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Therapeutics > AST 4 Quizzes > Flashcards

AST 4 Quizzes Flashcards

1
Q

What kind of risk factor are nephrotoxins?

A

Exposure

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2
Q

What mechanism(s) do RAS inhibitors use?

A

-decrease glomerular hypertension
-decrease proteinuria

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3
Q

What causes hypocalcemia?

A

Hyperphosphatemia

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4
Q

What acid/base disorder results from altitude, and what drug treats it?

A

respiratory alkalosis
acetazolamide

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5
Q

What drug acts on site II of the nephron (the loop of Henle)?

A

Furosemide

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6
Q

What is a complication of late-stage SHPT?

A

Osteo- disorders

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7
Q

Why is furosemide an efficacious diuretic?

A

-The region it acts on is responsible for 20-30% of filtration
-it disrupts the counter-current multiplier

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8
Q

What site in the nephron is responsible for diuretic-induced hypokalemia?

A

Site IV- collecting duct

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9
Q

What is the recommended treatment for shock-induced (?) Anion Gap Metabolic Acidosis?

A

Norepinephrine

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10
Q

What is the preferred term for acute renal insufficiency?

A

Acute kidney disease

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11
Q

What diuretic acts at site III, the distal tubule?

A

HCTZ (thiazides)

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12
Q

What class of medications can cause pre-renal AKI?

A

diuretics

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13
Q

True or false: Loading doses should be avoided in patients with kidney impairment

A

False: if anything is changed, it should be the maintenance dosing

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14
Q

Where is the ultrafiltrate in the nephron?

A

Site I (proximal tubule)

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15
Q

Which part of the nephron does triamterene affect?

A

Site IV (collecting duct)

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16
Q

What differentiates chronic kidney disease?

A

Adaptation

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17
Q

__1__ are used to prevent esophageal varices from bleeding by __2__ the __3__ vasculature

A
  1. Non-selective beta blockers
  2. Vasoconstricting
  3. Splanchnic
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18
Q

Which of the following beta blockers are non-selective:
Acebutolol
Metoprolol
Timolol

A

Timolol

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19
Q

What type of anemia is associated with low hemoglobin and elevated MCV?

A

macrocytic, normochromic

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20
Q

What is required to diagnose SBP?

A

ONLY a PMN count>250
(WBC count x Poly %)

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21
Q

What drugs treat Non-Alcoholic Fatty Liver Disease?

A

None!

22
Q

How long should SBP be treated with antibiotics?

A

5 days
(7 days for prophylaxis)

23
Q

If a patient on epoetin has an Hgb of 11.2 when checked, what should be done to their dosing?

A

Decreased by 25%

24
Q

What should patients be advised when taking po ferrous sulfate?

A

take with food for tolerability

25
Q

How to diagnose a patient with CKD?

A

-More than 3 months!
-eGFR<60?

26
Q

What treatment should be given to a CKD patient with a phos level 5.6 and calcium level 10.2?

A

Sevelamer 800 mg po tid with food

27
Q

G3a/A2 patient on HCTZ not controlling hypertension

A

keep HCTZ dose and initiate losartan

28
Q

What lab value is most important to determine liver function?

A

Albumin

29
Q

What is the pathophysiology of anemia in CKD?

A
  1. shortened RBC lifespan
  2. uremic inhibition of epoetin
  3. Up-regulation of hepcidin
30
Q

What drug should be discontinued in a hospitalized CKD patient to avoid AKI?

A

furosemide
(diuretics)

31
Q

A patient has been on ergocalciferol for 2 weeks and their 25(OH) vitamin D level is unchanged. What should be done to their dosing?

A

Keep dose the same, wait another few weeks

32
Q

What lab test helps to determine the etiology of ascites?

A

SAAG (serum ascites albumin gradient)

33
Q

What are the indications for dialysis?

A

Acidosis, EIOU

34
Q

Which form of dialysis can cause hypotension?

A

IHD

35
Q

How is the severity of ascites determined?

A

amount of fluid AND response to diuretics

36
Q

What drug should be avoided in kidney failure?

A

morphine/codeine

37
Q

What analytic determines the severity of alcoholic hepatitis and whether to start steroids?

A

Maddrey Discriminant Function (MDF)
start steroids if over 32

38
Q

What is a common chronic condition leading to kidney failure?

A

Hypertension

39
Q

Which diuretic’s mechanism of action works with the pathophysiology of ascites?

A

Spironolactone

40
Q

What severity is an acute variceal bleed?

A

Active bleeding is ALWAYS severe life-threatening

41
Q

When should 25% albumin be given in ascites?

A

Only to patients who undergo large-volume paracentesis

42
Q

How will decreasing dialysate flow rate affect the rate of drug removal?

A

Decrease the rate of drug removal

43
Q

How is HRS-AKI (hepatorenal syndrome-acute kidney injury) treated?

A

vasopressors and albumin

44
Q

What vasoactive substances operate in the liver?

A

nitric oxide and endothelins

45
Q

What scale is used to evaluate hepatic encephalopathy?

A

West Haven Criteria

46
Q

How often is intermittent hemodialysis delivered?

A

2-3 times/week

47
Q

How does the dialysate in IHD run?

A

countercurrent to blood flow through the filter

48
Q

What is a common cause for acute kidney failure?

A

Drug toxicity

49
Q

What factors make a drug likely to be cleared by the kidneys?

A

-Low molecular weight
-low protein binding
-low volume of distribution

50
Q

In what two conditions is a TIPS procedure a possible treatment?

A

-variceal bleeding
-ascites

51
Q

What is the Lille score used for?

A

Alcoholic hepatitis when steroids are not working

52
Q

What OTC pain medication is appropriate in cirrhotic patients, and at what dose?

A

Acetaminophen, max 2 g/day

Therapeutics (9 decks)

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