Renal Failure

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Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

Renal Failure

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dr.roh
Forum Guru

Topics: 159
Posts: 361

09/18/07 - 08:21 AM

PreRenal failure
*initial test: Urinalysis
*best test: FeNa value

Renal/IntraRenal Failure
*initial test:Urinalysis
*Best Test: Renal Biopsy or FeNA????

PostRenal
*initial test: Catheter or Bladder scan
*Best test: Ultrasound (look for Hydronephrosis)

---are my choices of diagnostic tests correct????

peraspera
Forum Elite
avatar

Topics: 38
Posts: 233

09/18/07 - 09:34 AM

The best initial test for pre-renal, intra-renal, post-renal -is
BUN/CR ratio, urine Na, urine osm, to find out where problem is inside the kidneys or outside.
Next exclude obstruction, the best test is ultrasound.
Look for hystory of ATN, due to ischemia ( poor perfusion) or due to toxins. For toxins there is no spesific test, we need to exclude other causes of renal failure ( look for toxins in the hystory).
If the problem in the kidneys( intra-renal)- best diagnostic test is urinalysis: cristals- gout,ethylene glycol, ( depends on type of cristals). Eosinophylia- allergic interst. nephritis. Pigments- myoglobin, look for rhabdomyolysis ( do EKG).

dr.roh
Forum Guru

Topics: 159
Posts: 361

09/18/07 - 11:29 AM

thanx

starcraftbw
Forum Senior

Topics: 13
Posts: 166

09/18/07 - 03:14 PM

Best test for Intra-renal:

If: tubulo/interstitial: U/A

If: glomerulo/vascular: Biopsy

dr.roh
Forum Guru

Topics: 159
Posts: 361

09/18/07 - 03:17 PM

thanx for the input... smiling face

doyoudig
Forum Guru

Topics: 144
Posts: 613

09/19/07 - 11:55 AM

hey roh, just to add, anytime u suspect renal disease the initial test will alsways be a UA b/c it will be able to r/o or r/in many other conditions after that the test to confirm will depend...

dr.roh
Forum Guru

Topics: 159
Posts: 361

09/19/07 - 01:37 PM

Ok...thanx doyoudig

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