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dua_frank
03-04-2005, 08:45 PM
Welcome
dua_frank has joined the chat.
[erum] hellooooooo
[hoor] hi usmleed how was your exam
[john002800] hi
[Jibbsie] Hi everyone. Is the step 1 chat session
[aliyaz123] hi
[david100] hi
[david100] any one here?
[david100] hi
[ohmar_kyi] hi,
[avicennaMD] hiii :) :) :)
Now entering USMLE_Step_2 subroom.
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[fero] hello dua
[dua_frank] hi fero
[dua_frank] fero when are you taking your exam?
[fero] hopefuly early april
[dua_frank] done with kaplan?
[fero] its my 3 rd rev,,ya
[dua_frank] wow nice
[dua_frank] how long did you take to prepare?
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[fero] i started in jan
[dua_frank] so 4 months
[fero] rt 4 months on my own,,before i also took kaplan videos
[fero] center prep
[dua_frank] oh how long did that last?
[dua_frank] two months?
[fero] i should have taken the course after the review
[fero] rt
[dua_frank] why do you say that?
[dua_frank] you mean you would have been better prepared closer to the course time?
[fero] didnt help me that much,,i should have reviewed the books before watching videos
[dua_frank] oh
[megs] ho fero.
[fero] i could have gained more now
[megs] hi dua
[fero] hi megs
[dua_frank] hi megs
[megs] have u started guys
[dua_frank] megs did you finish kaplan course too?
[megs] no
[dua_frank] how are you preparing then?
[erum] hi
[dua_frank] hi erum
[samantha] hi everyone
[fero] hi
[megs] i have just got kaplan notes...harrison and step2 highlight vidios and some blueprints
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[megs] hi sammy
[fero] wat about u dua,, r u doing kaplan?
[dua_frank] just started fero
[megs] hi uni
[uniteus] hi guys
[dua_frank] hi uni
[fero] hi uni
[dua_frank] so i was trying to plan out how long it would take for me to finish the course and prepare
[fero] mediciene take long,other subjects not that much dua
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[dua_frank] thats good to know
[dua_frank] thanks fero
[lanny] hello all
[fero] hi lanny
[dua_frank] hi lanny
[uniteus] hi lanny
[lanny] started?
[dua_frank] without you lanny? never
[megs] waiting for u lanny
[lanny] oh dua thanks
[dua_frank] welcome :P
[lanny] thanks all of you
[dua_frank] so nephrology today
[lanny] yes
[dua_frank] polyuria and nocturia with history of urolithiasis
[dua_frank] dx?
[dua_frank] its hydronephrosis with bilateral partial obstruction
[dua_frank] if its complete it would present as anuria or oliguria
[megs] then why poluurea dua???
[megs] ok
[fero] BUEGERS syn?
[dua_frank] polyurea and nocturia are due to problems in concentrating urine
[megs] IGa nephropathy fero
[fero] buergers synd
[fero] think megs think
[fero] trick here...
[dua_frank] hematuria, polyuria, flank pain, hypertension, proteinuria. nephrectomy had to be performed. dx?
[fero] buergers syn is THROMBOANGITIS OBLITERANS.... associa with smoking... IgA nep is BERGERS SYN
[megs] ok thanx fero
[fero] rcc
[fero] ?
[dua_frank] rcc?
[megs] renal cell carcinoma
[lanny] fero you didnot spell correctly so hard to know what you were asking
[fero] JUST WANTED TO make a point lanny..good to know
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[dua_frank] APKD
[dua_frank] flank pain, HTN and prgressive renal failure point to that
[dua_frank] besides he had to get his kidney removed
[fero] age and fam hx would have helped dua
[fero] lol
[dua_frank] :P
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[dua_frank] this is all you are getting fero :P
[fero] alport SYN?
[dua_frank] you could say it could be medullary sponge kidney too
[dua_frank] but in MSK you will not see evolution to renal failure
[dua_frank] clincally
[uniteus] kidney, hearing loss, cataract n family hx of heari loss
[fero] WHY NOT renal cell ca
[fero] good uni
[dua_frank] they would have some type of blood picture too fero
[fero] ok..thx
[dua_frank] and also polycythemia or cushings
[dua_frank] paraneoplastic syndromes
[fero] rt,,good
[uniteus] for which one dua?
[dua_frank] for renal cell ca uni
[uniteus] thx
[dua_frank] fero had asked why not
[lanny] renal cell ca
[dua_frank] could be
[dua_frank] but going by incidence, safer to select most common
[dua_frank] which would be APKD
[uniteus] oh..sorry..forgive..me ..just recovering from yesterday being ill
[fero] how r u now uni
[uniteus] better...
[dua_frank] aww uni, hope you are doing okay now.
[uniteus] the cold
[uniteus] thx guys
[dua_frank] viruses
[dua_frank] they're aliens i tell you
[fero] diff b/w good pastures and wegeners granolomatosis?
[lanny] dua you are diff between RCC and APKD rught?
[uniteus] :) true
[dua_frank] attacking us at our cellular level :an
[dua_frank] lanny just clinically
[uniteus] lol
[dua_frank] sinuses in wegeners?
[fero] rt,,more
[megs] wegeners has necrotising lesion...urespiratory tract involvement
[uniteus] with renal failure - is cANCA
[megs] while goodpasteurs lowe rti
[fero] rt megs.and... lets discuss this
[dua_frank] c anca
[dua_frank] also in PSC?
[uniteus] no..
[dua_frank] isn't that what we said yseterday/
[dua_frank] ?
[uniteus] P-anca for psc
[fero] c anca in wat dua?
[dua_frank] oh
[dua_frank] ok
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[dua_frank] not in polyarteritis nodosa too?
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[megs] p anca in PAN
[megs] AND C ANCA IN WEG
[uniteus] nope.its is p-anc
[uniteus] yup
[dua_frank] also in PSC says uni
[fero] rt megs ,lets discuss these r for the time being
[uniteus] no i didnt dua
[fero] glomerular pic?
[dua_frank] uni *)
[dua_frank] ok
[dua_frank] APKD what do you seen in the brain adn the heart?
[fero] cresenteric pic in both
[megs] GLOMERULAR PIC CRESENTIC
[megs] FOR BOTH
[fero] anerrysm,,SAH
[uniteus] aneurysm
[dua_frank] yes and MVP in heart
[megs] ANTI GBM IN GOOD PASTURES
[fero] TREATMENT OF GOOD PAstures
[fero] linear patt rt megs in GP
[lanny] steoids
[dua_frank] what type of amyloid in kidney amyloidosis
[megs] PHASMAPHERESIS GOODPAS
[fero] thas for weg> prednisone and cyclophosphamide
[dua_frank] ?
[uniteus] plasmaphoresis n steroid for goodpastu
[lanny] cyclophosphamide
[dua_frank] primary or secondary and what is the name of the amyloid?
[megs] AGREE UNI
[fero] rt uni
[megs] AA
[dua_frank] b2 microglobulin and its secondary amyloidosis in kidney
[fero] the stains used to enlight amyloid?
[fero] thx dua
[megs] CONGO RED
[lanny] congo red
[dua_frank] yeah congo red
[fero] good and apple green bi.ref
[dua_frank] welcome
[fero] hep C associa with which GN?
[dua_frank] whats VHL?
[dua_frank] RPGN
[uniteus] membrano GN
[lanny] membranous
[megs] membranous
[lanny] proliferative
[samantha] membranous
[fero] MEMRANO proliferative
[fero] MGN> hep B
[fero] TUMORS of cerebellum and eye?
[dua_frank] hemangioblastomas of cns and retina with bilateral renal cas
[lanny] fero membranous glom
[lanny] for M
[lanny] for hep B?
[megs] von hipple
[fero] rt lanny
[fero] GN assoia with AIDS? AND IVDA?
[lanny] focal segmental glom sclerosis
[megs] focla segmental glo scerosis
[uniteus] glomerulosclerosis focal
[dua_frank] 16 yr old female, epilepsy, MR. multiple lesions on skin, nephrectomy had to be performed. dx?
[fero] RT LANNY MEGS UNI
[lanny] polycyatic kidney
[uniteus] neurofibr?
[megs] ???dua dunno
[dua_frank] angiomyolipoma or hamartomas in kidneys, tuberous sclerosis
[uniteus] what kind of kidney damage is in DM?
[samantha] von hipel lindau
[fero] kmmelsteel wilson
[lanny] glomerulosclerosis
[megs] nodular pattern
[fero] hylinization
[uniteus] rt fero...kimmelstil wilson nodules....rt megs
[uniteus] rt lanny too
[samantha] membranous found in?
[fero] diffB/W TTP, and HU syndrome
[fero] hep B,
[uniteus] hep B sam?
[lanny] more kidney involve in HUS
[samantha] TTP in immune mediated adn hus in inf
[fero] age ?
[megs] agree sammy
[uniteus] ttp has neurological while HUS dont have, n due to e. coli
[fero] good uni
[fero] wat about fever?
[lanny] ttp has more CNS HUS has more kidney
[samantha] SLE Cancer or drugs like gold penicillamine uni
[lanny] fever in both
[fero] NO FEVER IN HUS...
[lanny] more in TTTP
[uniteus] thx sam
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[fero] lab finding s both same, also HUS < 5 yrs age
[uniteus] n hus has rash below wasteline rt megs??
[lanny] fero sure no fever in HUS?
[fero] ya,,lanny
[samantha] wc uni
[dua_frank] 69 yr old man with fever, night sweats, painless lypmedenopathy, testicular mass. dx?
[fero] HUS> treatment is just symp...
[dua_frank] thanks fero, that was a nice differentiation
[fero] looks like TB dua metastizied
[megs] LYMPHOMA
[dua_frank] good megs
[dua_frank] what if it was a younger man megs? what will you think of then?
[fero] lymphoma..
[megs] ALL????
[uniteus] leukemia?
[dua_frank] seminoma
[samantha] why testicular mass dua?
[uniteus] oh
[megs] I WAS THINKING THAT DUA
[lanny] isnt seminoma in older males
[megs] BUT DOES SEMINOMA CAUSES FEVER
[uniteus] night sweats too?
[megs] AND LN PATHY
[megs] DUA???
[fero] inc renin, inc aldos, dec K, normal BP? DX?
[dua_frank] was just talking abot mass
[dua_frank] in younger men
[dua_frank] not the other findings, sorry
[dua_frank] fanconis fero?
[megs] OK
[fero] CLOSE
[lanny] in older men isnt it yolk sac tumor
[dua_frank] type 2 RTA :P
[fero] BARTERS syn
[dua_frank] oops
[dua_frank] i meant to say that
[fero] ok , ACCEPTED... good dua..lol
[dua_frank] thanks :P:)
[samantha] yes BP is normal in barters
[megs] FERO CAN U EXPLAIN WHY BP IS NORMAL IN BARTERS
[megs] though renin is high
[dua_frank] bad renin megs
[dua_frank] doesn't work
[fero] in barters there is a primary defect in NACL absorb , IN LOOP OF HENLE,,, will lose it insite of INC aldoc
[megs] dua???really
[fero] I KNOW THIS MUCH
[dua_frank] yes
[lanny] fero this is a good summary
[fero] megs........ :(
[samantha] In Barters Naoh3 is not absorbed in asc loop of henle so the kidney things low blood and secretes more renin
[dua_frank] its an AR disease
[dua_frank] actually i think the story starts with renin hypersecretion
[dua_frank] but bad renin so inability of tubules to absorb nacl
[samantha] not so sure
[lanny] no dua
[lanny] fero said it correct
[fero] Tram tack app of BM, WHICH, GN?
[lanny] it is a prob with NACL abs in loop
[lanny] NA dont reach DCT so inc NA in DCT
[dua_frank] if it was functional it sould have caused high BO
[dua_frank] BP
[fero] ya thats wat i learnt too lanny
[dua_frank] which it doesn't, that means there is faulty renin being produced in the first place
[lanny] kidney senses inc Na and starts inc RENN ALDOSt in an effort to reabs Na
[uniteus] membranoprolifer GN for tram tract?
[fero] rt uni
[dua_frank] yeah then the story goes to that
[fero] spike N dome app which GN?
[dua_frank] turns into a cyle
[dua_frank] how else can you explain normal BP?
[dua_frank] if it was reactive renin inc
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[uniteus] Dictionary says = Bartter
[uniteus] is hypertropy n hyperplasia of jg apparatus cells, producing hypoK alkalosis
[dua_frank] well yes uni
[dua_frank] you will see hyperplasia of JG apparatus on biopsy
[uniteus] hyper aldostero n characterised by absence of HTN in presenced of increased plasma renin
[uniteus] due to wasting of na , k, cl
[dua_frank] what about AT II factor?
[uniteus] by insensitiviy to d pressor effects of ang
[dua_frank] will that not cause high BP too then?
[fero] didnt mention that in barters dua
[uniteus] dunno..just read from dic
[dua_frank] ah see
[lanny] my prob with barters is why cant the Na be reabs if the renin and aldost are high??
[dua_frank] insensitivity of pressor effects of angiotensin
[lanny] ive not seen an answer to this so i just memorize it
[fero] lanny ,,,,prob is NA CL ABS IN LOOP OF HENLE,,,,
[lanny] yes fero i know
[samantha] Beta Streptococcal inf fero?
[fero] THAS the defect,,
[dua_frank] ok lets move on
[dua_frank] let the researchers figure it out
[lanny] agree memorize and go!!
[dua_frank] we'll just memorize it
[dua_frank] yeah
[fero] no infect samantha
[fero] o..spike an dome is in mem GN
[dua_frank] CV causes leading to ARF?
[fero] chf
[megs] subepithelis humps
[fero] psgn
[dua_frank] and tamponade, pericarditis and COA
[dua_frank] kidney thinks body is in low output state so conserve more water
[dua_frank] more edema
[dua_frank] viscios cycle
[samantha] ok fero
[megs] ok
[dua_frank] guys who do ACE inhib produce ARF?
[dua_frank] in renal artery stenosis
[megs] yeah
[dua_frank] explain please megs
[lanny] bilateral renal artery sten
[megs] unilateral and bilateral renal artery stenosis
[megs] angiotensin 2 preserves glomerular filteration pressure distal to stenosis
[fero] MCC of rhabdomyolysis in US?
[megs] by elavati ng syst BP
[dua_frank] right
[megs] AND ACE INHIBITORS BLUNT THIS
[dua_frank] how?
[dua_frank] oh yeah :O
[megs] CRUSH INJURY FERO
[uniteus] thx megs
[fero] mcc is alcholism..
[dua_frank] thanks megs
[megs] HOW FERO???
[lanny] how does alcohol cause it fero
[megs] HOW ALCOLISM CAUSE RHABDOMYOLYSIS
[fero] guy drink so much that pass away,,,,,,doesnt move for hrs an hrs an hrs....
[lanny] cause they fall around and hurt themselves?
[fero] wakes up witjh aces n pains
[megs] *) FERO
[lanny] sounds plausible
[uniteus] radial nerve palsy
[uniteus] saturday nite palsy
[dua_frank] uni wake up lol
[fero] ya, megs,,i didnt know that too,,even today armin posted it at us m l e . n et
[lanny] park bench sd
[uniteus] :(
[dua_frank] lol
[uniteus] :)
[megs] OK GUYS
[lanny] has anyone checked this armins guys postings are they legit?
[lanny] i dont wanna confuse myself so i didnt look into them
[megs] PT PRESENT WITH ARTHRALGIA RASH AND RENAL FAILURE WHATS DX???
[lanny] age?
[fero] HS PURPURA
[samantha] HSP
[lanny] HSP
[megs] CLUE HISTORY OF TAKING ANTIBOIOTCS FEW DAYS BACK
[dua_frank] ATN
[lanny] HUS
[megs] ALLERGIC INTERSTITIAL NEPHRITIS
[dua_frank] yeah leading to ATN
[lanny] whats seen in urinalysis
[dua_frank] causing acute renal failure
[dua_frank] rx?
[lanny] steroids
[megs] STEROIS...ITS SELF LIMITING
[dua_frank] inc eosinophils lanny
[dua_frank] yes
[lanny] right dua
[megs] DUA IT DO NOT CAUSE ATN
[dua_frank] yeah it will megs
[dua_frank] its a toxic ATN
[uniteus] eosinophils
[lanny] yes dua is right
[lanny] megs
[megs] IT WILL CAUSE ACUTE RENAL FAILURE NOT ATN I GUESS
[dua_frank] hmm
[lanny] no it will cause AT
[lanny] N
[uniteus] i dont think so
[dua_frank] ok so ischemic and toxic and allergic interstitial neprhirits will all cause ARF
[megs] WHICH TYPE OF HYPERSENSITIVITY REAN IS IT??
[dua_frank] will i be right in saying that?
[dua_frank] type 3
[lanny] ARF is an umbrella term dua
[dua_frank] yes lanny
[megs] ITS TYPE 4 SENSITIVITY
[fero] drug induced r type 4
[dua_frank] these were the intrarenal causes of ARF
[dua_frank] oh
[lanny] that comprises preenal renal postrenal
[lanny] renal could be many tubulointerstitial dz
[dua_frank] yeah and ATN would be one among those lanny
[lanny] yes
[dua_frank] can infections cause allergic interstitial nephritis?
[lanny] ATN will then be renal
[lanny] yes
[megs] YEAH THEY CAN CAUSE DUA
[lanny] infections toxins drugs can
[dua_frank] yes
[lanny] what diabetic med can cause ATN?
[megs] DUNNO LANNY
[uniteus] sulfornyureas
[lanny] metformin
[dua_frank] thanks
[megs] THANX
[megs] WHICH DIURTIC CAUSES RENAL STONES???
[lanny] any mnemonic for prerenal renal azotemia
[dua_frank] loops?
[lanny] thiazides
[uniteus] thiazide
[samantha] loop diuretic'
[megs] YEAH LANNY
[megs] FOR WHICH STONES THEY R USED
[dua_frank] uric acid
[megs] CACIUM OXALATE STONES WE TRAET WITH THIAZIDES
[uniteus] hypercalciuria = uric acid
[lanny] megs i dont get you
[fero] dunno , even i am confused on that one,,,, loops loose calcium but they give thizaied as trreatment for cal stones....anyone know y?
[megs] SORRY GUYS WANT TO CORRECT MYSELF
[samantha] thiazides causes hypercalcemia
[dua_frank] coz thiazides retain calcium
[fero] t megs u rt,,,, we do use them for thiazides
[dua_frank] so less calcium in the tubules to form stones
[uniteus] agree
[dua_frank] so diuretics prone to causing more stones would be loops
[samantha] so they are used in renal stones as treatment
[lanny] no dua
[dua_frank] coz they dump calcium into tubules
[fero] calcium stones form in hypercalcemic states,,so y will we not like to give loop diuretics to get rid of ca
[dua_frank] oh lanny :(
[lanny] ok dua
[dua_frank] they form in kidney, the stones
[dua_frank] divert the calcium fero from kidney to body
[dua_frank] reabsorb them back with thiazides
[megs] RIGHT FERO
[dua_frank] its like hyperkalemic states and insulin
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[dua_frank] insulin diverts potassium from blood back into cells
[fero] so dua , u mean ,, even with apt with hyper cal we will still not give loop diur ?
[dua_frank] thus treating hyperkalemia
[dua_frank] yes fero
[lanny] side eff of thiazide is hyper Ca
[lanny] so in trt stones we give loops
[fero] ya lanny thas wat i dont understand
[lanny] that dont cause hyper Ca but will excrete Ca
[fero] FA say we give thiazides
[uniteus] guys...thiazide is used for pt wid stones that has hypercalciuria
[fero] ok..move on
[uniteus] hypercalciuria --> cant reabsorb ca in urine--> formation of Ca
[fero] ecg show, peaked T WAVES, QRS wide, wat electro abnorm?
[dua_frank] hyperkalemia
[uniteus] so thiazide --> pth acts on na-ca channel resulting in CA reabsorption
[fero] treatment?
[megs] AGREE
[dua_frank] insulin
[uniteus] cal gluconate
[dua_frank] yeah and mg too
[fero] rt ,,both
[megs] CALCIUM CHLORIDE FIRST
[megs] THEN BICARBONATE
[uniteus] ok thx
[dua_frank] when insulin megs?
[dua_frank] last or first?
[megs] YEAH DUA
[lanny] megs what was your q?
[lanny] treatment of what?
[megs] DUAS Q LANNY
[megs] NOT MINE
[lanny] what is it/
[dua_frank] not even mine :p
[dua_frank] feros :P
[megs] OK FERO
[fero] u ans it fellows
[lanny] what was the Q though?
[fero] treatment of hyperkalemia..
[lanny] thanks
[megs] WHEN IN HYPERKALEMIA EKG ABNORMAL...TREAT WITH CALCIUM GUCONATES
[megs] MOST EMERGENBT TREATMENT
[megs] HOW KAYEXALATE ACTS??/
[fero] its K
[fero] ?
[dua_frank] megs what *)
[megs] THIS RESIN
[dua_frank] kayexalate is a resin?
[dua_frank] never heard of it :(
[megs] ABSORB EXCESS K+...HENSE DECREASE K+ IN BLOOD
[megs] DUA KAPLAN HAS GIVEN THIS
[dua_frank] ok thanks
[dua_frank] what do oxalate and urate crystals do to kidney?
[dua_frank] cause stones ofcourse :P
[fero] PICKWICKIAN syn?
[dua_frank] how do you treat hyperoxaluria due to antifreeze ingestion?
[samantha] obesity
[dua_frank] fat boy with apnea
[fero] flomipazole?
[dua_frank] ethanol
[fero] rt dua and saman
[megs] ETHANAOL DUA
[samantha] ethanol
[megs] ETHANOL DUA
[dua_frank] yes megs
[dua_frank] is alkalanizing urine good or bad in calium oxalate crstals?
[lanny] bad
[dua_frank] good
[megs] BAD DUA
[dua_frank] coz they ppt in alkaline media
[megs] R U SURE
[fero] dua is rt
[dua_frank] what subs ppt in acid medium?
[megs] SO ITS BAD DUA ISNT IT
[fero] uric acid
[dua_frank] yes megs
[megs] AGREE URIC ACID
[dua_frank] yes urate and myoglobin
[fero] u alkalinaze urine to get rid of cal stones
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[dua_frank] you do not fero
[dua_frank] that should be a contraindication in fact, right?
[fero] o yes
[lanny] fero it deps on the type of stone
[fero] yes ,,,
[dua_frank] you alkalanize in urate stones
[fero] agree
[lanny] yes
[megs] AGREE DUA
[dua_frank] agents to acidify and alkalanize urine?
[megs] WHICH STONES PASS SPONTENEOUSLY??/
[fero] craneberry juice to acidify r grapefriut juice
[lanny] is calcium oxalate stones alkaline or acidic?
[lanny] less than 3 mm
[fero] na bi carb to alkalanize
[megs] ITS 5MM
[dua_frank] yes fero
[fero] pt prone to uric acid stones?
[megs] ALCOHOLICS
[dua_frank] chenotherapy
[dua_frank] gout
[megs] GOUT
[fero] rt ,,,megs dua
[megs] MALIGNANCIES
[fero] can they b seen on a reg XRAY
[dua_frank] no
[fero] GOOD DUA
[dua_frank] radioopague
[megs] RADIOLUCENT DUA
[dua_frank] alcohol causes stones?
[fero] RADIOLUCENT,,,,, dua> meaning they allow rays to pass
[dua_frank] oh right, sorry
[fero] duno dua
[megs] ALCOHOLICS MORE PRONE TO GOUT...
[megs] HENSE I SAID DUA
[dua_frank] oh ok thanks megs
[dua_frank] makes sense
[megs] AS Q WAS LIKE WHO..R PRONE??
[megs] :)
[dua_frank] v good q megs :)
[lanny] uric acid are r lusent
[lanny] radiolusent stones
[megs] LETHARGY WEKNESS IRRITABILITY SEZURS AND COMA WHATS DX???
[megs] NA + INCRE OR DECR
[lanny] hyper natremia
[megs] YEAH LANNY
[megs] WHAT IS THE TREATMENT
[lanny] fluids isotonic
[megs] AGREE
[dua_frank] what electrolyte abnormality seen in aminoglycosides causing renal failure?
[megs] hypokalemia
[uniteus] Increase Na, decrease K
[megs] and hypo mg
[lanny] RTA type1
[dua_frank] yes megs good
[dua_frank] HTN in HSP present absent?
[megs] which is the most common drug causing renal damage???
[uniteus] NSAIDS
[dua_frank] phenacetin?
[lanny] NSAIDS
[megs] radio contrast dyes..and amino glycosides
[dua_frank] really??? *)
[megs] i mean to say acute tubular necrosis sorry for wrong q
[fero] yes dua htn + due to Ig a nephropathy
[dua_frank] actually no htn or edema in HSP
[dua_frank] unlike in bergers disease
[dua_frank] but both have igA deposition
[fero] dua..but they do get IG a nephro..then how come
[dua_frank] its a different form of ig A deposition fero
[megs] HSP IS WITHOUT RENAL INVOLVEMENT
[dua_frank] yeah mostly extrarenal involvement
[dua_frank] like purpura, arthralgias and GI bleeding with colic
[dua_frank] along with fever, hematuria and proteinuria
[fero] thx dua, didnt know that
[megs] WHAT IS BEST SCEENING TEST FOR DIABETIC NEPHROPATHY???
[fero] i though Ig A NEP WAS A PART
[lanny] dua going back you said alkalinaize urine is good cause the stones ppt in alkali media i said the opposite how is it good then if you are ppt the stones?
[dua_frank] renal failure, microangiopathic hemolytic an, dec platelets dx 2 conditions
[uniteus] TTP n ITP
[fero] ttp
[fero] HUS
[dua_frank] biopsy megs?
[dua_frank] yes fero
[dua_frank] what will you find in addition in TTP?
[uniteus] Neurological
[megs] 24 HRS URINE PROTIEN ....SCEENING DUA...NOT DIAGNOSTIC
[lanny] thrombocytopenia
[fero] FEVER AN MORE NUERO signs
[dua_frank] lanny urate vs calcium oxalate stones
[dua_frank] alkaline urine is bad for ca oxa stones
[fero] hemolt anemia
[dua_frank] yes gero good
[dua_frank] fero
[dua_frank] oh thanks megs
[lanny] i said bad but you said good thats why i got confuse ok
[dua_frank] oh you did? sorry in that case lanny
[dua_frank] might have misread what you wrote
[lanny] calcium ox stones you acidify the urine right
[dua_frank] yes right
[lanny] uric acid stones you alakalinize the urine
[dua_frank] yes
[lanny] ok all clear now
[megs] YEAH LANNY
[megs] RENAL ARTERY STENOSIS HOW TO DIAGNOSE??
[megs] BEST INITILA SCEEING IS WHAT
[dua_frank] radioscan
[dua_frank] hmm
[megs] AND WHAT IS MOST CONFIRMMATORY
[dua_frank] u/x
[fero] best test is arteo gram,,but best non invasive is captopril..renogram
[dua_frank] u/s
[dua_frank] size of kidney maybe
[dua_frank] dunno
[megs] YUPO FERO
[uniteus] oral captopril
[dua_frank] ok
[dua_frank] what will captopril renogram show?
[fero] dec uptake of dye after captopril shows stenosis
[fero] rt megs?
[megs] IF STENOSIS PRESENT THEN DECREASE IN UPTAKE OF ISOTPE AFTER GIVING CAPTOPRIL
[fero] rt
[dua_frank] nice
[megs] WHAT IS TREATMENT
[dua_frank] what can SLE cause?
[fero] PTANIGIO
[megs] PERCUT TRANSLUMINAL ANGIOPLASTY..YUP FER
[fero] per cut angio plasty
[fero] med treat of BPH?
[megs] PRAZOCIN
[megs] TETRAZOCIN
[fero] RT... also amiloride..
[dua_frank] RPGN
[fero] which zone of prostate invo?
[megs] IT CAN CAUSE A LOT TO KIDNEY DUA
[fero] ya dua , and loop wire app of glomerluls
[megs] MIDDLE ZONE FERO CENTRAL I MEAN
[uniteus] periurethral BPH
[dua_frank] oh
[fero] rt
[dua_frank] guys add another to anca list
[dua_frank] RPGN
[dua_frank] PSC, RPGN, wegeners
[dua_frank] and PAN
[megs] PHEOCROMOCETOMA IS BENIGN OR MALIGNANT
[fero] benign
[uniteus] benigh
[megs] YUP
[fero] cause of malignant htn lol
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[dua_frank] bloody nephrology
[fero] lol
[dua_frank] PAN with granulomas is?
[megs] PRIMARY HYPERTENSION
[fero] weg gran
[dua_frank] good fero
[fero] treatment of weg gran?
[uniteus] Cyclophoshamide
[megs] STEROIDS
[dua_frank] cytotoxics and steroids
[fero] good,,all of u
[dua_frank] are lungs involved in PAN?
[lanny] dua what type of anca P or c
[lanny] no
[megs] WHAT IS MALIGNANT HT???
[dua_frank] P for PAN
[fero] no
[dua_frank] all others answer c anca
[dua_frank] yes good no
[fero] lungs when invol its the churg strass variant i guess
[dua_frank] good fero good
[lanny] even RPGN is C anca?
[dua_frank] not sure lanny
[dua_frank] says anca positive
[dua_frank] not which type
[dua_frank] sorry
[lanny] ok thx
[fero] treatment of hypertensive amergency?
[dua_frank] malignant is end organ failure megs
[lanny] diff diag churg strauss and wegener?
[dua_frank] nitrates, na nitroprusside, hydrallazine
[fero] weg is gran ulomatous dis,,with upp resp problems and C ANCA
[megs] CHRUG TRUSS WITH ASTHMA
[megs] ???
[fero] ALSO WEG HAS hymoptysis
[lanny] churg is a vasculitis in pts with asthma
[fero] rt lanny
[lanny] high eosinophils
[lanny] no renal involement
[fero] good pastures is more obviously confused with weg gran
[lanny] fero megs right too
[lanny] right give us diff fero
[fero] ok
[megs] REMEMBER GOODPASTURES LOWER RSPIRATORY LIKE LUNG INVOLVES
[fero] more upp resp findings in weg like, sinusitis, h epistaxis, OM IN WEG GRAN
[megs] AND WEGNESS UPPER RESP..LIKE SINUS
[fero] ALSO THE AB is diff, c , ANCA IN WEG AND ANTI. GBM ab in good pastures
[lanny] good pasture is MEMOPTYSIS
[lanny] hemoptysis usu presnetation
[fero] both have hemop and hematuria
[fero] both have cresentric GN
[dua_frank] nice guys
[uniteus] thx
[dua_frank] i like the discussion
[uniteus] how many stages r in lupus nephritis and wht are they?
[lanny] WEGENER usu present is SINUSITIS URT i
[fero] WORSENING c XRAY FOR GOOD PASTURE IS A CLUE
[dua_frank] why is there osteodystrophy in end stage renal disease?
[megs] TELL US UNI
[fero] vid D DEF, ca loss also
[megs] DUE TO SECONDERT PARATHYROIDISM DUA
[dua_frank] yes megs
[fero] 1 alpha hydrox is defective in kidney
[uniteus] due to secondary hyperparathyroidism def in vit D
[lanny] i have a step 1 pnemonic need a WAGON wegener to climb the PASTURES up the crescent hill
[dua_frank] fero no its due to secondary hyperparathy
[fero] o
[dua_frank] it sucks out ca from bones
[lanny] dua right
[dua_frank] to compensate for hypocalcemia seen in end stage renal disease due to dec vit d
[lanny] PTH takes out all calcium from bone dt osteoclast
[dua_frank] nice lanny
[fero] thx dua i noted it
[fero] thx lanny
[uniteus] lupus nephritis stage 1 = no renal invol, 2= mesangial disease, 3=forcal proliferative (common in sle), 4=diffuse prol n 5 = membranous disease
[dua_frank] same reason for hyperphosphatemia
[megs] THANX UNI
[uniteus] urw
[dua_frank] thanks uni
[uniteus] urinalysis has fatty cast dx?
[uniteus] rbc cast dx?
[fero] nephrotic
[uniteus] which one fero?
[megs] FATTY CAST LIPOIN NEPHROSIS
[megs] RBC CASTS NEPHRITIC
[uniteus] rt megs
[fero] rt megs
[lanny] lannys belly is making noises guys
[dua_frank] add RPGN to the list too uni
[uniteus] thx dua
[lanny] gotta go eat may join you guys in a few if youre still here
[megs] LANNY :p
[dua_frank] welcome
[lanny] will serve you all through my server
[megs] WHAT R TOMM HORSFALL PRT???
[fero] indications for dialysis?
[dua_frank] shall we stop?
[lanny] some ppt seen in ESRD
[megs] ASSOCIATED WITH MYELOMA KIDNEY LANNY
[megs] U R PARTIALLY CORRECT
[uniteus] pericarditis, sever acidosis, fluid overload n encephalopahty fero
[lanny] fero high K fluid overload acidosis
[megs] HYPERKALEMIA TOO
[fero] hyperkalemia also,,good lanny
[uniteus] yeah
[fero] rt
[fero] bladder cancer,,,most comm histoly variant which type i mean?
[lanny] transitional
[megs] AGREE
[lanny] cell
[fero] ya and if he had a swin in river nile then?
[fero] lol
[lanny] schistosoma
[uniteus] Schisto
[lanny] adeno
[megs] SQUAMOUS
[fero] squamous and yes schitosoma hematobium
[megs] SCISTO SQUAMOUS
[lanny] ok east to remember SS
[lanny] easy
[fero] which drus cause transitional ca of bladder?
[lanny] whats Rx for bladder ca
[lanny] phenacetin
[lanny] oh
[fero] treatment lanny depends on extent,,, surgery?
[fero] rt phenacitin, cyclophoaphamide, anelinhe dye
[lanny] fero what drug cyclo
[fero] wat lanny, couldnt get u
[lanny] i added cyclophosphamide
[fero] cyclo ph also cause hem cystitis remember step 1 pharm
[fero] rt good
[lanny] yes
[fero] dua u having dinner? lol
[lanny] ok guys if i dont meet you again in a few mins have all a good night see you all tom
[megs] are we staying guys
[fero] good nite lanny
[fero] as u wish megs
[uniteus] nite lanny
[lanny] nite nite
[megs] i have a query want to ask...
[dua_frank] computer stuck :(
[uniteus] oh sorry :(
[fero] o,dua i though u having dinner
[megs] why ace inhibitors are given as treatment for renal artery stenosis??
[dua_frank] to dec renin?
[megs] i dunno ans
[fero] angio 2 is a constrictor dua
[megs] i have this query dua
[dua_frank] i mean at ii
[uniteus] it is used for those pt who have failed from angioplasty or surgery
[megs] agrre uni
[fero] ace inhib,,,,dec it
[megs] but why ace inhoibitor..why not ca channel blocker
[uniteus] n depends on the creat, BUN level to use ace I too..
[megs] ok thanx uni
[samantha] megs i might be wrong
[samantha] but i thought the mech was with bradykinin
[dua_frank] less at ii= low vasocontrcition
[samantha] ACE causes bradykinin sec right
[samantha] bradykinin causes vaso constriction
[samantha] and so ACE inhibitors block this
[dua_frank] could be sammy
[dua_frank] so we have two possible mechanisms
[samantha] any way i will check
[dua_frank] drugs causing SIADH?
[fero] lithium
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[uniteus] NSAIDS, antidepressant
[dua_frank] oral hypoglycemics, haldol, cyclophosmaphide. vincristine
[uniteus] n phenothizine
[fero] sorry lithium cause nephro DI
[megs] lithium demeclo..for treatment
[uniteus] agree..megs
[megs] of SIADH FERO
[fero] RT MEGS
[uniteus] what lab findings in SIADH?
[fero] URIN OSMO HIGH THEN SERUM
[uniteus] na level?
[fero] ALSO URIN SODIUM MORE THEN 20 MEG
[megs] URINE OSMOLARTY IS LESS THAN SERUM OSM
[samantha] hypo natremia
[uniteus] urine osmolarity is more than serum osm
[uniteus] rt hypoNa
[samantha] high urine osmo
[fero] MEGS low serum osmo
[samantha] and low serum osmo
[uniteus] rt
[megs] OK
[megs] OK
[fero] dirty brown casts ? dx
[uniteus] ATN?
[fero] good uni
[megs] ARE THEY GRANULAR FERO??
[fero] dunno megs....
[samantha] Strep GN?
[fero] wat about it saman?
[samantha] what drugs cause DI?
[fero] lithium cause neph type DI
[megs] LITHIUM DEMECLO
[uniteus] neprho DI = Li, aminogly , demeclocycline
[fero] test for urethral relux?
[samantha] right
[fero] ureteral reflux
[megs] MCU
[samantha] ampho B
[fero] its VCGS>VOIDING CYS URETH GRAM
[megs] MCU=MICTURATINGCYSTOURETHROGRAMM
[uniteus] is it the same? dunno?
[fero] IS IT THE same megs?
[megs] YUP FERO
[uniteus] thx
[fero] ok thx
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[uniteus] guys go to go
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[fero] ok uni,,
[uniteus] nite all...
[megs] OK ME TOO LEVING
[fero] nite
erum has left the chat.
[fero] bye evryone
[megs] BYE
uniteus has left the chat.
[samantha] bye
[fero] ok dua,,bye too
megs has left the chat.
[samantha] bye everyone
[fero] bye saman
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Asclepius1
03-08-2005, 02:07 PM
hello?

Asclepius1
03-08-2005, 02:08 PM
hello?

Asclepius1
03-08-2005, 02:09 PM
anyone heard of Prazocin?

dua_frank
03-09-2005, 08:44 PM
Its a vasodialator used in BPH

Asclepius1
03-21-2005, 10:06 AM
what is churg-strass syndrome







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