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Flashcards in Quiz 2 real Deck (31)
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1
Q

Main symptoms of Diabetic Nephropathy?

A
  • Albuminuria
  • Occult hematuria
  • Diabetic symptoms
2
Q

What test must you do to monitor diabetic nephropathy

A
  • Microalbumin

- can also run HbA1c

3
Q

Treatment approaches for Diabetic Nephropathy

A
  • Ginkgo
  • Flax/Pumpkin Seed
  • Curcumin
  • Guggul
  • Chromium
  • Alpha lipoid acid
4
Q

Major cause of hypertensive nephropathy?

A

-Atherosclerosis

5
Q

What steps should be taken to prevent Hypertensive Nephropathy

A
  • Lifestyle
  • Exercise
  • Loose weight
  • Dietary
  • Sodium Intake
6
Q

Past medical history of PN, urolithiasis, hydronephrosis, radiation to the abdomen and Wilms tumor suggests what?

A
  • Hypertensive Nephropathy

- Nephrosclerosis

7
Q

Sx that suggest HTN Nephropathy

A
  • Ha
  • Fatigue
  • Confusion
  • Vision Changes
  • Angina like chest pain
  • Heat failure
  • Hematuria
  • Epistaxis
  • Irregular heartbeat
  • ear buzzing
  • Pulmonary edema
  • Difficulty to control HTN
  • Sudden aggravation of earlier well-controlled HTN in elderly
8
Q

What are signs of complications in HTN nephropathy or nephrosclerosis

A
  • Left ventricular hypertrophy
  • hypertensive retinopathy
  • abdominal bruits
9
Q

What labs suggest a high clinical suspicion of HTN Nephropathy

A
  • UA
  • EKG
  • Plasma Renin
  • Catopril challenge test
  • elevated creatinine
10
Q

What imaging should you order on a patient with HTN Nephropathy or Nephrosclerosis?

A
  • Renal arteriography
  • Doppler US of renal arteries
  • MR angiography
  • CT
11
Q

Treatment for HTN nephropathy or Nephrosclerosis?

A
  • Blood pressure meds
  • Guggal, garlic EFA, B vit
  • bioflavonoids
  • vaccinium
12
Q

What is nephroptosis

A

kidney drops > 5 cm when moving from supine to standing

13
Q

-Severe Abdominal Pain
-Costovertebral flank pain
-Vomiting in upright position
-Pain relieved with upward movement of the kidney
suggest what?

A

Nephroptosis

14
Q

What is Dietl Crisis

A
  • Severe Colicky Flank Pain
  • Nausea
  • Vomiting
  • Chills
  • Tachycardia
  • Oliguria
  • Hematuria
  • Proteinuria
15
Q

What physical exam finding suggests nephroptosis

A

-Kidney palpable in ipsilateral lower abdomen

16
Q

What Labs should you run if you suspect Nephroptosis?

A
  • Renal US
  • IV urography
  • Look for hydronephrosis
17
Q
  • Flank or back pain
  • Intermittent and dull
  • Fever and malaise (if infection present)
  • Abdominal mass

What does this suggest?

A

Cyst in the kidney

18
Q

What labs must you run if you suspect kidney cysts

What are the findings?

A
  • UA: Normal
  • U/S: Echo-free, sharp demarcated, smooth walls, enhanced back wall indicates good transmission
  • CT: Smooth thin wall, sharply demarcated, does not enhanced with contrast media
19
Q

Age of DX and requirements Autosomal Dominant Polycystic Kidney Disease?

A

15-39 yo: 3 cysts in both kidneys

40-59 yo: 2 cysts

Both must have positive FHx

20
Q
  • Pain over both kidneys
  • Gross hematuria
  • HTN
  • Nocturia
  • Palpable nodular kidney
  • HA
  • N&V
  • Weight loss

Suggests what?

A

Autosomal Dominant Polycystic Kidney Disease

21
Q

Labs for Autosomal Dominant Polycystic Kidney Disease

A
  • Increased erythropoietin
  • Increased HGB and HCT
  • Proteinuria
  • Anemia
  • Increased Bun and Creatinine
22
Q

Imaging for Polycystic Kidneys

A

KUB—enlarged renal shadows up to 5X size
CT—95% accurate for dx, can detect cysts from 0.5cm
US—can detect cysts from 1-1.5cm (Most cost effective, usu start here)
MRI can differentiate Renal Cell Carcinoma (RCC) from cysts

23
Q

General Measures for Polycystic Kidneys

A
  • Low protein diet
  • Fluids!
  • No caffeine
  • Flax Oil
  • Reasonable physical activity
  • HTN treatment
24
Q

What are risk factors for RCC and RCA

A

Cigarette smoking, chronic analgesic use, ADPKD, obesity, toxin exposure (Cd, Pb, asbestos, PAHs), coffee, animal fat diet, dialysis, hysterectomy, contrast IVU, Von Hippel-Landau dz

25
Q
  • Erthrocytosis
  • Hypercalcemia
  • Hypertension
  • Non-metastatic hepatic dysfunction

suggest what

A

Paraneoplastic Syndrome

26
Q
  • Gross hematuria
  • Flank Pain
  • Palpable Abdominal Mass
  • Fever
  • Weight Loss
  • HTN
A

RCC or RCA

27
Q

What symptoms suggest metastasis

A
  • dyspnea
  • cough
  • seizure
  • bone pain
28
Q

What labs suggestt RCA or RCC

A
  • Hematuria
  • Elevated ESR
  • Low Iron
  • Low TIBC
  • Abnormal LFT
  • Increased Alpha-fetoprotein
29
Q

What imaging for RCA and RCC and why

A
  • US- defines simple cysts, tumor thrombus (done first)
  • CT- method of choice for staging and extent of brain mets

-CXR useful for mets; radionucleotide useful for bone mets; MRI useful for
vascular extension

30
Q

Other name for nephroblastoma

A

Wilms tumor

31
Q
  • -Abdominal mass
  • Abdominal Pain
  • Hypertension
  • Hematuria
  • Anemia
A

Wilm’s/ nephroblastoma