ABIM Nephrology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Nephrotic syndrome definition

Proteinuria >3.5 g/day, hypoalbuminemia, edema, and hyperlipidemia; associated with thrombosis and infection.

Minimal change disease

Most common nephrotic syndrome in children; selective proteinuria; foot process effacement on EM; responsive to corticosteroids.

Membranous nephropathy antibodies

Anti-PLA2R antibodies are present in 70-80% of primary membranous nephropathy; associated with malignancy and hepatitis B.

IgA nephropathy presentation

Most common primary glomerulonephritis; synpharyngitic gross hematuria; mesangial IgA deposits; elevated serum IgA in 50%.

Acute interstitial nephritis causes

Most common causes are antibiotics (beta-lactams, rifampin), NSAIDs, and PPIs; urinalysis shows sterile pyuria and WBC casts.

Scleroderma renal crisis treatment

Abrupt hypertension, AKI, and microangiopathic hemolysis; treat with ACE inhibitors (captopril); avoid steroids.

Renal papillary necrosis causes

Diabetes, sickle cell disease, analgesic abuse, pyelonephritis, and obstruction; sloughed papillae may cause hematuria or obstruction.

KDIGO AKI definition

Increase in serum creatinine ≥0.3 mg/dL within 48 hours, or ≥1.5 times baseline within 7 days, or urine volume <0.5 mL/kg/h for 6 hours.

Prerenal AKI indices

FENa <1%, BUN/creatinine ratio >20, bland urine sediment; responds to volume repletion. FENa unreliable with diuretics (use FEUrea <35%).

Hepatorenal syndrome treatment

Functional renal failure in advanced liver disease; treat with terlipressin plus albumin; diagnostic criteria include ascites and creatinine >1.5 mg/dL.

CKD staging by GFR

G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15 mL/min/1.73 m².

Albuminuria categories

A1 <30 mg/g, A2 30-300 mg/g, A3 >300 mg/g; higher category predicts faster progression and cardiovascular risk.

CKD metabolic acidosis treatment

Serum bicarbonate <22 mEq/L associated with protein catabolism and bone disease; treat with oral sodium bicarbonate to maintain ≥22 mEq/L.

Hyponatremia in SIADH

Urine osmolality >100 mOsm/kg, urine Na >40 mEq/L, euvolemia; treat with fluid restriction, vaptans, or urea.

Hyperkalemia emergency treatment

IV calcium gluconate for cardiac stabilization, insulin/glucose, beta-agonists, and potassium removal (diuretics, binders, dialysis).

Anion gap formula

Anion gap = Na - (Cl + HCO3); normal 8-12 mEq/L; elevated gap causes include ketoacidosis, lactic acidosis, renal failure, and toxins.

Primary aldosteronism screening

Hypertension with hypokalemia, elevated aldosterone, suppressed renin; screen with aldosterone-to-renin ratio; confirm with saline suppression or captopril challenge.

Malignant hypertension management

Severe hypertension with target organ damage; treat with IV medications and lower mean arterial pressure by ≤25% in the first hour.

Hemodialysis adequacy target

Kt/V ≥1.2 per session (three times weekly) or urea reduction ratio ≥65%.

Peritoneal dialysis peritonitis

Abdominal pain, cloudy effluent, and effluent WBC >100/mm³ with >50% neutrophils; treat with intraperitoneal antibiotics.

Dialysis disequilibrium syndrome

Cerebral edema from rapid osmolar shifts; prevent with slower initial dialysis and lower blood flow; symptoms include headache, nausea, confusion, seizures.

Hyperacute rejection

Occurs minutes to hours after transplant; caused by preformed antibodies; treatment is immediate nephrectomy.

Acute cellular rejection treatment

Occurs days to months; rising creatinine; biopsy shows interstitial lymphocytic infiltrate and tubulitis; treat with pulse corticosteroids.

BK virus nephropathy

Presents with rising creatinine and BK viremia; biopsy shows viral cytopathic changes; reduce immunosuppression.

Calcium oxalate stones

Most common stone type; associated with hypercalciuria, hyperoxaluria, hypocitraturia, and low urine volume; treat with hydration and thiazides for hypercalciuria.

Struvite stones

Associated with urease-producing bacteria (Proteus); staghorn calculi; require complete stone removal and eradication of infection.

ADPKD treatment

Bilateral cysts, hypertension, hematuria, and risk of intracranial aneurysms; treat with tolvaptan to slow cyst growth.

Alport syndrome

X-linked (COL4A5) in 80%; presents with hematuria, progressive renal failure, sensorineural hearing loss, and anterior lenticonus.

Fabry disease

X-linked deficiency of alpha-galactosidase A; presents with proteinuria, angiokeratomas, acroparesthesias, and corneal verticillata; treat with enzyme replacement.

Aminoglycoside nephrotoxicity

Cause acute tubular necrosis; risk factors include prolonged use, elevated trough levels, and concurrent nephrotoxins; monitor levels.

NSAID nephrotoxicity

Cause hemodynamically mediated AKI (especially with ACE inhibitors and diuretics), acute interstitial nephritis, and papillary necrosis.

Sepsis-associated AKI management

Often multifactorial; maintain mean arterial pressure ≥65 mmHg with vasopressors if needed; avoid nephrotoxins.