG (and repeat K+ levels). Ca2+Gluconate immediately if EKG is weird (otherwise Glc/insulin first since it takes forever)
What anesthetic causes K+ to release from cell succinylcholine
Hypokalemia occurs in which RTA RTA I+II
Fad diets with high vit D/A can cause ____calcemia hyper
increased Ca causes ____ QT short (increased HR)
Created by: jsad