IM：腎內

32 flashcards · Other · by Wanying Koh

1. hyporeninemic hypoaldosteronism K, Na, acid levels

   high K, high acid, low Na (aldosterone 留Na排K,acid) metabolic acidosis w hyperK

2. long term thiazide diuretics use metabolic acidosis or alkalosis Cl responsive or non-responsive

   metabolic alkalosis Cl responsive (Urine Cl <20)

3. acetazolamide meta / respiratory acid/alkalosis? which ion imbalance?

   cause HCO3- loss (reabsorption dec.) --> metabolic acidosis hypoK

4. nephrotic syndrome effective blood volume

   PALE (proteinuria, hypoALB, hyperlipidemia, edema) 因為 loss of albumin --> dec osmotic pressure --> fluid shifts out of blood into extracellular and intracellular --> effective blood volume dec ECF increase ICF increase effective blood volume decrease

5. SIADH tx

   first line: fluid restriction hypertonic saline (3% N/S) NOT 0.9%

6. tx of hypoaldosterone

   0.9% N/S isotonic saline

7. 補充 K during hypokalemia tx 不能用什麼

   KCl + N/S dont use dextrose or glucose --> release of insulin, causing K to enter cells

8. renal tubular acidosis 什麼可以同時治療 acidemia & hypoK

   potassium citrate

9. Bartter's syndrome & Gitelman syndrome 特性

   metabolic alkalosis, low/normal BP, hypoK, hypoMg GDt BLf Bartter's: @loop of henle, like furosemide --> urine Ca inc., blood Ca dec (記得furosemide 排 Ca) Gitelman's: @distal tubule, like thiazide --> urine Ca dec, blood Ca inc

10. hyperkalemia 跟 meta acidosis/alkalosis 有關？

    metabolic acidosis

11. hyperthyroidism causes hyperK or hypoK?

    hypoK hyperthyroidism --> affects Na-K-ATPase channel (Na out, K in)

12. 造成 constipation (low GI motility) K levels Ca levels thyroid hyper or hypo

    K: hypo (weaker GI muscle contractions) Ca: hyper thyroid: hypo

13. hypoCa caused by Mg levels thiazide? furosemide? CKD? PTH levels

    Mg levels - LOW thiazide - FALSE. causes hyperCa furosemide - TRUE. causes hypoCa 排 Na, K, Cl, Ca, Mg CKD - TRUE PTH levels - LOW

14. acute pancreatitis association w Ca levels

    hyperCa --> acute pancreatitis --> hypoCa

15. hypoMg due to what syndromes (x3) thyroid hypo or hyper?

    Gitelman, Bartter, refeeding syndrome hypothyroidism

16. delirium, Cr increased from 7.5 --> 9.6 in 1 week, kidney size small Dx Tx

    uremic encephalopathy dialysis

17. RBC cast+, CXR pulmonary infiltrates, proteinuria trace, inc. BP Dx

    pulmonary renal syndrome Goodpasture's syndrome RPGN SLE

18. FeNa formula

    (UNa/PNa) / (UCr/PCr)

19. bacteria most associated with GN

    Streptococcus

20. nephrotic syndrome associated w what cancer

    hodgkin lymphoma

21. 會有 low C3

    Hep C (cryoglobulinemia) PSGN MPGN infective endocarditis lupus nephritis (NOT IgA nephropathy -- URTI 後 --> normal C3)

22. every year most common reason for new dialysis pts due to?

    DM

23. earliest clinical symptom of DM nephropathy

    GFR increase >120mL/min

24. most common nephritis in Taiwan adults

    IgA nephropathy

25. 13 year old boy with edema, hyperlipidemia, hypoalbuminemia, proteinuria Dx pathology

    PALE nephrotic syndrome: minimal change dz similar to normal kidney

26. reuptake of HCO3- occurs in which part of nephron

    proximal tubule

27. myogenic mechanism affects which arteriole causes what tubuloglomerular feedback affects which arteriole causes what

    myogenic mechanism afferent arteriole to constrict/dilate based on BP tubuloglomerular feedback: if macular densa detects dec. in NaCl, causes: afferent - dilate (inhibit adenosine) efferent - constrict (inhibit renin, angiotensin II)

28. CKD anemia type ?chromic ?cytic anemia

    normochromic normocytic anemia

29. uremic bleeding tx

    DDAVP - tx and prophylaxis

30. stage 5 CKD, pericardial friction rub, hyperK, EKG ST-segment inc Dx? Tx?

    uremic pericarditis dialysis

31. CAPD peritonitis most common 致病菌

    Staphylococcus epidermidis GPC 60-70% GNB 15-20% 拔除透析導管

32. vomiting how does it cause hypoK

    vomiting --> hyperbicarbonate --> K loss via renal --> hypoK vomiting --> volume depletion --> aldosterone inc --> 留Na排K