Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

Define chronic kidney disease

A

The presence of kidney damage or decreased kidney function for three months or longer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define accelerated CKD

A

A sustained decrease in GFR of at least 25% and a change in GFR category within 12 months, or when GFR decreases by 15ml/min per year.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define kidney failure

A

GFR < 15ml/min, or when dialysis or transplant is required.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe Stage 1 CKD

A

Kidney damage
Normal or high GFR
GFR>90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe Stage 2 CKD

A

Kidney damage
Mild reduction in GFR
GFR = 60 - 89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe Stage 3 CKD

A

Kidney function is moderately impaired

3a: GFR = 45 - 59
3b: GFR = 30 - 44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe Stage 4 CKD

A

Kidney function is severely impaired

GFR = 15 - 29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe Stage 5 CKD

A

Advanced disease or patient is on dialysis

GFR <15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does it mean if the suffix “p” is added onto the CKD classification?

A

The patient has proteinuria as well as decreased GFR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give five pieces of evidence that indicate CKD, other than GFR.

A
  • Persistent microalbuminuria.
  • Persistent proteinuria.
  • Persistent haematuria (after exclusion of other causes – e.g. urological disease).
  • Structural abnormalities of the kidneys, demonstrated on ultrasound scanning or other radiological tests
  • Biopsy-proven chronic glomerulonephritis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List possible causes or risk factors for CKD

A 
Diabetes
Glomerulonephritis
Hypertension
Renovascular disease
Polycystic kidney disease
Infective, obstructive and reflux nephropathies
Hypercalcaemia
Multisystem diseases such as SLE
Neoplasms
Myeloma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the specific symptoms that can present in sever CKD

A 
Anorexia, nausea and vomiting
Fatigue, lethargy, weakness
Weight loss
Dyspnoea, pulmonary oedema, peripheral oedema
Nocturia, polyuria, headache
Pruritus
Impotence (men), amenorrhoea (women)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the clinical signs that can present in a patient with advanced CKD

A

Skin pigmentation or pallor
Excoriation (skin picking) due to pruritus
Hypertension but with postural hypotension
Peripheral oedema
Left ventricular hypertrophy
Pleural effusions
Peripheral vascular disease, peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give five classes of drugs that are particularly significant in kidney disease

A 
NSAIDs
penicillins/aminoglycosides
chemotherapeutic drugs
narcotics 
ACE inhibitors/ARBs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is eGFR calculated?

A

eGR is calculated by measuring serum creatinine and using a set formula.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the gold standard for measuring kidney function?

A

Glomerular filtration rate (GFR) using inulin.

17
Q

In CKD, would serum levels of sodium, potassium, bicarbonate and phosphate be expected to be high, low or normal?

A

Sodium - usually normal but may be low
Potassium - high
Bicarbonate - low (four from 24 = chronic)
Phosphate - usually high

18
Q

When might hypoalbuminaemia occur in patients with chronic kidney disease?

A

Hypoalbuminaemia may occure in patients who are nephrotic and/or malnourished. Low levels of albumin at the start of dialysis are associated with a poor prognosis

19
Q

How is serum level of parathyroid hormone affected by chronic kidney disease?

A

Serum PTH rises progressively with declining kidney function.

20
Q

What is the significance of a high serum alkaline phosphatase in CKD patients?

A

A high alkaline phosphatase is indicative of the development of bone disease.

21
Q

What is the cause of anaemia in CKD?

A

low levels of haemoglobin (normal Hb is 11.5-16g/dL in females and 13.5-18g/dL in males)

22
Q

Describe the three components of the nephrotic syndrome triad

A

Proteinuria (>3.5g/24hrs)
Hypoalbuminaemia - due to renal protein loss
Oedema - due to low intravascular oncotic pressure associated with hypoalbuminaemia, and to some extend the fluid retention caused by decreased tubular function in the kidney.
(may also have hypercholersterolaemia)

23
Q

Describe the components of nephritic syndrome

A

Hyperension
Haematuria (usually microscopic but can be macroscopic)
Acute renal failure
(may also have oedema)

24
Q

Name three equations used to calculate eGFR from serum creatinine

A

Cockcroft Gault equation
MDRD 4 variable equation
CKD-EPI equation

25
Q

List the types of imaging which may be used in the investigation of kidney disease

A 
ECG and echocardiography
Abdominal X-ray
Renal ultrasound
Renal CT
MRI
26
Q

What should always be done before taking a renal biopsy?

A

Check clotting ability

27
Q

List 10 potential complications of chronic kidney disease

A 
Acidosis
Anaemia
Bone disease
Cardiovascular risk
Dialysis and Death
Electrolytes
Fluid overload
Gout
Hypertension
Iatrogenic issues
28
Q

Generally speaking, when does fluid overload become problematic?

A

When GFR<20mls/min

29
Q

How is hyperkalaemia managed?

A

Acute:

  • administer calcium gluconate to stabilise patient
  • administer salbutamol or insulin-dextrose to shift potassium into cells
  • use dialysis and/or calcium resonium to remove excess potassium

Chronic hyperkalaemia can be managed with diet and drug modifications.

30
Q

What is the normal range for potassium? At what level is there a serious risk of cardiac arrest?

A

Normal range 3.5 - 4.5 mmol/L

K+ > 7 mmol/L may induce cardiac arrest

31
Q

Describe the management of fluid overload in CKD

A

Na+ restriction
Fluid restriction
Loop diuretics

32
Q

Describe the presentation of Polycystic Kidney Disease

A 
Acute loin pain
May have haematuria
Vague abdominal/loin discomfort due to increasing size of kidneys
Hypertension
Features of uraemia
33
Q

What are the potential extrarenal manifestations of PKD?

A

Cysts can occur in the liver (most common), pancreas, spleen and/or lungs
Berry aneurysms
Mitral valve prolapse
Increased frequency of colonic diverticula

34
Q

What is the prognosis of Polycystic Kidney Disease?

A

45% will be in end stage renal disease by the age of 60

Urinary (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions