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GIR Test 4 > B5-092 Dialysis > Flashcards

B5-092 Dialysis Flashcards

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1
Q

accumulation in blood of nitrogenous end products

A

azotemia

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2
Q

symptom complex resulting from failure to excrete nitrogenous end products

A

uremia

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3
Q

90% of patients with a GFR <30 are

A

anemic

appears at beginning of GFR stage 4

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4
Q

treatment for anemia due to CKD may require […] iron

(administration method)

A

IV

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5
Q

mineral and bone disorder is often evident in what stage of CKD?

A

3

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6
Q

most important symptom of CKD-MBD

A

vascular calcification

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7
Q

calcium deposits in small vessels of dermis

A

calciphylaxis

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8
Q

important player in the “trade-off” hypothesis of CKD-MBD

causes the increase in PTH

A

FGF23

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9
Q

most important cause of volume overload in CKD

A

sodium retention

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10
Q

diet for CKD

A
  • low sodium
  • low potassium
  • low phosphorus
  • fluid restriction
  • protein restriction
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11
Q

meds for CKD

A
  • phosphate binders
  • calcitriol
  • antihypertensives
  • ESA
  • treatment for renal disease
  • treatment for comorbid conditions
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12
Q

indications for dialysis

A
  • uremic pericarditis
  • uremic encephalopathy
  • severe bleeding with uremia
  • fluid overload refractory to diuretics
  • refractory metabolic disturbances
  • refractory HTN
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13
Q

most common cause of death in CKD

A

heart disease

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14
Q

does kidney transplant or dialysis offer a better quality of life for CKD patients?

A

kidney transplant

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15
Q

if a patient had cancer and is currently in remission, and in need of kidney transplant, are they eligible?

A

yes after certain wait time depending on type of cancer

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16
Q

low bone density due to hormonal changes or calcium or vitamin D deficiency

A

osteoporosis

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17
Q
  • occurs with a relatively suppressed PTH and alkaline phosphate levels
  • associated with significant vascular calcifications
A

adynamic bone disease

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18
Q

defect of both low turnover and abnormal mineralization of bone

A

osteomalacia

19
Q

why was osteomalacia more common in the past?

A

nephrologists used aluminum-based phoshorus binders

aluminum toxicity causes osteomalacia

20
Q

class bone disease associated with renal failure

A

osteitis fibrosa

21
Q

associated with increased bone turnover and elevated PTH and alkaline phosphatase

A

osteitis fibrosa

22
Q

glucocorticoid therapy for primary renal disorder or renal transplant can lead to CKD patients developing

A

osteoporosis

23
Q

bone disease in CKD with elements of both low and high bone turnover

A

uremic osteodystrophy

24
Q

is osteoporosis typically caused by ESKD?

A

no

25
Q

does increasing the frequency of dialysis improve survival or hospitalizations?

A

no

26
Q

most likely positive outcome from increasing dialysis

A

improved blood pressure control

fluid removal

27
Q

conservative management of ESKD has a […] shorter median survivial

A

2 year

28
Q

patients who choose […] are more likely to die at home or in hospice and have lower rates of hospitilization overall

A

conservative management

29
Q

individuals who chose […] maintain QOL over those who chose RRT

A

conservative management

30
Q

patients who chose […] have shorter survival but fewer hospitalizations

A

conservative management

31
Q

mortality and hbA1c have a […] relationship

A

U shaped

32
Q

both high and low hemoglobin A1c are associated with

A

higher levels of mortality

33
Q

lowest mortality in ESKD is seen in patients with a hemoglobin A1c of

A

7-8%

34
Q

what should be done for a patient with persistent severe secondary hyperparathyroidism and four-gland hyperplasia who has not responded to medical therapy

A

subtotal parathyroidectomy

35
Q

persistent PTH following kidney transplant with values above […] increase all-cause mortality and risk of graft loss

A

65

36
Q

elevated PTH causes […] wasting

A

postassium

37
Q

what procedure is required for evaluation prior to kidney transplant?

A

urethrocystoscopy with bladder capacity

38
Q

[…] before kidney transplant is critical to prevent complications after transplant

A

urological assessent

39
Q

many kidney transplant candidates have received dialysis for many years and have long periods of oliguria or anuria. This may result in

A

bladder dysfunction/atrophy

urethrocystoscopy prior to transplant to evaluate

40
Q

patients who urinate greater than […] ml/d likely do not need urethrocystoscopy prior to transplantation

A

300

41
Q

patients with <100 ml bladder capacity should receive treatment for […] prior to transplantation

A

improving bladder capacity

42
Q

patients with a history of invasive bladder cancer must wait […] after successful treatment to be eligible for kidney transplant

A

2 years

superficial bladder cancer does not require waiting

43
Q

patients who receive education and guidance from a multidisciplinary approach are more likely to choose

A

home-based modality

44
Q

kidney transplants for a [….] donor are associated with longevity and fewer comorbidities

A

living

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