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Jason's Renal Block > Chronic & Acute Renal Failure > Flashcards

Chronic & Acute Renal Failure Flashcards

1
Q

Do you need ARF to get CRF?

A

Nope

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2
Q

if you have CRF does that mean you had to have ARF?

A

Nope

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3
Q

Renal failure is defined as failure of what?

A

filtration

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4
Q

ARF reversible?

A

yes the sooner you treat it the better the outcome

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5
Q

definition of renal failure is how much urine flow per day?

A

less than 500ml/day

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6
Q

CRF timeline? reversible?

A

develops over 6 months-years

irreversible

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7
Q

What is normal GFR /min? /day?

A

125ml/min

180ml/day

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8
Q

GFR at 65? at 80?

A

65: 100ml/min 144L/day
80: 75ml/min 108L/day

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9
Q

What is considered significant CRF ____ml/min?

A

<72L per day

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10
Q

loss of GFR is coupled with loss of?

A

tubular reabsorption/secretion

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11
Q

When do you get endocrine impairment with renal failure?

A

more so CRF

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12
Q

3 main endocrine impairment with renal failure?

A

RAS: +++vasocontriction
impaired vitamin D activation
decreased erythropoeitin - anaemia

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13
Q

plasma urea for GFR assessment?

A

NOPE. crap

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14
Q

what is normal creatinine levels?

A

50-120uM/L

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15
Q

equation for creatinine clearance?

A

UV/P = GFR

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16
Q

Normal hydrostatic pressure in glomerulus is?

A

55mmHg

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17
Q

when do you no longer filter anything in glomerulus?

A

<40-45mmHg

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18
Q

ARF: What’s more common? oliguria? Anuria?

A

oliguria

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19
Q

ARF: GFR falls how?

A

acutely hours/days

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20
Q

3 areas of acute renal failure?

A

pre-renal
renal
post-renal

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21
Q

what is ATN?

A

acute tubular necrosis

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22
Q

in pre-renal ARF: what would systemic and Glomerulous pressures be less than?

A

systemic: <45mmHG

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23
Q

causes of pre-renal ARF? 5 big ones

A 
Shock
Sepsis
Haemolysis
rhabdomyolysis
nephrotoxic drugs
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24
Q

3 big causes of renal/intrinsic ARF?

A

glomerular disease
interstitial nephritis
tubular damage

25
Q

what can cause glomerular disease?

A

IgA immune complexes post group A strep infections

26
Q

interstitial nephritis often related to?

A

drugs

27
Q

3 Toxins that can cause tubular damage in ARF?

A

antibiotics
contrast media
myo/haemoglobin

28
Q

2 ischemic events that cause tubular damage in ARF? which one is most common?

A

ATN (most common)

vascular obstruction

29
Q

how does ATN cause death?

A

Acidosis, increase in K+ levels: arrythmias

30
Q

what is a post-renal cause of ARF?

A

outlet obstruction

stones, clots, tumours

31
Q

What is uraemia?

A

CRF

32
Q

CRF reversible?

A

Nope

33
Q

CRF leads to what?

A

end-stage renal disease

34
Q

in CRF what happens to remaining nephrons?

A

hypertrophy

hyperfiltration

35
Q

What happens in glomerular hyperfiltration in CRF? 3 things

A

loss of functional reserve
glomerular hypernsion
damage/glomerulosclerosis

36
Q

What is uraemia exactly beside CRF?

A

accumulation of urea

37
Q

when do you get symptoms with uraemia?

A

<30% normal renal function

fatigue, anorexia, skin pigmentation (lemon)

38
Q

4 common causes of CRF?

A

diabetes
high blood pressure
chronic glomerulonephritis
cystic disease

39
Q

What happens to sodium in glomerular disease?

A

sodium retention

hypertension

40
Q

what happens to sodium in tubular disease

A

sodium wasting
low BP
crappy concentrating ability/polyuria

41
Q

What happens to [K+] in CRF?

A

tends to rise in late stage

42
Q

what happens to pH in CRF?

A

falls cause it fails to excrete

43
Q

what happens to PO4 in CRF?

A

reduced excretion
rise in PO4
reduction in Ca2+

44
Q

what happens to Ca2+ in CRF?

A

reduction

rise in PO4

45
Q

What is renal osteodystrophy?

A

reduced Vitamin D3 activation: osteomalacia, fractures

46
Q

why high PTH in CRF?

A

with less PO4 excretion = increase Ca2+ excretion = increase in PTH to get Ca2+ levels up = hyperparathyroidis (contributes to bone degradation)

47
Q 
Which can be salt and water
imbalances in CRF?
1. Sodium retention and hypertension
2. Sodium wasting and low BP
3. Polyuria
A

?

48
Q

Impairment of which of the following is the
most important in defining renal failure?
1. renal blood flow
2. glomerular filtration rate
3. renal tubular reabsorption
4. renal tubular secretion
5. renal concentrating ability

A

?

49
Q 
Predisposition to acute renal failure is
seen in which of the following groups?
1. < 5 years of age
2. > 60 years of age
3. vegans
4. obese
5. pre-existing renal disease
A

?

50
Q 
28
Which of the following provide a clinical
estimate of GFR
1. Plasma sodium concentration
2. Plasma potassium concentration
3. Plasma bicarbonate concentration
4. Plasma pH
5. Plasma urea concentration
6. Plasma creatinine concentration
A

?

51
Q

Which of the following scenarios involving
plasma creatinine would worry you?
1. A value of 110 μM/L in a frail old lady
2. A value of 130 μM/L in an elite body builder
3. An increase from 60 to 120 μM/L
4. An increase from 300 to 360 μM/L

A

?

52
Q 
Which of the following are true?
1. A urine output of  500 mL per day
excludes the presence of renal failure
3. Both
4. Neither
A

?

53
Q 
Which of the following can cause
pre-renal renal failure?
(via glomerular filtration driving force)
1. Hemorrhage
2. Hypoalbuminemia
3. Renal artery stenosis
4. NSAIDs
5. ACE inhibitors
6. Cardiac failure
A

?

54
Q 
The most accurate measure of
daily fluid balance is:
1. Hospital admission and careful
monitoring of fluid intake and urine
volumes
2. Changes in plasma urea
3. Changes in plasma creatinine
4. Jugular venous pressure
5. Daily body weight measurement
A

?

55
Q 
Which of the following can cause
anuria?
1. Glomerulonephritis
2. Interstitial nephritis
3. Renal artery occlusion
4. Prostatic malignancy
A

?

56
Q 
Which of the following are problems
in acute renal failure?
1. Hypokalemia
2. Hypercalcemia
3. Hypophosphatemia
4. Sodium and water retention
5. Acidosis
6. Severe anemia
A

?

57
Q 
Which of the following are functions
of the normal kidney?
1. Maintenance of volume of ECF
2. Maintenance of composition of ECF
3. Vitamin D activation
4. Control of red blood cell production
A

?

58
Q 
Which of the following would be of
benefit to remaining nephrons
1. High protein diet
2. Low protein diet
3. Keeping blood pressure high
4. Keeping blood pressure low
A

?

59
Q 
Which can be salt and water
imbalances in CRF?
1. Sodium retention and hypertension
2. Sodium wasting and low BP
3. Polyuria
A

?

Jason's Renal Block (20 decks)

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