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Step III
Step III - Renal 4
| Question | Answer |
|---|---|
| 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
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