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Medicine (MD/DO)
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USMLE Step 2
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Nephrology & Urology
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Acute & Chronic Kidney Disease

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Nephrology & Urology | Medicine (MD/DO) School Study Aid

Acute & Chronic Kidney Disease
10 Picmonics to Learn | 23 mins
Acute Tubular Necrosis
ETIOLOGY
Ischemic Injury
Nephrotoxic Injury
HISTOLOGY
Granular Muddy Brown Casts
Signs & Symptoms
Intrinsic Renal Failure
Oliguric Phase
Metabolic Acidosis
Hyperkalemia
Increase in BUN and Creatinine
Polyuria Phase
Decrease in BUN and Creatinine
Hypokalemia
Treatment
Supportive Care
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3 mins
Chronic Kidney Disease Early Symptoms Assessment
Characteristics
GFR < 60mL/min
Accumulation of Waste Products
Clinical Features
General Malaise
Hypertension
Proteinuria
Hyperkalemia
Mineral and Bone Disorders
Neuropathy
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2 mins
Chronic Kidney Disease Late Symptoms Assessment
Metabolic Acidosis
Severe Uremia
Arrhythmias
Edema
CNS Depression
Anemia
Oliguria
Pruritus
Considerations
End Stage Renal Disease (ESRD)
GFR < 15mL/min
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2 mins
Chronic Kidney Disease Interventions
Interventions
Daily Weights
Strict I/O
Renal Diet
Strict Medication Regimen
Erythropoietin
Manage Hyperkalemia
Manage CKD-MBD
Dialysis
Kidney Transplant
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2 mins
Prerenal Acute Kidney Injury Pathophysiology and Presentation
Pathophysiology
Decreased Renal Perfusion
Decreased GFR
Increased Sodium and Water Reabsorption
Presentation
Edema
Dyspnea
Hypotension with Tachycardia
Altered Mental Status
Oliguria
Etiologies
NSAIDs
Renal Artery Stenosis
ACE Inhibitors
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2 mins
Renal Osteodystrophy
Pathophysiology
Chronic Kidney Disease
Secondary Hyperparathyroidism
Hyperphosphatemia
Hypocalcemia
Decreased Calcitriol
Clinical Features
Osteitis Fibrosa Cystica
Osteoporosis
Osteomalacia
Management
Treating Underlying Disorder
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2 mins
Prerenal Acute Kidney Injury Diagnosis and Management
Diagnostic Findings
BUN:Creatinine Ratio > 20:1
Fractional Excretion of Sodium (FENa) < 1%
Urine Osmolality > 500 mOsm/kg
Hyaline Casts
Management
Fluid Replacement
Monitor Renal Function
Diuretics
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2 mins
Postrenal Acute Kidney Injury Pathophysiology and Presentation
Pathophysiology
Bilateral Outflow Obstruction
Decreased GFR
Etiologies
Benign Prostatic Hyperplasia (BPH)
Nephrolithiasis
Neoplasm
Neurogenic Bladder
Presentation
Bladder Distension
Lower Abdominal Pain
Edema
Oliguria
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3 mins
Post Renal Acute Kidney Injury (AKI) Diagnosis and Management
Diagnosis
Physical Examination
BUN:Creatinine ratio of 20:1 in the Initial Stages
BUN:Creatinine ratio of 10:1 in the late stages
Urine Osmolality <350 mOsm/kg
Variable Fractional Excretion of Sodium (FENa)
Ultrasound
CT Scan
Management
Treat Underlying Cause
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4 mins
Intrinsic Renal Failure
Etiologies
Acute Tubular Necrosis
Acute Interstitial Nephritis
Vasculitis
Malignant Hypertension
Acute Glomerulonephritis
TTP-HUS
Diagnosis
Fractional Excretion of Sodium (FENa) > 2%
Urine Osmolality < 350 mOsm/kg
Urine Na+ >40 mEg/L
Serum BUN/Cr < 15
Treatment
Treat Underlying Disorder
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2 mins

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