Brainscape's Knowledge GenomeTM

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


See full index

Urinary (Semester 3) > Chronic Kidney disease > Flashcards

Chronic Kidney disease Flashcards

1
Q

What defines chronic kidney disease?

A

Reduced kidney function or structural damage (or both) for 3 months with reduced GFR and abnormal creatinine and albumin

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

What is the significance of CDK1 vs CDK5?

A

CDK1: normal kidney
CDK5: renal failure, needs renal replacement therapy. Means GFR is <15

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

What are the 2 main risk factors for chronic kidney disease? Which ethnicities are more likely to acquire them?

A
  1. Hypertension: damages kidney function, higher in Africans
  2. Diabetes: vascular damage hurts the glomerulus, higher in Caribbean
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Define the following renal diseases:
a) glomerulonephritis
b) polycystic kidney disease
c) chronic pyelonephritis
d) interstitial nephritis 
e) myeloma
f) outflow obstruction 
Which one is commonly in the FH?
A

A) Glomerulonephritis: immune-mediated acute inflammation of the kidney

b) polycystic kidney disease: inherited, dilated nephron causing fluid-filled cysts on kidney. Commonly in the FH
c) chronic pyelonephritis: characterized by chronic tubulointerstitial inflammation, causes end-stage renal disease
d) interstitial nephritis: inflamed space between tubules
e) Myeloma: malignant bone marrow tumour, kidney not producing EPO so bone marrow overworks

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

Name 4 systemic diseases that can induce kidney problems

A
  1. Heart failure: kidney doesn’t get enough blood flow
  2. Renovascular disease; e.g renal artery stenosis
  3. Multisystemic disease
  4. Vasculitis: inflammation of blood vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List 2 drugs that can induce kidney problems

A
  1. NSAIDS

2. Lithium

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

When is kidney dysfunction reversible? (4 scenarios)

A
  1. Relieving a urinary obstruction
  2. Immunosuppression in glomerulonephritis and vasculitis
  3. Treating accelerated hypertension
  4. Correcting a renal artery narrowing, e.g; stent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 4 drugs should you NOT give in chronic kidney disease?

A
  1. NSAIDs: anti-inflammatory
  2. Antibiotics; preventing infection
  3. Diuretics; relieve fluid buildup
  4. Heparin; prevents blood clots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name 8 complications of chronic kidney disease?

LCBPEAMM

A
  1. Loss of renal function; can’t excrete waste and retains too much
  2. CVS disease
  3. Bone disorder: normally kidneys create calcitriol which breaks down bone mass, parathyroid may overcompensate for lack of calcitriol by increasing PTH
    - Too much bone gets broken down
  4. Malignancy: thyroid and renal tract
  5. peripheral neuropathy and myopathy due to vasculature damage
  6. Malnutrition
  7. End-stage renal disease
  8. Renal anemia: kidney not producing enough erythropoietin required by the bone marrow to make RBCs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the prognosis of chronic kidney disease?

A

10-15% progress, 50% stable, 30% improve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What kinds of things might you find in a patient history with chronic kidney disease?
When do symptoms tend to present?

A

May have no symptoms until an advanced stage…
Fatigue, trouble concentrating, poor appetite, trouble sleeping, frequent urination (at night), may also be depressed/anxious due to these symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kinds of physical symptoms would you discover in a patient history with chronic kidney disease?

A

Swollen feet and ankles, dry and itchy skin, eye puffiness, muscle cramping due to hypocalcemia (less calcitriol means less Ca2+ gets resorbed and less bone breakdown)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What might you notice on an examination of a patient with chronic kidney disease?

A
  1. pallor; anemia
  2. cachexia
  3. dehydrated
  4. *tachypnoea; the body is in state of metabolic acidosis and breathes out more CO2 to compensate
  5. Hypertension; raised JVP
  6. *Distended bladder
  7. Peripheral edema or neuropathy
  8. frothy urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does frothy urine indicate?

A

Protein in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which investigations should you do on the patient? (6)

A
  1. Albumin creatinine ratio (ACR) >3mg/mmol
  2. Urine sediment and electrolyte abnormalities
  3. Abnormalities on biopsy
  4. structural abnormalities on imaging
  5. Measure eGFR
  6. Are they on any nephrotoxic drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How should you image any patient?

A

With a CT scan, but always know renal function before doing a CT scan as contrast can make the renal function worse

17
Q

What are hematinics? Give 3 examples

A

Nutrients required for the formation of blood cells; B12, folate, iron

18
Q

How should you manage anemia (including what you can give)? What should your target Hb level be?

A

Target: 100-120 g/L Hb
Check hematinics

Give:

  1. IV iron since it’s poorly absorbed in CKD
  2. ESAs: recombinant human EPO stimulating agents
19
Q

Describe how dialysis works and how often it should be done

A

Blood is taken from the patient, goes through a heparin pump and is dialyzed/cleansed, and sent back into the patient

4-hour treatment 3X a week

20
Q

How does dialysis correct acidosis?

A

Allows bicarbonate to diffuse into the blood

21
Q

What is the function of dialysis?

A

To maintain euvolemia (weight) and electrolytes in a patient

22
Q

What is a fistula? How can you tell if someone has had one?

A

Fistula: when you connect a vein to an artery it will arterialize over time (about 6 weeks) and can be used for dialysis.

A thrill can be felt or bruit heard once it has arterialized as the blood is moving from high - low pressure quickly

23
Q

Why is a fistula needed?

A

A vein will collapse if it is punctured too often

An artery will become damaged and lead to ischemia if punctured too often

24
Q

What is a graft/line? What are the pros and cons?

A

Synthetic plastic to rejoin a vein to an artery that can be punctured with a needle (for dialysis!)
Pros: don’t need to wait for it to arterialize
Cons: Increased risk of infection, over time venous drainage becomes damaged and patient can develop a swollen neck or face

25
Q

What is the difference between hemodialysis and peritoneal dialysis? What are some advantages of one over the other?

A

Hemodialysis: blood gets pumped out of body

Peritoneal: pumping fluid: Inserted into the peritoneal cavity; between parietal and visceral peritoneum as peritoneum acts as a semi-permeable membrane
Pros: fewer side effects, more gentle treatment done every day
Cons: bacterial peritonitis

26
Q

When should you remove a dialysis insertion?

A

If it is causing extreme side effects and if you have other access - if not you may need to handle the infection with antibiotics

27
Q

How do you match a renal transplant?

A

Matching HLA: human leukocyte antigen

28
Q

What are the types of donors?

A

Live: from anyone and can be altruistic (random)
Dead: categorized into “Heart beating” or “heart not beating” when kidney was removed

29
Q

What are some consequences/risks of having a renal transplant?

A

The body may attack the new kidney (may need to prescribe immunosuppressants).

Increased risk of sepsis (body thinks its an infection) and cancer

30
Q

When should you remove a dysfunctional kidney?

A

ONLY if the kidney is causing harm to the patient, e.g; polycystic kidney. If it isn’t, no point in risking infection by removing it

31
Q

What are the benefits of a renal transplant over dialysis?

A

Cost-effective, better quality of life, corrects symptoms and metabolism (improved patient survival)

Urinary (Semester 3) (14 decks)

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