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MHD V: Renal > 10.27: intro > Flashcards

10.27: intro Flashcards

1
Q

Major functions of the kidney?

A
  1. Filtration
  2. Excretion
  3. Electrolyte / acid base homeostasis
  4. BP regulation
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2
Q

When are GFR calculations reliable?

A
  • Only when ptn. is in steady state

- Calculations do not work once patient has renal impairment

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3
Q

Equation for fractional excretion of Na / urea?

A

= (Urine Na / Plasma Na) / (Urine Creatinine / Plasma Ca)

***Helps to determine cause of acute kidney injury

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4
Q

Components of the kidney?

A
  1. Glomeruli
  2. Tubules
  3. Interstitium
  4. Vasculature
  5. Renal calyx
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5
Q

Components of collecting system?

A
  1. Ureters
  2. Bladder
  3. Urethra
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6
Q

GFR equation?

A

(Urine creatinine x volume) / Plasma creatinine

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7
Q

Cockrost Gault GFR forluma?

A

( (140 - age) x weight (kg) x .85 (females)) / 72 x serum Cr

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8
Q

What is normal urine output?

A

1500 ml per day

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9
Q

What is Oliguria?

A
  • Too little urine output
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10
Q

What is anuria?

A

No urine output

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11
Q

What is polyuria?

A
  • > 3000 ml per day

- Too much urine output

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12
Q

What is azotemia?

A
  • An elevation in renal indices

- Normally an increase in BUN

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13
Q

What is BUN?

A

“Blood urea nitrogen”

- Urea nitrogen is formed when protein breaks down

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14
Q

What is uremia?

A
  • Syndrome that can accompany severe renal failure
    1. Fatigue
    2. Anorexia
    3. Altered mental status
    4. Serositis: effusion
    5. Platelet dysfunction
    6. Itching
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15
Q

What is AKI? ARF?

A

ARF: “Acute renal failure” old term
AKI: “Acute kidney injury” new term

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16
Q

What are CRI? CRF? CKD?

A

CRI: “Chronic renal insufficiency”
CRF: “Chronic renal failure”
CKD: “Chronic kidney disease” NEW TERM

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17
Q

What is ESRD?

A
  • “End stage renal disease”
18
Q

Parameters for AKI?

A

Abrupt drop in kidney function in 48 hours defined as:

  1. Increase serum Cr
  2. Oliguria
19
Q

Characteristics of CKD?

A
  • Progressive decrease in GFR over time
  • Usually lasting at least 3 months
  • With or without albuminuria
20
Q

What is normal GFR?

A

> 90

21
Q

What are the 5 stages of renal disease?

A
  1. Kidney damage with normal GFR > 90
  2. Kidney damage with GFR 60 - 89
  3. GFR 30 - 59
  4. GFR 15 - 29
  5. Kidney failure: GFR
22
Q

What is hematuria?

A

Blood in the urine

23
Q

What is nephrolithiasis?

A
  • AKA “Kidney Stones”
  • Presents as moderate to severe renal colic
  • Ca oxalate and Ca phosphate most common
24
Q

Another name for kidney stones?

A

Nephrolithiasis

25
Q

What are dysmorphic RBCs in urine characteristic of?

A
  • Glomerular hematuria
26
Q

What is pyuria?

A

WBCs or pus in the urine

27
Q

When are epithelial casts usually seen?

A

Acute tubular necrosis

28
Q

When are fatty casts seen?

A

Lipiduria seen in nephrotic syndrome

29
Q

When are hyaline casts seen?

A
  1. Dehydration
  2. Exercise
  3. Diuretic therapy
30
Q

When are waxy casts seen?

A

Advanced kidney disease

31
Q

What is nephrotic syndrome? Characteristics?

A
    • > 3 - 3.5g / day of protein in urine
      1. Hypoalbuminemia
      2. Peripheral edema
      3. Hyperlipidemia: to raise oncotic pressure
      4. Thrombophilia: tendency to clot, in renal vein
      5. Bland urinary sediment
      6. Non inflammatory renal biopsy
32
Q

Characteristics of nephritic syndrome?

A
  1. Inflammatory renal biopsy
  2. Active urinary sediment
  3. Variable proteinuria
  4. Azotemia / oliguria
  5. Mild Htn.
33
Q

What is normal total body water?

A
  • 60% total body weight
  • 2/3 intracellular, 1/3 extra
  • 1/4 of extra is plasma volume
  • 3/4 extra is interstitial space
34
Q

What are IV crystalloid solutions?

A
  • Used in volume depletion

- Disperse across ECW

35
Q

What are IV colloid solutions?

A
  • Given in volume depletion
  • Tend to stay in plasma volume
  • Packed RBCs or albumin solution
36
Q

Where is EPO produced?

A

Kidneys

37
Q

Function of Vitamin D?

A
  • Regulates Ca absorption and maintains normal levels of Ca and phosphorus
38
Q

Where is vitamin D activated?

A
  • In the kidneys

- Produced in liver

39
Q

Why is anemia seen in advanced kidney disease?

A

EPO is made in kidney

40
Q

Why is there decrease in vitamin D in kidney disease?

A
  • Vitamin D is activated in kidney
41
Q

What are the non specific symptoms of renal disease?

A
  1. Fever
  2. Pain
  3. Rash
  4. Eosinophilia
42
Q

What type of molecules can be

A
  • Small, uncharged un protein bound molecules

MHD V: Renal (28 decks)

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