Chronic Kidney Disease

Question 1

Two major causes of chronic kidney disease

Answer 1

diabetes and HTN

Question 2

T/F uremia is a condition resulting from early stages of kidney failure in which urea and other nitrogen containing wastes are found in the blood.

Answer 2

False it’s a condition resulting from advanced stages of kidney failure

Question 3

Symptoms of uremia

Answer 3

fishy breath, metallic taste in mouth, dyspnea, restless legs, hiccups

Question 4

Which of the following are signs of uremia: sallow appearance, pallor, urinous breath, stupor, peripheral neuropathy?

Answer 4

all are signs of uremia

Question 5

Lab findings associated with uremia

Answer 5

hypophosphatemia, hyperkalemia, broad waxy casts, anemia

Question 6

imagining results for uremia

Answer 6

Small echogenic kidneys bilaterally and renal osteodystrophy

Question 7

Staging of CKD

Answer 7

Stage 1: Kidney damage with normal or increased GFR (>90mL/min). Stage 2: Mild reduction in GFR (60-89mL/min). Stage 3: Moderate reduction in FGR (30-59mL/min). Stage 4: Severe reduction of GFR (15-29 mL/min). Stage 5: Kidney failure (GFR<15mL/min or dialysis)

Question 8

When do clinical manifestations of CKD typically appear?

Answer 8

stages 4-5

Question 9

First step in the management of CKD

Answer 9

appropriate screening and diagnosis

Question 10

Blood pressure targets for patients with CKD

Answer 10

PROTEINURIA 1G/DAY: <125/75

Question 11

dietary management of CKD

Answer 11

Restrict: protein, Na/H2O, K+, phosphorus, Mg+

Question 12

phosphorus binders

Answer 12

Calcium carbonate (TUMS) and Calcium acetate (Phoslo)

Question 13

Indications for dialysis

Answer 13

hyperkalemia, uremia, overdose

Question 14

Most common organisma causing peritonitis due to peritoneal dialysis

Answer 14

staph aureus

Question 15

Advantages to peritoneal dialysis

Answer 15

minimizes symptomatic swings, phosphates better cleared, greater patient autonomy

Question 16

T/F viral testing and a CXR is required before a kidney transplant

Answer 16

True

Question 17

Criteria that exclues someone from a kidney transplant

Answer 17

age > 70, severe cardiovascular disease, bladder diseases, cancer, carriers of chronic infections

Question 18

What is used to prevent rejection and suppress the immune system for a kidney transplant?

Answer 18

MMF is a potent immunosuppressor. Simulect is used to prevent rejection

Question 19

What is one of the first signs of graft vs host disease?

Answer 19

skin sores/lesions

Question 20

How is a diagnosis of kidney transplant rejection established?

Answer 20

Cr elevation of 20% over baseline

Question 21

Findings that may indicate the chronicity of renal failure inclde all of the following, except: Azotemia for at least 3-6 months, Bilaterally small kidneys by sonogram, Hematuria, Broad casts in urinary sediment, Anemia

Answer 21

all indicate chronic renal failure except hematuria