Chronic Kidney Disease

Question 1

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

Answer 1

> 90days

Question 2

what drugs are risk factors for CKD

Answer 2

genta, NSAID, trimethoprim, PPI

Question 3

how can CKD cause arrhythmias

Answer 3

decreases K

Question 4

how can CKD cause bone pain

Answer 4

secondary hyperparathyroidism

Question 5

how can CKD cause pallor, tiredness and fatigue

Answer 5

decreases EPO

Question 6

what acid base disturbance does CKD cause

Answer 6

metabolic acidosis

Question 7

presentation of mild uraemia

Answer 7

anorexia, nausea, vomiting, itch

Question 8

presentation of severe uraemia

Answer 8

pericarditis (pericardial rub), uraemic frost, encephalopathy

Question 9

CKD affects fluid balance. how may this present

Answer 9

JVP, creps, pulmonary oedema, peripheral oedema

Question 10

investigations for CKD

Answer 10

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

Question 11

in what conditions will the urine pH be abnormal

Answer 11

renal tubular acidosis, UTI

Question 12

what causes hyaline urinary casts

Answer 12

benign

Question 13

what causes RBC urinary casts

Answer 13

nephritic

Question 14

what causes granular urinary casts

Answer 14

CKD

Question 15

does low muscle mass over or underestimate GFR

Answer 15

overestimate

Question 16

what is stage 1 CKD

Answer 16

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

Question 17

what is stage 2 CKD

Answer 17

pathology + mild decrease GFR 60-89

Question 18

what is stage 3a CKD

Answer 18

moderate; GFR 45-59

Question 19

what is stage 3b CKD

Answer 19

moderate; GFR 30-44

Question 20

what is stage 4 CKD

Answer 20

severe GFR 15-29

Question 21

when is ACEI contraindicated for renovascular disease

Answer 21

if bilateral

Question 22

what is stage 5 CKD

Answer 22

kidney failure GFR <15 / dialysis

Question 23

how is the aetiology of CKD classified

Answer 23

vascular
pre-renal
renal
post-renal

Question 24

general management of CKD

Answer 24

ACEI or ARB
atorvastatin
+- aspirin (PMH thrombus)

Question 25

which drugs decrease proteinuria in CKD

Answer 25

ACEI / ARB

Question 26

what are the options for RRT

Answer 26

haemodialysis, peritoneal dialysis, transplant

Question 27

what is the target BP

Answer 27

130/80

Question 28

what are the complications of arteriovenous catheters

Answer 28

steal syndrome, stenose, thrombose

Question 29

what is the commonest cause of death in CKD patients

Answer 29

cardiovascular disease

Question 30

what is the management of CKD-MBD

Answer 30

restrict phosphate, Na, K, fluid | alfacalcidol active vit D

Question 31

what is the commonest cause of ESRF in the UK

Answer 31

diabetic nephropathy

Question 32

what is glycated in diabetic nephropathy

Answer 32

proteins in the efferent arteriole

Question 33

which arteriole dilates in diabetic nephropathy

Answer 33

afferent arteriole

Question 34

how does diabetic nephropathy 1st present

Answer 34

asymptomatic proteinuria at screening

Question 35

complications of peritoneal dialysis

Answer 35

site infection, peritonitis, peritoneal membrane failure, hernia

Question 36

definitive management of diabetic nephropathy T1DM

Answer 36

kidney pancreas transplant

Question 37

is renal artery stenosis bilateral

Answer 37

usually unilateral

Question 38

management of renal artery stenosis

Answer 38

interventional uroradiology

Question 39

age and gender most affected by fibromuscular dysplasia

Answer 39

female aged 15 - 50

Question 40

what conditions are associated with fibromuscular dysplasia

Answer 40

EDS, carotid artery dissection, HTN

Question 41

1st investigation after bloods for renovascular disease

Answer 41

ultrasound; shrunken / scarred kidneys

Question 42

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

Answer 42

convection

Question 43

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

Answer 43

adsorption

Question 44

what is the gold standard access site for haemodialysis

Answer 44

arteriovenous fistula

Question 45

what is the 2nd line access site for haemodialysis

Answer 45

tunneled venous catheter

Question 46

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

Answer 46

tunneled venous catheter

Question 47

haemodialysis is primarily diffusive. true or false

Answer 47

true

Question 48

what are the complications of tunneled venous catheter access sites

Answer 48

aureus endocarditis, block, stenose, thrombose

Question 49

how often must a patient be in hospital for haemodialysis

Answer 49

4 hr 3X wk

Question 50

what is the fluid restriction in haemodialysis

Answer 50

1L / day

Question 51

what sets the osmotic gradient in peritoneal dialysis

Answer 51

glucose and bicarbonate

Question 52

what is involved in continuous peritoneal dialysis

Answer 52

4X 2L bag/day

Question 53

what is involved in automated peritoneal dialysis

Answer 53

1 bag per day + drain overnight

Question 54

management of hyperacute renal transplant rejection

Answer 54

nephrectomy

Question 55

management of acute renal transplant rejection

Answer 55

increase immunosuppression

Question 56

mechanism of cyclosporin

Answer 56

calcineurin inhibitor

Question 57

mechanism of azaioprine

Answer 57

blocks purine synthesis

Question 58

what infections are transplant patients particularly at risk of

Answer 58

PCP, CMV, HSV

Question 59

what is maintenance immunosuppression for renal transplant patients

Answer 59

pred + tacrolimus + MMF or pred + cyclosporin + azathioprine

Question 60

complications of overimmunosuppression

Answer 60

infection, NMSC, lymphoma