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ninetwo
9-2
| Question | Answer |
|---|---|
| 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
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