what should be carefully done about the use of exogenous insulin to the patient with CKDChronic kidney disease
Patients taking exogenous insulin are at increased risk of hypoglycemia if there is no decrease in dosage to compensate for renal failure. In light of this patient's worsening CKD, his symptomatic hypoglycemia is likely due to ☆reduced renal insulin clearance and a prolonged insulin effect. renalUWorldUWorld step2CK Mar 4, 2020, 2:17 AM HirotoShishido
the most common cause of prenatal unilateral hydronephrosisinadequate canalization of the ureteroplelvic junction renalUWorld Jan 29, 2020, 11:02 PM HirotoShishido
renal papillary necrosis
associationtriggered by recent infection or immune stimulus
→gross hematuria, proteinuria
SAAD PAPa with PAPillary necrosis
Sickle cell disease or trait
Acute pyelonephritis
Analgesics(NASIDs)
Diabetes mellitus renal Dec 30, 2019, 10:23 PM HirotoShishido
the most common cause of nephrotic syndrome in African-Americans and Hispanicsfocal segmental glomerulosclerosis(FSGS) renal Dec 23, 2019, 10:28 AM HirotoShishido
pathophysiology of minimal change diseasewith disruption of ☆negatively charged heparan sulfate, negatively charged albumin is no longer repelled and protein is lost in the urine renal Dec 22, 2019, 6:43 AM HirotoShishido
treatment of electrolyte abnormality in aspirin overdose(respiratory alkalosis+anion gap metabolic acidosis)
1. Inciting event -(24-36hrs) (ischemic, nephrotoxic)
2. Maintenance phase- oliguric; lasts 1–3 weeks; risk of hyperkalemia, metabolic acidosis
3. Recovery phase- (months) polyuric; BUN and serum creatinine fall; risk of ☆hypokalemia and renal wasting of other electrolytes and minerals (GFR often improves before tubular function is restored, so patient develop transient polyuria)☆re-epithelization renalpharmacology国試 Dec 13, 2019, 11:58 PM HirotoShishido
effects of ethylene glycol
antidote, mechanism(used as a substitute for alcohol, found in antifreeze, engine coolants, and brake fluids)
anion gap metabolic acidosis
calcium oxylate crystals obstruct the renal tubules, causing renal failure and hematuria
metabolized to glycolic acid and oxalic acid→☆(★)oxalate cystals can be seen
★FOMEpizol
☆competitive inhibitor of alcohol dehydrogenase(ADH)
For Overdose of Methanol or Ethylene glycol renalpoisoningUWorld step2CK Dec 8, 2019, 8:50 AM HirotoShishido
causes of hypocalcemia☆chelation(blood citrate transfusion)
tumor lysis syndrome
pancreatitis
parathyroidectomy
diseases associated with type Ⅲ hypersensitivityPAN, PSGN, SLE, serum sickness, arthus reaction(infrequently reported after vaccinations containing diphtheria and tetanus toxoid)
