-
4 methods to measure tubular function
- fractional excretion or reabsorpitve percentages
- osmolality (concentration)
- urine protein electrophoresis (low-molecular weight proteins)
- direct measurement of substances not normally found in urine (glucose, amino acids)
-
3 transient causes of proteinuria
-
9 further studies to evaluate proteinuria
- CMP
- C3/C4
- ANA
- anit dsDNA
- HBVsAg
- HCVAb
- CMV/EBV IgM, IgG
- HIV
- renal US
-
edema
hypoalbunimemia
normal complement
nephrotic range proteinuria
2-12 years of age
no gross hematuria, HTN or renal insufficiency
Minimal change disease
-
5 findings c/w urologic bleeding pRBCs
- Pain
- Round RBCs in urine
- Bright red blood
- Clots
- Stream variation in color
-
7 findings c/w glomerular hematuria
CD PHAGE
- Casts
- Deformed RBCs on micro
- Proteinuria
- Hypertension
- Anemia
- GFR changes
- Edema
-
Causes of anion-gap metabolic acidosis
MUDPILES
- Methanol
- Uremia
- Diabetic ketoacidosis
- Paraldehyde
- INH, Iron
- Lactic acidosis
- Ethylene glycol
- Salicylate
-
Causes of non-anion-gap acidosis
ACCRUED
- Acid loading
- Carbonic anhydrase inhibitor
- Compensation for respiratory alkalosis
- TRA
- Ureteral diversion
- Extra alimentation TPN
- Diarrhea
-
impaired acidification of urine in distal tubule
nephrocalcinosis
alkaline urine with serum acidosis
low potassium
Type I (distal) RTA
-
impaired proximal tubule reabsorption of base
can be secondary to systemic disease
proteinuria, glucosuria, aminoaciduria
Type II (proximal) RTA
-
resistance to aldosterone
may associated with obstructive uropathy
high potassium
Type IV (hypoaldosteronism) RTA
-
overly rapid correction of hyponatremia
central pontine myelinolysis
-
euvolemia
hyponatremia
low serum osmolality
high urine osmolality
SIADH
-
overly rapid correction of hypernatremia
cerebral edema
-
thirst
hypernatremia
high serum osmolality
low urine osmolality
DI
-
5 EKG findings of hyperkalemia
- peaked T waves
- shortened QT
- ST segment depression
- increased PR interval
- widening of the QRS
-
5 steps in the treatment of hyperkalemia
- IV calcium, stabilizes myocardial membrane
- insulin, glucose, bicarbonate infusion to drive K into cells
- Kayexalate
- inhaled albuterol
- dialysis
-
3 Findings of hypocalcemia
- weakness/tetany
- Chvostek's sign
- widened QTc interval
-
3 findings in nephrotic syndrome
- edema
- hypoalbuminemia
- severe proteinuria
-
5 glomerulonephritides presenting with only hematuria
- postinfectious glomerulonephritis
- IgA nephropathy
- thin basement membrane disease
- HSP
- Alport's syndrome
-
4 glomerulonephritides presenting with only proteinuria
- minimal change nephrotic syndrome
- congenital nephrotic syndrome
- focal segmental glomerulosclerosis
- membranous nephropathy
-
3 glomerulonephritides presenting with hematuria and proteinuria
- lupus nephropathy
- membranoproliferative glomerulonephritis
- anti-glomerular basement membrane disease
-
normal C3
normal C4
normal CH50
- minimal change disease
- membranous nephropathy
- IgAnephropathy
-
low C3
normal or low C4
low CH50
C3 nephritic factor postive
immune deposits
membranoproliferative glomerulonephritis
-
low C3
normal C4
low CH50
elevated ASO
postinfectious glomerulonephritis
-
low C3
low C4
low CH50
anti-ds DNA antibody positive
lupus nephritis
-
congenital nephrotic syndrome
Wilms' tumor
ambiguous genitalia
Denys-Drash syndrome
-
hearing loss
microscopic glomerula hematuria
genetic abnormality of collagen
Alport syndrome
-
8 conditions associated with a diagnosis of sickle cell nephropathy
HIP PINCH
- Hyposthenuria
- Infarction
- Papillary necrosis
- Pyelonephritis
- Insufficiency
- Nephrotic syndrome
- Carcinoma
- Hematuria
-
congenital anomaly
lack of abdominal musculature
undescended testicles
renal dysplasia
Eagle-Barrett (Prune-Belly) syndrome
-
progressive cystic enlargement of the kideys
CNS, GU, GI involvement
presents in adulthood
AD Polycystic Kidney Disease
-
cystic disease of kidneys
hepatic fibrosis
presents in neonatal period
AR Polycystic Kidney Disease
-
chronic inherited sclerosing tubulointerstitial disease
Juvenile nephronophthisis/Medullary Cystic disease
-
AR blond, fair-skinned individuals
Northern Europeans
disorder of cysteine metabolism
cystinosis
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