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ECOS 2 Pre-Midterm > Approach to Renal Complaint > Flashcards

Approach to Renal Complaint Flashcards

1
Q

Proteinuria

A

Protein in the urine

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2
Q

Glucosuria

A

Glucose in the urine

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3
Q

Hematuria

A

Blood in the urine

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4
Q

Dysuria

A

Painful urination

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5
Q

Polyuria

A

Frequent urination

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6
Q

UTI

A

Urinary Tract Infection

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7
Q

GFR

A

Glomerular Filtration Rate

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8
Q

CrCl

A

Creatine Clearance

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9
Q

AKI

A

Acute Kidney Injury

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10
Q

CKD

A

Chronic Kidney Disease

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11
Q

ESRD

A

End stage renal disease

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12
Q

Uremia

A

Elevated BUN levels

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13
Q

BUN

A

Blood Urea Nitrogen

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14
Q

What is and How is urea nitrogen created?

A

A waste product created when liver breaks down proteins and sends to kidney for excretion

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15
Q

Cr

A

Creatine

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16
Q

How is creatine created?

A

Waste product of muscle breakdown that is constantly produced and excreted by kidneys

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17
Q

4 Renal labs

A

BMP
CMP
Urinalysis
Urine Microscopy

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18
Q

What should the levels of protein, blood, glucose and bilirubin be in the urine?

A

ZERO

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19
Q

CMP test

A

A BMP + liver function tests

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20
Q

What is an AKI?

A

Impairment of renal function that results in retention of waste products that are normally excreted by kidney

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21
Q

If AKI does not resolve in _____ it may progress to ____

A

3 months

CKD

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22
Q

Is AKI a structural injury to the kidney?

A

NO

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23
Q

List some risk factors for AKI

A 
Old age
CKD
Hypertension
Diabetes
Nephrotoxins (NSAIDS, Antibiotics)
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24
Q

What are the 3 categories of causes for AKI?

A
  1. Pre-renal AKI
  2. Intrinsic AKI
  3. Post-renal AKI
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25
Q

Pre-Renal AKI

A

Injury occurring upstream of the kidneys

ex. Hypertension

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26
Q

Intrinsic AKI

A

Injury occurring at the level of the kidneys

ex. Glomerulonephritis

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27
Q

Post-Renal AKI

A

Injury occurring downstream of the kidneys

ex. Bladder outlet obstruction

28
Q

Main physical exam finding for pre-renal AKI?

A

HISTORY IS IMPORTANT
Fluid loss, volume depletion
- dry tongue, poor skin turgor, hypotension

29
Q

Renal ROS?

A

All things urine

- Urine frequency, appearance, painful

30
Q

Main thing to look at during a renal exam?

A

Volume status!

- jugular venous pressure (distended?), dry tongue, cap refill, edema

31
Q

What are the very important labs to obtain on all patients with AKI?

A

BMP and Urinalysis with urine microscopy

32
Q

What must be present to diagnose CKD?

A

FOR AT LEAST 3 MONTHS:

  • GFR < 60
  • Proteinuria and Abnormal urinary sediment
33
Q

GFR is less than ___ for CKD

A

60

34
Q

If the GFR is less than 60 for less than 3 months what is the diagnosis?

A

AKI

35
Q

In absence of _______, stages 1 and 2 of CKD are not enough to diagnose CKD

A

Kidney damage

36
Q

As you progress further towards CKD stage 5, what number is dropping?

A

GFR

37
Q

List some risk factors for CKD

A

AKI
Hypertension
Diabetes
Cardiovascular disease (CVD)

38
Q

Signs and symptoms for CKD are similar to AKI. What are a few extra things to look for?

A

Pericardial friction rub
Asterixis - wrist thing
Uremic frost

39
Q

What are the 3 labs to get for CKD patients?

A
  1. GFR
  2. Proteinuria
  3. Urinalysis with Urine microscopy
40
Q

GFR is not reliable in patients with?

A

AKI

41
Q

Treatment for CKD?

A

Dialysis

42
Q

Indications for dialysis?

A 
A - acidosis 
E - electrolyte disturbance
I - ingestion
O - volume overload
U - uremia
43
Q

Cystitis

A

Bladder infection

44
Q

Pyelonephritis

A

Kidney infection

45
Q

How does a UTI occur?

A

Colonization of urethra or urine with uropathogen

46
Q

Most common uropathogen with a UTI?

A

E. Coli

47
Q

Common causes of UTI

A

Sexual activity
Outflow obstruction
Fecal contamination

48
Q

Symptoms of cystitis

A

Dysuria, urinary frequency

49
Q

Symptoms of pyelonephritis

A

Dysuria, urinary frequency, fever, flank pain, nausea

50
Q

Important lab to order for UTI?

A

Urine culture

51
Q

What number should you be looking for with a urine culture?

A

> 100,000 cfu/mL

52
Q

What is the gold standard test for pyelonephritis?

A

Ct scan

53
Q

Special test for Kidney (pyelonephritis)?

A

Lloyd’s sign (punch)

54
Q

Lloyd’s sign

A

(+) = pain with deep percussion of costovertebral angle

55
Q

Treatment for UTI/cystitis/pyelonephritis?

A

Antiobiotics

56
Q

Nephrolithiasis

A

Kidney stones

57
Q

Normally, kidney stones are made of?

A

Calcium oxalate

58
Q

Symptoms of nephrolithiasis?

A

Pain, urinary urgency, dysuria, polyuria

59
Q

Upper ureter sympathetic innervation

A

T10-T11

60
Q

Upper ureter parasympathetic innervation

A

Vagus

61
Q

Lower ureter sympathetic innervation

A

T12-L2

62
Q

Lower ureter and bladder parasympathetic innervation

A

S2-S4

63
Q

Palpable points that are reflections of visceral dysfunction

A

Chapman’s reflex points

64
Q

Anterior kidney chapman point

A

1 inch superior and 1 inch lateral to umbilicus

65
Q

Anterior bladder chapman point

A

umbilicus

66
Q

Posterior kidney chapman point

A

Lateral to spinous process of L1

67
Q

Posterior bladder and ureter chapman point

A

Transverse processes of L2

ECOS 2 Pre-Midterm (14 decks)

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