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Y2 Renal > Chronic Kidney Disease > Flashcards

Chronic Kidney Disease Flashcards

1
Q

how long apart must samples be taken for a diagnosis of CKD

A

> 90days

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2
Q

what drugs are risk factors for CKD

A

genta, NSAID, trimethoprim, PPI

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3
Q

how can CKD cause arrhythmias

A

decreases K

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4
Q

how can CKD cause bone pain

A

secondary hyperparathyroidism

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5
Q

how can CKD cause pallor, tiredness and fatigue

A

decreases EPO

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6
Q

what acid base disturbance does CKD cause

A

metabolic acidosis

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7
Q

presentation of mild uraemia

A

anorexia, nausea, vomiting, itch

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8
Q

presentation of severe uraemia

A

pericarditis (pericardial rub), uraemic frost, encephalopathy

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9
Q

CKD affects fluid balance. how may this present

A

JVP, creps, pulmonary oedema, peripheral oedema

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10
Q

investigations for CKD

A

BP, US, GFR, U+E, urinalysis, UPCR, urine microscopy, ECG +- biopsy

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11
Q

in what conditions will the urine pH be abnormal

A

renal tubular acidosis, UTI

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12
Q

what causes hyaline urinary casts

A

benign

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13
Q

what causes RBC urinary casts

A

nephritic

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14
Q

what causes granular urinary casts

A

CKD

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15
Q

does low muscle mass over or underestimate GFR

A

overestimate

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16
Q

what is stage 1 CKD

A

kidney function normal GRF >90 + urine/structural/genetic pathology

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17
Q

what is stage 2 CKD

A

pathology + mild decrease GFR 60-89

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18
Q

what is stage 3a CKD

A

moderate; GFR 45-59

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19
Q

what is stage 3b CKD

A

moderate; GFR 30-44

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20
Q

what is stage 4 CKD

A

severe GFR 15-29

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21
Q

when is ACEI contraindicated for renovascular disease

A

if bilateral

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22
Q

what is stage 5 CKD

A

kidney failure GFR <15 / dialysis

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23
Q

how is the aetiology of CKD classified

A

vascular
pre-renal
renal
post-renal

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24
Q

general management of CKD

A

ACEI or ARB
atorvastatin
+- aspirin (PMH thrombus)

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25
Q

which drugs decrease proteinuria in CKD

A

ACEI / ARB

26
Q

what are the options for RRT

A

haemodialysis, peritoneal dialysis, transplant

27
Q

what is the target BP

A

130/80

28
Q

what are the complications of arteriovenous catheters

A

steal syndrome, stenose, thrombose

29
Q

what is the commonest cause of death in CKD patients

A

cardiovascular disease

30
Q

what is the management of CKD-MBD

A

restrict phosphate, Na, K, fluid

alfacalcidol active vit D

31
Q

what is the commonest cause of ESRF in the UK

A

diabetic nephropathy

32
Q

what is glycated in diabetic nephropathy

A

proteins in the efferent arteriole

33
Q

which arteriole dilates in diabetic nephropathy

A

afferent arteriole

34
Q

how does diabetic nephropathy 1st present

A

asymptomatic proteinuria at screening

35
Q

complications of peritoneal dialysis

A

site infection, peritonitis, peritoneal membrane failure, hernia

36
Q

definitive management of diabetic nephropathy T1DM

A

kidney pancreas transplant

37
Q

is renal artery stenosis bilateral

A

usually unilateral

38
Q

management of renal artery stenosis

A

interventional uroradiology

39
Q

age and gender most affected by fibromuscular dysplasia

A

female aged 15 - 50

40
Q

what conditions are associated with fibromuscular dysplasia

A

EDS, carotid artery dissection, HTN

41
Q

1st investigation after bloods for renovascular disease

A

ultrasound; shrunken / scarred kidneys

42
Q

in regards to dialysis, what does “ultrafiltration solute drag across membrane in response to pressure gradient” refer to

A

convection

43
Q

in regards to dialysis, what does “plasma proteins & solute stick/adsorb to high flux membrane surfaces” refer to

A

adsorption

44
Q

what is the gold standard access site for haemodialysis

A

arteriovenous fistula

45
Q

what is the 2nd line access site for haemodialysis

A

tunneled venous catheter

46
Q

what is the 1st line access site for haemodialysis in AKI

A

tunneled venous catheter

47
Q

haemodialysis is primarily diffusive. true or false

A

true

48
Q

what are the complications of tunneled venous catheter access sites

A

aureus endocarditis, block, stenose, thrombose

49
Q

how often must a patient be in hospital for haemodialysis

A

4 hr 3X wk

50
Q

what is the fluid restriction in haemodialysis

A

1L / day

51
Q

what sets the osmotic gradient in peritoneal dialysis

A

glucose and bicarbonate

52
Q

what is involved in continuous peritoneal dialysis

A

4X 2L bag/day

53
Q

what is involved in automated peritoneal dialysis

A

1 bag per day + drain overnight

54
Q

management of hyperacute renal transplant rejection

A

nephrectomy

55
Q

management of acute renal transplant rejection

A

increase immunosuppression

56
Q

mechanism of cyclosporin

A

calcineurin inhibitor

57
Q

mechanism of azaioprine

A

blocks purine synthesis

58
Q

what infections are transplant patients particularly at risk of

A

PCP, CMV, HSV

59
Q

what is maintenance immunosuppression for renal transplant patients

A

pred + tacrolimus + MMF
or
pred + cyclosporin + azathioprine

60
Q

complications of overimmunosuppression

A

infection, NMSC, lymphoma

Y2 Renal (13 decks)

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