tailieunhanh - Ebook First aid for the family medicine boards (2/E): Part 2

Part 2 book “First air for the family medicine boards” has contents: Nephrology, dermatology, neurology, surgery, pediatric and adolescent medicine, psychiatry and behavioral science, geriatric medicine, reproductive health, sports medicine and musculoskeletal disorders, emergency/urgent care. | CHAPTER 9 Nephrology Kerry Kay, MD, MPH Diagnostic Testing 320 Acute Renal Failure 324 Acid-Base Disorders 344 Metabolic Acidosis 344 Metabolic Alkalosis 346 Chronic Kidney Disease 328 Respiratory Acidosis 347 Nephrotic Syndrome 330 Respiratory Alkalosis 348 Nephritic Disease 333 Mixed Acid-Base Disorders 348 Hematuria 334 Other Urinary Tract Disorders 349 Sodium and Water Disorders 336 Hyponatremia 336 Syndrome of Inappropriate Secretion of ADH 339 Hypernatremia 340 Potassium Disorders Rhabdomyolysis 349 Nephrolithiasis 349 Polycystic Kidney Disease 351 341 Hyperkalemia 341 Hypokalemia 343 319 320 CHAPTER 9 NEPHROLOGY Diagnostic Testing The first steps in the evaluation of kidney disease are the measurement of serum creatinine and the urinalysis (UA). Additional laboratory tests and imaging can also assist in the diagnosis and treatment of disease. Table summarizes the various types of diagnostic tests available in the evaluation of kidney disease and their indications. Table reviews urinary casts as part of the UA. T A B L E 9 . 1 .    Types and Uses of Diagnostic Tests Diagnostic Test Types Serum creatinine Measurements Produced in skeletal muscle Indications First step in evaluating kidney disease. metabolism and filtered by Monitor kidney function. the kidney. Elevated in renal Used in determination of BUN-to-creatinine dysfunction. Higher in muscular people and lower ratio, fractional excreation of sodium or urea. in elderly and pregnant women. Can be elevated by medications such as ACE inhibitors, ARBs, cimetidine, trimethoprim, aminoglycosides. UA Random specimen, midstream collection protein, hemoglobin, glucose, (“clean catch”), first ketones, bilirubin, nitrite, leukocyte morning collection, bladder catheterization. Urine culture Dipstick testing: specific gravity, pH, esterase. Microscopy: crystals, cells, casts, First test in patients with kidney .