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USMLE STEP 2 CK- NEPHROLOGY UPDATED STUDY GUIDE QUESTIONS AND CORRECT ANSWERS

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USMLE STEP 2 CK- NEPHROLOGY UPDATED STUDY GUIDE QUESTIONS AND CORRECT ANSWERS

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USMLE STEP 2 CK- NEPHROLOGY UPDATED STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
C




Initial test for proteinuria UA


More accurate test for proteinuria Protein to creatinine ratio
- easier to get and more accurate than 24 hr protein


Significance of Microalbuminuria tiny proteins normally not found in Urine.
-important to check in Diabetes


Wright and Hansel stains significance detect eosinophils in urine - allergic or acute interstitial nephritis. To detect
eosinophils in urine. AIN, drugs like penicillin, cephalosporine, infections,
Addison's disease, parasites, allergies all these increase eosinophils.


Dysmorphic RBCs Glomerulonephritis




Do Cystoscopy when? hematuria w/out infection, trauma AND CT negative, and bladder sonography
shows mass.
-cystoscopy allows direct visualization and biopsy.




Urinary casts are tiny tube-shaped particles that can be Urinary casts may be made up of white blood cells, red blood cells, kidney
found when urine is examined under the microscope cells, or substances such as protein or fat
during a test called urinalysis.




RBC cast Glomerulonephritis




WBC cast Pyelonephritis

, Eosinophil cast acute (allergic) interstitial nephritis




Hyaline cast dehydration




Broad, waxy cast Chronic renal disease




Granular "muddy-brown" cast acute tubular necrosis, collections of dead tubular cells




definition of AKI. Acute kidney injury (AKI), previously decrease in creatinine clearance resulting in sudden rise in BUN and creatinine.
called acute renal failure (ARF), is an abrupt loss of
kidney function that develops within 7 days. Its causes
are numerous.




3 types of Acute Kidney Injury 1) prerenal-decrease perfusion.
2) postrenal-obstruction.
3) interstitial-ischemia and toxins




Causes of prerenal azotemia 1-8 1) Hypotension-sepsis bleeding, dehydration.
2) Hypovolemia- diuretics, burns, pancreatitis.
3) Renal artery stenosis.
4) Hypovolemia from cardiac problems.
5) Hypoalbuminemia (liver dyfxn etc).
6) Cirrhosis.
7) NSAIDs- constrict afferent arteriole.
8) ACEi-dilation efferent arteriole

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