Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary System > 20) CKD > Flashcards

20) CKD Flashcards

1
Q

Define chronic kidney disease:

A

Irreversibleandsometimesprogressiveloss ofrenalfunctionoveraperiodofmonthstoyears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What effects does renal injury have on renal tissue?

A

Renaltissueisreplacedbyextracellularmatrix

Get glomerulosclerosis and tubular interstitial fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List some of the less common causes of CKD:

A

Immunologic- glomerulonephritis
Infection– pyelonephritis
Genetic- PCK,Alport’s
Obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

State the most common cause of CKD:

A

Unknown, but from combined cardio-metabolic factors: hypertension, diabetes and vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the macroscopic appearance of CKD?

A

Shrinkage and scarring of kidney
Irregular outline
Decreased cortical thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the microscopic appearance of CKD?

A

Glomerulosclerosis

Loss of tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What co-morbidities are often present in patients with CKD?

A

Diabetes, hypertension and ischaemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who is CKD more common in?

A

Elderly
Multi‐morbid
Ethnicminorities
Sociallydisadvantaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many stages are there in the classification of CKD?

A

5 stages

3 has A and B stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the stages of CKD based on?

A

GFR: decreasing GFR = increasing stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is it hard to stage people with GFR higher than 60ml/min?

A

Estimates for GFR above 60 aren’t accurate, so stages 1 and 2 must show symptoms (haematuria) or structural abnormalities on imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What sub-classification may be used in staging?

A

Measurement of proteinuria using albumin:creatinine ratio (ACR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is associated with worsening of CKD?

A

Substantial cardiovascular morbidity and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

At what GFR does mortality start to increase?

A

75ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is it important to do a urine dipstick?

A

Test for proteinuria - predicts development of end-stage renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is serum creatinine a poor measure of renal function?

A

Serum creatinine also determined by muscle mass, which is dependent on age, sex and race. Therefore, if unadjusted serum creatinine may look normal but could have severely reduced renal function

17
Q

What research tools can be used to measure GFR?

A

Inulin clearance
51Cr EDTA clearance
Creatinine clearance (24 hour urine)

18
Q

How is GFR estimated?

A

Use of MDRD eGFR, which adjusts serum creatinine based on age, gender and ethnicity

19
Q

What are the limitations of eGFR

A

Only accurate in adults

Needs a stable GFR, so only used in chronic kidney disease not AKI

20
Q

What assessments may be used to look for specific causes of CKD?

A 
Auto-Antibodyscreen
Complement 
Immunoglobulin 
ANCA
CRP 
SPEP/UPEP
Renal biopsy
21
Q

What imaging can be used to look for cause of CKD?

A

Ultrasound - size, hydronephrosis
CT
MRI

22
Q

What is a nephrostomy?

A

Draining of urine from obstructed kidney

23
Q

List some complications associated with CKD:

A

Acidosis (eGFR<25)
Anaemia (eGFR<30)
Metabolic bone disease
Non-bone calcification

24
Q

What systems can acidosis affect and how is it treated?

A

May affect muscle, bone and renal function

Treated using oral NaHCO3 tablets

25
Q

What causes anaemia to develop and how is it treated?

A

Decreasederythropoietinproduction
Resistancetoerythropoietin
DecreasedRBCsurvival
Bloodloss

Inject EPO

26
Q

Describe the pathway of metabolic bone disease:

A

Decreased GFR –> increased phosphate conc. so decreased calcium conc. –> PTH release (secondary hyperparathyroidism) –> breakdown of bone (osteitis fibrosis cystica)

27
Q

Why can you get osteomalacia in CKD?

A

Less activation of vitamin D

28
Q

Describe some features of renal osteodystrophy:

A

Rugger jersey spine - sclerotic end plates of vertebrae

Erosion of terminal phalanges

29
Q

What causes non-bone calcification and where can it occur?

A

High phosphate levels causing calcium phosphate deposition

Aorta, small vessels of skin, joints

30
Q

Describe the management of CKD:

A

Lifestyle - smoking, obesity, exercise, diet (salt, fat) Treatdiabetes(ifpresent)
Treatbloodpressure
ACEinhibitors/ARBsinproteinuria

31
Q

When does renal replacement therapy start?

A

eGFR = 8-10ml/min

32
Q

What are the indications to start dialysis?

A 
Uraemicsymptoms 
Acidosis 
Pericarditis 
Fluidoverload 
Hyperkalaemia

Urinary System (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions