Cardiorenal Syndrome

Question 1

______ _______dysfunction and ______dysfunctional frequently coexist in the same individual

Answer 1

left ventricular ; renal

Question 2

The pathophysiological basis for cardiorenal syndrome is that ___________

Answer 2

dysfunction in 1 organ lead to dysfuntion in the other organ

Question 3

Renal disease is associated with low _____ _____ such as _____ where renal blood flow is ________

Answer 3

cardiac output; HF; decreased

Question 4

Medications known to worsen renal function

Answer 4

Diuretics

Question 5

What plays a critical role in HF and is a prominent factor in renal dysfunction?

Answer 5

Neurohormonal Stimulation

Question 6

What are the two systems that preserve the integrity of the arterial circulation and maintenance of blood flow to the vital organs?

Answer 6

Renin-angiotensin-Aldosterone system

Sympathetic nervous system

Question 7

The NH response is initially compensatory but if left untreated lead to ________and _______ kidney injury

Answer 7

progressive; irreversible

Question 8

CRS Type I Acute worsening of the _____ leading to ______Injury/dysfunction.

Answer 8

Acute cardiorenal syndrome. heart function; kidney

Question 9

CRS Type II ________abnormalities of the _____ leading to ______Injury/dysfunction.

Answer 9

Chronic Cardiorenal syndrome; Chronic; heart; kidney

Question 10

CRS Type III : Acute worsening of the _______ leading to _____injury or dysfunction.

Answer 10

Acute Renocardiac syndrome: kidney; heart

Question 11

CRS type IV: Chronic ________ leading to ______ injury or dysfunction

Answer 11

Kidney injury ; heart

Question 12

CRS Type V: Secondary Cardiorenal syndrome defined as ______Conditions leading to simultateneous injury or dysfunction of _____ and ______

Answer 12

systemic;

Question 13

Most common cause of CRS type I

Answer 13

nonadherence to dietary or medication regimens

Question 14

In CRS Type I there is alterations in _____ ______ and _____ ____ _____ as well as _______ ________

Answer 14

Cardiac output: intra-cardiac filing pressures; peripheral vasoconstriction

Question 15

T or F : In ACS or cardiogenic shock , the risk of CRS type I is high despite the use of inotropes, vasopressors.

Answer 15

True

Question 16

What is the focus in CRS type 3?

Answer 16

prevention

Question 17

Medications known to worsen renal function

Answer 17

ACE
Diuretics
ARBs
anti-hyperlipidemics

Question 18

Patients with CKD are more likely to die of _________than to progress to dialysis

Answer 18

CVD

Question 19

2 Stronger predictors for worsening renal function are:

Answer 19

Hypertension and Hypervolemia

Question 20

Cautionary approach to the treatment of patients with CRS type I is to assume that _______ is a direct result of _____ ______ until otherwise identified

Answer 20

AKI; renal hypoperfusion

Question 21

What help tailor appropriate therapy

Answer 21

Hemodynamic and volume status

Question 22

Mainstay of therapy for CRS Type I

Answer 22

Loop diuretics

Vasodilators (nitrates and Nesiritide)

Question 23

Target fluid removal rate of

Answer 23

500ml/hr

Question 24

Concomittant HF and ______ insufficiency cause a shift in the diuretic “dose-response-curve” to address this challenge current guidelines advocate the use of ______doses of Loop diuretics or adding a ____ ______ that acts on a ___ ______ such as _______

Answer 24

higher; second loop diuretics; distal tubule; metolazone.

Question 25

Vasodilators provide hemodynamic benefits by (Increasing or decreasing) both _____ preload and afterload, leading to improvement is ________ , ______ and _______

Answer 25

Decreasing; cardiac output, BP and stroke volume