Brainscape's Knowledge GenomeTM

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


See full index

Primary Care HG > CKD + Chronic liver failure > Flashcards

CKD + Chronic liver failure Flashcards

1
Q

Mechanism of chronic liver failure

A

Commonly due to cirrhosis

Progressive destruction + regeneration of liver parenchyma leads to fibrosis + cirrhosis

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

Causes of liver failure

A

Hepatitis

Alcoholic liver disease

Methotrexate, amiodarone, nitrofurantoin

Fatty liver disease

Wilsons disease

Biliary cirrhosis

Sclerosing cholangitis

Right HF

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

RF of liver failure

A

Alcohol

Obesity

Metabolic syndrome

IVDUs

Unprotected sex with multiple partners

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

S+S liver failure

A

Ascites

Haematemesis

Itching

Gallstones

Jaundice

Loss of appetite

Easy bruising

Diarrhoea

Fatigue

Palmar erythema

Dupytrens contracture

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

Management of liver failure

A

Corticosteroids, interferons, antivirals, bile acids

Supportive: diuretics, albumin, vit K, abx

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

What is the definition of CKD?

A

Abnormality of kidney structure or function, present for >3 months, with implications for health

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

What is the definition of AKI?

A

Sudden deterioration of function in absence of prior abnormality

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

Causes of CKD

A

Diabetic nephropathy

Glomerulonephritis

HTN

Systemic disease (SLE, vasculitis, myeloma)

Renal artery stenosis

Polycystic kidney disease

Pyelonephritis

Urinary tract obstruction (inc prostatic disease)

HF

NSAIDs

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

How does CKD present?

A

HTN

Incidental findings on bloods

Symptoms usually late stage

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

Indications for screening pts at risk of developing CKD

A

Diabetes

HTN

CV disease

Nephrotoxic drugs (NSAIDs, lithium)

Structural renal disease

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

What causes a high serum urea?

A

Catabolic state

High protein intake

GI bleed

Dehydration

CV failure

Reduced renal function

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

What causes a low serum urea?

A

Liver failure

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

What causes a high serum creatinine?

A

Reduced renal function

Large muscle mass (young, male, muscular)

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

What causes a low serum creatinine?

A

Low muscle mass (elderly, wasting, females)

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

How do you calculate eGFR?

A

Calculated from blood results + demographic data (age, gender, race)

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

How is proteinuria measured + why is it important?

A

Measured in urine sample as protein: creatinine ratio (PCR) or albumin: creatinine ratio (ACR)

Guides management

17
Q

How would you investigate the cause of CKD?

A

Haematology/ biochem

Urine dip + MC+S

Immunology screen

Renal USS +- biopsy

18
Q

What is the normal function of the kidneys?

A

Excrete substances

Homeostasis - fluid balance, BP, acid-base

Endocrine - erythropoietin, bone metabolism

19
Q

Metabolic complications of CKD

A

Anaemia

Bone mineral disorder (low Ca, high PO4, high PTH

Metabolic acidosis (low bicarb)

Hyperkalaemia

20
Q

Clinical features of CKD

A

Renal: fluid retention, polyuria, polydipsia

CV: HTN, pulmonary oedema, vascular disease, dyslipidaemia

GI: anorexia, N+V, peptic ulcers

Neuro: neuropathy

Derm: pruritis, pigmentation

Endocrine: amenorrhoea, reduced fertility

MSK: bone pain, fractures

21
Q

When to refer pt to renal care

A

eGFR <30

Progression

Uncertain cause

Possible hereditary disease

Significant proteinuria

Haematuria + proteinuria

22
Q

Management of CKD

A

BP control

CVS risk reduction - statins

Diet

Vit D, folic acid, iron, phosphate control

Bicarbonate supplements

Dialysis

23
Q

What are the RF for progression?

A

Lower eGFR

BP control

Proteinuria

Smoking

Hyperglycaemia

Obesity

Nephrotoxic drugs

24
Q

What diet is recommended with CKD?

A

Restrict salt

Restrict calories

Restrict phosphate + potassium

25
Q

What is the target BP for CKD?

A

Less than 140/90

26
Q

How to manage HTN in CKD?

A

ACEi or ARBs except in renal artery stenosis

27
Q

Which drugs can cause hyperkalaemia in CKD?

A

ACEi, ARBs, amiloride, spironolactone, potassium

28
Q

When is dialysis needed?

A

When eGFR is <10

29
Q

What are the options for ESRD management?

A

Haemodialysis

Peritoneal dialysis

Kidney transplant

Conservative care

30
Q

What is CAPD vs APD?

A

CAPD: continous ambulatory peritoneal dialysis.

4x 2-3L exchanges per day

APD: automated PD - while asleep at night

31
Q

What are the symptoms of AKI?

A

Anorexia

Headache

N+V

Arrhythmias

Change in BP

Pain in flanks

32
Q

What are the causes of ascites?

A

Cirrhosis

Malignancy (GI tract)

HF

Nephrotic syndrome

TB

Pancreatitis

33
Q

What is the management of ascites?

A

Spironolactone

Loop diuretics

Paracentesis

34
Q

What are the U+E findings for CKD?

A

Hyperkalaemia

Hypercalcaemia

Hyponatraemia

Primary Care HG (23 decks)

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