A Cute Kidney
Definition for acute kidney injury
Cr increase 0.3 in 48 hours
1.5 times baseline Cr over seven days
urine output less than 0.5mL/kg/hr for 6 hr
3 intern points
Definition of CKD
Presence of kidney damage or decreased kidney function >3mo
5 points
Headache, nausea, vomiting, muscle cramps, altered mental status after first dialysis treatment
Diagnosis
Disequilibrium syndrome
Caused by cerebral edema from transient urea gradient
25 points
Tenderness overdraft, fever, hypertension, edema and decreased urine output, eight weeks post transplant. what is the pathophys of this condition
acute rejection
type IV hypersensitivity (T cell activation against donor MHC)
10,000 STEP 1 points
what percentage of stones are radiopaque
80%
80% of a point
The most sensitive test for rhabdomyolysis is
CK
1 conner kimbrell point (worth 100 regular points)
hyperphosphatemia and hypocalcemia are related to
increased PTH
15 points
indications for dialysis
AEIOU
BUN >100
Cr >10
10 Cohen points
workup for suspected acute rejection
UA, BMP,
renal ultrasound, trough cyclosporine level
knowledge is its own reward, no points
Bariatric surgery, short thousand room, inflammatory bowel disease all increase absorption of this substance
What is oxalate?
what is 25 points?
FENa formula
Urine Na / serum Na x100
urine Cr / serum Cr
10 Cohen points
how many stages?
Stage 1: Kidney damage (e.g. proteinuria) and GFR >90
Stage 2: GFR 60-89
Stage 3: GFR >30-59
Stage 4: GFR 15-29
Stage 5: GFR <15
Stage 5D: dialysis
5 or 6 points depends what they answered
true or false:
Guacamole is a good source of potassium
true
happy cinco de pointos
Most common life-threatening infection in kidney transplant patients
Cytomegalovirus
30 points
imaging study of choice in pediatric and pregnant patients
Renal ultrasound
5 points
Name two examples of a nephritic disease
Poststreptococl
Lupus
Goodpasture
IGA nephropathy
25 points
Renal protective therapy includes
ACE inhibitor or ARB
Blood pressure management
Statin
smoking cessation and protein restriction
10 points
Most common complication peritoneal dialysis
Peritonitis: abdominal pain and cloudy dialysate
Sample of dialysate for cell count and culture
Intraperitoneal antibiotics
10 points
pathophys of hyperacute rejection
type II hypersensitivity
preexisting antibodies react to donor antigen
100 STEP 1 points
recurrence rate
50% at 10 years
25 discharge instruction points
medication most strongly associated with acute interstitial nephritis
Methicillin
penicillin, cephalosporins, sulfonamides, NSAID, allopurinol, diuretics, anticoagulants
100 points
most common complications of CKD
volume overload, ^K, HTN, Anemia, metabolic acidosis
10 points
Thrombosis
Story time with Eli
100 points to everyone
management of acute rejection
3-4 days high dose steroids
graft biopsy, monoclonal anti T cell antibodies
25 points
indications for stone admission (give me 4)
infection, intractable N/V, uncontrollable pain, hypercalcemic crisis, solitary kidney, high grade obstruction or large stone, intrinsic renal disease
35 dispo points