Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI, liver, kidney > CKD > Flashcards

CKD Flashcards

1
Q

What is CKD?

A

More than 3 months reduction in kidney function or structural damage
<60 on eGFR

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

Diagnosis of CKD

A

-Markers of kidney damage
- Urinary albumin:creatinine ratio -ACR greater than 3mg/mmol
- Persistent reduction in kidney function <60

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

What measure determines staging of CKD?

A

Albumin and urea cretinine ratio
Underlyinh cause, GFR and proteinurua category

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

When do you offer dialysis in CKD?

A

On progression to kidney failure

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

Causes of CKD

A

diabetes
Hypertension
Glomerular disease
Polycystic kidney disease
History of AKI
Nephrotoxic drugs
Obstructive uropathy ass conditions eg structural renal tract disease, renal calculi
Multisystem diseases with renal involvement eg SLE, vasculutus, myeloma
FG of CKD stage 5, hereditary kidney disease
CVD
Obesity with metabolic syndrome
Gout
Incidental findings of haematuria or protein uria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of CKD

A

Bubbly wee
Any changes in wee frequency
General - lethargy, itch, SOB, camps, sleep disturbance, bone pain, loss of appetite, vomitting, weight loss + taste disturbance

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

Features of CKD

A

Uraemic odour
Pallor
Cachexia + malnutrition
Cognitive impairment
Dehydration, hypovolaemua
Tachypnoea
HPTN
Palpable bilateral flank masses w possible hepatomegaly
Palpable distended bladder
Peripheral oedema
Peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is CKD classified?

A

eGFR (G1-5) and urinary ACR (albumin creatinine ratio) categories (A1-3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the eGFR value for each G stage of CKD?

A

> 90 = normal = G1
60-89 = G2 = mild reduction
45-59 = G3a - mild to mod reduction
30-44 = G3b mod to severe reduction
15-29 = G4 - severe reduction
<15 = G5 - kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ACR parameters each stage

A

<3 - normal to mildly increased
3-30 - moderately increased
>30 - severely increased

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

What is the parameters for CKD diagnosis?

A

eGFR consistently over 60mL/min/1.73m2 and/or urinary ACR persistently

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

Initial investigations for CKD

A

Blood tests for serum creatinine and eGFR
Urine smaple for urinary albumin to creatinine ratio
Uirne dipstick for haematuria, midstream sample if more than 1
Nutritional status, BMI, BP and serum HbA1c, lipid profile

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

When does a urine sample for CKD need ot be taken

A

Early morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is considered significant proteinuria in urine sample?

A

Over 70 mg/mmol

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

What values mean you repeat urine sample ACR in 3 months?

A

3-70mg/mmol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for renal tract ultrasound

A

Renal tract ultrasound if indicated - urinary tract obstruction, FH of polycystic kidney disease, over 20 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is acclereated progression of CKD?

A

25% decrease in eGFR from baseleine and change in CKD category within 12 months OR
decrease in eGFR by 15mL/min/1.73min2 in a year
Assess eGFR at least 3 times over 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hoq long after an AKI do you monitor fr CKD?

A

2-3 YEARS even if serum creatinine has returned to baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When do you arrange FBC to exclude renal anaemia in CKD patients?

A

Stages 3b, 4 and 5 or if develop anaemia symtpoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do serum calcium, phosphate, vit D and parathyroid hormone tests in CKD test for?

A

Renal metabolic and bone disorder for stages 4-5 of CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When to do 2 week urgent referral in CKD?

A

Isolated perisitent haematuria and urological cancer suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When to reer to nephrology with CKD

A

ACR over 70mg/mmol or 30mg/mmol with persistnet hameaturia
Uncontrolled HPTN
Rare or genetic cause CKD
Sus renal artery stenosis
Accelerated progression
eGFR < 30
Sus complication of CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What to assess ofr with CKD in primary care?

A

CVD risk
Underlying causes, risk factors for progression
Nephrotoxic drugs
Anxiety and depression
HPTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why do yuo prescribe lipid lowering therapy in everyone with CKD?

A

Primary or secondary prevention of CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
When is an antiplatelet drug prescribed in CKD
Secondary prevention of CVD
26
What OTC should people with kdney disease avoid?
NSAIDs eg naproxen, iburogen
27
Complications of CKD
AKI HPTN Dyslipidemia CVS disease - IHD, Periph artery disease, HF, stroke Renal miineral and bone disorder Peripheral neuropathy and myopathy MALNUTRITION malignanacy End stage renal disease Mortality
28
Renal anaemia presenation
SOB, fatigue, pa
29
What is renal anaemia?
Reduced production of erythropoietin by the kidney causes reduced RBC surcical, iron deficinecy
30
Presentation of renal mineral and bone disorer
Bone paun Increased bone fragility -Extra skeletal calciication - skin, blood vessels
31
What causes renal mineral and bone disorder?
Disturbed vit D, calcium, PTH and phosphate metabolism due to impaired regulation of intestinal absorption and renal tubular excretion
32
Typical picture mineral levels in CKD
Calcium low or high Vit D deficiency Raised serum phosphate Low serum calcium Secondary or tertiary hyperparathyroidism
33
What is tamulosin for
BPH
34
Why do you test PSA before putting in a catherter?
Puting a catheter in can raise the PSA level -> false positive high
35
What is post obstruction diruesis
Polyuric state - salt and water are elimianated after relief of urinary tract obstruction Resolves when kidneys normaluse volume, solutte status
36
Risk from post obstruction diuresis
Severe dehydration Electrolye imbalances Hypovolaemic shock Death
37
Questions to ask in pulmonary renal syndrome
Systemic symptoms - night sweats, abdo pain, bloody diarrhoea Sepsis - fever, lymphadenopathy AI conditions - joint pain, myalgia, rash, sicca, epistaxis, deaf, ulcers prev DVT/PE, thrombotic disorders, SLE, AI conditions
38
What is pulmonary renal syndrome?
Diffuse alveolar haemorrhage + glomerulonephritis AI disorder - treat w corticosteroids and cytotoxic drugs
39
Diagnosis of pulmonary renal syndrome
Serologic tests, sometimes lung and renal biopsy
40
Systemic vasculitis that can cause renal damage
Behcets disease Cryoglobulinaemia Granulomatoisis with polyangitis Microscopic polyangitis Eosinophilic granulomatosis w polyangitis IgA ass vasculitis
41
Causes of pulmonary renal disorder
Connective tissue disorder Good pasteurs syndrome Renal disorders eg IgA nephropathy Systemic vasculitis Drugs eg propothyouracil HF
42
What antibody diagnosis for good pateurs syndrome
anti-GBM
43
Treatment for good pasteurs syndrome
Plasma exchange (remove antiGBM antibodies) Prednisolone + cyclophosphamide V rare to relapse - smoking trigger If remain on dialysis can have transplant if anti-GBM antibodies undetectable
44
Markers of kidney damage
- Albuminuria >3 mg/mmol -Abnormalities secondary to tubular disorders -Structural abnormalities -Abnormalities on histology -History of kidney transplant -Reduced eGFR <60
45
A staging of kidney disease
A1 - <30mg/g / <3 mg/mmol A2 - 30-300mg/g/3-30mg/mmol (microalbuminuria) A3 - >300mg/g/>30mg/mmol (macroalbuminuria)
46
How often do you monitor CKD
Low moderate risk - annually High risk - every 6 months V high risk - monitor every 3-4 months
47
Common causes CKD
Diabetes HPTN vascular disease
48
How is CKD normally detected?
HPTN Haematuria/proteinuria Reduction in GFR + increased serum creatinine
49
G staging of CKD (eGFR)
G1 - normal or high >90 G2 - mild - 60-89 G3a - mild to mod - 45-59 G3b - mod to severe - 30-44 G4 - severe - 15-29 G5 - Kidney failure <15 G5D = dialysis
50
Monitoring in CKD
FBC Iron studies Serum calcium phosphate PTH
51
General CKD symptoms
Fatigue, N+V, cramps, insomnia, restless legs, taste disturbance, bone pain, pruritis Abnormal urine output Fluid overload Sexual dysfunction Severe uraemia
52
Clinical findings in CKD
Uraemic fetor - ammonia smell breath Pallor (anaemia) Cachexia Cognitive impairment Tachypnoea HPTN Volume disturbance - overload or depletion Peripheral neuropathy Fundoscopy if HPNT/DM
53
What do bilateral masses on flank palpation signal with kidney symptoms?
Polycystic kidney disease
54
What does palpable bladder sugnal in kidney symptoms
Obstructive uropathy Often accompanied by prostatic enlargement in men
55
Urine investigations CKD
Dipstick Microscopy ACR spot test ACR 24 hour Electrophoresis eg myeloma
56
What does urine electrophoresis detect?
Protein levels including M and BJ protein produced by abnormal plasma cells in multiple myeloma
57
Bloods in CKD
FBC U+Es Bone profile PTH Bicarbonate LFTs Lipid profile AI screen - ANCA, ANA Myeloma screen
58
Imaging
Renal US MR angiograph ECHO ECG - high risk CVS disease
59
When should a renal US scan be offered
Patients with visible/persistent non visible haematuria Evidence of obstructive uropathy FH PCKD Reduced eGFR <30 Accelerated progression of CKD
60
Prinicples of CKD management
Treat the underlying cause Prevent or slow progression - Renoprotective therapy Treat ass complications CV disease prevention Plan for RRT
61
General measures for management CKD
Exercise Healthy weight loss Smoking cessation Good glycaemic control Control of blood pressure Immunisations: influenza and Pneumococcus Avoidance of nephrotoxic medication Diet: adequate protein intake, restricted sodium and phosphate intake Statin
62
What is renoprotective therapy
Reducing BP Reducing protein uria
63
BP target for CKD + <70 ACR
<140/90
64
BP target CKD + ACR >70
<130/80
65
What drug should be prescribed where significant proteinuria in CKD
ACEi/ARB AntiHPTN and antiproteinuric
66
When offer a ACEi/ARB (renin angiotensin system antagonists) in CKD
Diabetic and ACR>3 HPTNsive and ACR >30 ACR >70 1 and 3 even in absence of HPTN
67
When should you not prescribe a ACEi/ARB in CKD
Pretreatment potassium is over 5
68
When is it ok to carry on with ACEi/ARB in CKD
eGFR is less than 25% changed OR <30% serum creatinine increase from baseline since commencing
69
A WET BED complications of CKD
Acidosis Water - pulmonary oedema Erythropoiesis - anaemia Toxin removal - uraemic encephalopathy BP control - CVD disease Electrolyte balance - hyperkalaemia Vitamin D activation -BMD of CKKD

GI, liver, kidney (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions