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2 Renal > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

you can have chronic kidney disease and normal renal function tests T or F

A

T

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2
Q

CKD tends to present without comorbidities T or F

A

F, usually presents with other conditions eg diabetes and CVD

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3
Q

the risk of developing CKD increases with age T or F

A

T

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4
Q

define CKD?

A

abnormal biochem or urinalysis for >90 days in >2 samples

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5
Q

eGFR has to be multiplied by ___ if you are afro-caribbean or african-american

A

1.2

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6
Q

a low stage of CKD would have a __ eGFR

A

normal/high

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7
Q

stage G1 CKD has an eGFR of

A

> 90

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8
Q

stage G5 CKD has an eGFR of

A

<15

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9
Q

what CKD stage should be referred to a renal specialist?

A

G4

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10
Q

what eGFR level would prompt starting dialysis?

A

<8

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11
Q

what does the A1 stage of albumin:creatinine ratio indicate?

A

no proteinuria

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12
Q

you should do an albumin:creatinine ratio if what is detected on testing?

A

proteinuria

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13
Q

you would have proteinuria if your A:C ratio was over…

A

3

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14
Q

what test should be used for AKI?

A

creatinine (not eGFR)

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15
Q

what test should be used for CKD?

A

eGFR

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16
Q

how long should be patients be montitored for after an episode of AKI and why?

A

2-3yrs; looking for signs of CKD

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17
Q

there is no relationship between past AKIs and increased risk of CKD: T or F

A

F, they are at a much higher risk and must be monitored

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18
Q

what conditions are monitored for CKD?

A

diabetes

hypertension

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19
Q

dysmorphic RBCs on urine microscopy indicate bleeding from where?

A

glomerulus

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20
Q

normal RBCs on urine microscopy indicate bleeding from where?

A

distal to glomerulus

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21
Q

when would CKD be defined as progression?

A

decreased eGFR by 25%

more proteinuria

22
Q

symptoms of CKD?

A 
nocturia
dilute urine
tired
anorexia
itch
can't sleep
anaemia (dec. erythropoeitin)
23
Q

management of CKD?

A

control risk factors - salt reduction, smoking
ACEi to reduce BP and proteinuria (monitor eGFR)
atorvastatin 20mg
fluid restrict(1-1.5l) if overloaded
restrict phospate if PO4 high
active vit d + phosphate binders

24
Q

which patients with CKD should you refer?

A 
G4 +
A3 (A:C ratio)
a decreasing eGFR (>25%)
difficult to control hypertension
suspect renal artery stenosis
25
Q

when would you qualify with difficult to control hypertension?

A

using at least 4 hypertensive drugs at max dose

26
Q

what BP target should a CKD patient aim for if they dont have proteinuria?

A

140/90mmHg

27
Q

what BP target should you aim for in a CKD patient with proteinuria?

A

130/80mmHg

28
Q

secondary causes of glomerulonephritis?

A

diabetes
lupus
heroin addiction
obesity

29
Q

vasculitic causes of CKD?

A

GPA
MPA
EGPA

30
Q

what microangiopathies can cause CKD?

A

thrombotic thrombocytopaenia purpura

HUS

31
Q

signs of advanced uraemia?

A 
lemon yellow skin
twitching
encephalopathy- confusion/tremor
peicardial rub
metabolic acidosis - kussmauls
32
Q

you are less likely to bleed when uraemic T or F

A

F, more likely

33
Q

symptoms of uraemia?

A 
nausea
vomiting
anorexia
weight loss
itch
restless legs
twitch
altered taste
34
Q

main categories of symptoms in CKD?

A

uraemia
anaemia
pain

35
Q

type of pain felt in CKD?

A

neuropathic
ischaemic
bony
visceral

36
Q

symptoms of anaemia?

37
Q

why do you get fluid overload and hypertension in CKD?

A

impaired salt and water handling

38
Q

why do you get nocturia in CKD?

A

can’t concentrate urine so will need to pee constantly

39
Q

why do you get metabolic acidosis in CKD?

A

impaired reabsorption and secretion of H+ and HCO3

40
Q

what can CKD cause?

A

bone disease
CVD
anaemia

41
Q

Tx of end stage renal failure?

A

haemodialysis
peritoneal dialysis (draws off salt + h20)
transplant
conservative

42
Q

how much higher is mortality of CVD in dialysis patients compared to non-renal patients?

A

10-20x higher

43
Q

best form of vascular access for dialysis?

A

arteriovenous fistula

44
Q

what form of hyperparathyroidism can happen as a result of CKD and why?

A

tertiary as you get hyperplasia of glands -> hypercalcaemia

45
Q

should you be able to see BVs on x ray?

A

no, can only see them if they’re calcified

46
Q

what is calciphylaxis?

A

calcification and occlusion of the medium sized blood vessels

47
Q

what patient would not fall into the increased risk category for CKD?

  1. diabetic
  2. hypertension pt
  3. coronary heart disease pt
  4. long term steroid pt
  5. pt with family history of stage 3 ckd
A

FH of CKD

only worry if someone in the family had stage 5

48
Q

chronic __ disease is a risk factor for urinary incontinence?

49
Q

which GFR is stage 4 CKD?

50
Q

first line therapy for high BP in a patient with CKD and proteinuria

51
Q

how would a patient with stage 3 CKD be monitored

A

measure eGFR, PCR, Hb, K, Ca and phosphate 6 monthly

2 Renal (34 decks)

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