Chronic renal failure

Question 1

gen char. of chronic renal failre

Answer 1

irreversible, progressive reduction in GFR over moths to years

Question 2

5 main cuases

Answer 2

1. DM in 30%
2. HTN in 25%
3. chronic GN
4. interstitial nephritis
5. any of the other causes of AKI can if not Tx

Question 3

5 stages by GFR

Answer 3

1. 90
2. 60-90 mild
3. 30-60 mod
4. 15-30 severe
   5 ESRD

Question 4

group more common in

Answer 4

blacks

Question 5

how to use Cr

Answer 5

need baseline to compare to to understand if acute or not

Question 6

3 CV clincial features of CRF

Answer 6

1. HTN
2. CHF
3. Pericarditis

Question 7

2 GI features

Answer 7

1. N/v

2. loss of appetite

Question 8

2 neuro features

Answer 8

1. lethargy, somnolence

2. hypocalcemia

Question 9

2 heme features

Answer 9

1. normocytic anemia - low EPO

2. bleeds due to low plat due to uremia

Question 10

3 endo

Answer 10

1. Ca/phos disturbances
2. sexual - HPA distrubabces
3. pruritis

Question 11

5 fluid and lytes probs

Answer 11

1. vol. overload
2. hyperkalmia - low urine secretion
3. hyprmag - as ablove
4. hyperphos
5. met acidosis

Question 12

5 tests to Dx

Answer 12

1. urinalysis
   - see AKI
2. meaure Cr
3. CBC
4. lytes
5. renal US
   - small is unlikely to recover

Question 13

10 Tx in increasing invaaiveness

Answer 13

1. diet
   - low protein, salt and lytes
2. ACEi
   - dilate efferent arteriole
3. BP control
4. glycemic control
   5 correct lyte abnormalities
5. anemia -EPO
6. edema - dysliss
7. pruritis - capsasis or UV lite
8. dyalsis
   10 - transplant

Question 14

3 life threatening complications

Answer 14

1. hyper K
2. pulm edema
3. infection

Question 15

2 main types of dialysis

Answer 15

1. hemo

2. peritoneal

Question 16

3 main indications for dialsys

Answer 16

1. CRF
2. AKI - temp until improive
3. overdose

Question 17

5 absolute indications for dialsys

Answer 17

AEIOU
Acidosis
Electrolytes - severe hyperK
Intoxications
Overload - hypervolemia
Uremia - severe