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Clin Phys- Renal Disease Flashcards

1
Q

Metabolic by product of muscle catabolism

A

SCr

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2
Q

How is serum creatinine cleared?

A

Via glomerular filtration

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3
Q

As one ages, muscle mass generally ______.

A

Declines

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4
Q

What 2 drugs can impact creatinine secretion within the proximal tubule and give a false elevation?

A
  1. Cimetidine
  2. Trimethoprim
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5
Q

What is GFR adjusted for?

A

Body surface

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6
Q

What is GFR commonly classified for?

A

Classification of CKD

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7
Q

Which clearance mechanism uses more markers such as SCr, insulin, iothalamate, or iohexal?

A

GFR

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8
Q

What is the more expensive assay?

A

Cystatin C

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9
Q

Exogenous protein primarily cleared by glomerular filtration

A

Cystatin C

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10
Q

Test that has been found to be just as accurate of predicting GFR as the equation

A

24 hr urine collection

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11
Q

What must be stable if you are using SCr as the marker to estimate CrCl?

A

Renal function

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12
Q

What processes can impact SCr levels?

A

Hypercatabolic

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13
Q

When should you use ideal body weight?

A

If actual weight is > ideal

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14
Q

What is the ideal body weight equation for men?

A

50 + (2.3 x inches > 5 ft)

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15
Q

What is the ideal body weight equation for women?

A

45.5 + (2.3 x inches > 5 ft)

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16
Q

When should you use the adjusted bw equation?

A

If actual body weight is 30% > than ideal

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17
Q

What is the equation for adjusted body weight?

A

IBW + 0.4 ( actual- ideal)

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18
Q

When is the MDRD less accurate?

A

When GFR is> 60 mL/min/1.73 m2

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19
Q

What is a limitation to the CKD-EPI equation?

A

Less accurate when GFR > 60 mL/min/1.73 m2

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20
Q

What equation has the better predictive value for medication clearance

A

CKD-EPI

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21
Q

What test is better for patients who are > 80

A

Cystatin C

22
Q

What body weight equation(s) should you use in obese patients?

A

Ideal body weight or adjusted body weight

23
Q

What are sodium bicarbonate tablets only indicated for?

24
Q

What is a sign of CKD?

A

Proteinuria

25
What 3 things does CKD lead to?
1. Fluid 2. Electrolyte 3. Acid-base disorders
26
What are symptoms of CKD (stages 4 & 5)? 6
1. Fatigue 2. Weakness 3. SOB 4. Bleeding 5. Itching 6. Confusion
27
What are signs of CKD (stages 4&5)? 4
1. Edema 2. Weight gain 3. Changes in urine output 4. “Foaming” of urine
28
What is metallic acidosis treated with?
Sodium bicarbonate supplementation
29
Hyper______ can occur with significant CKD
Kalemia
30
When do uremic symptoms typically develop?
When CrCl is < 10 mL/min
31
What are 7 symptoms of Uremia?
1. Anorexia 2. Weight loss 3. SOB 4. Fatigue 5. Pruritis 6. Sleep disturbances 7. Encephalopathy
32
What are 3 physical findings of Uremia?
1. Hypertension 2. Asterixis 3. Jugular venous distention
33
What drugs have limited utility in stage 3-5 CKD?
Thiazide diuretics
34
What should you be worried with for a 800 mg dose of a loop diuretic?
Tinitus
35
What stage of AKI if the SCr is 1.5-1.9x the baseline?
Stage 1
36
What stage of AKI if the SCr is 2.0-2.9x greater than baseline?
Stage 2
37
What stage of AKI if SCr is 3.0x the baseline or increases to at least 4.0 mg/dL?
Stage 3
38
Stage of AKI when urine output is <0.5 mL for 6-12 hrs
Stage 1
39
Stage of AKI when the urine output is < 0.5 mL for 12 hours or more
Stage 2
40
Stage of AKI when the urine output is <0.3 mL for 24 hours or Anuria for 12 hours or more
Stage 3
41
What factor cannot be used when determining AKI?
CrCl
42
Laboratory test where the urine sediment has hyaline casts
Prerenal
43
Laboratory test where the urine sediment shoes granular casts and cellular debris
Intrinsic
44
Laboratory test with a urine sediment that shows cellular debris
Postrenal
45
Laboratory test where there is no rbc in the urine
Prerenal
46
Laboratory test that has 2-4+ rbc in the urine
Intrinsic
47
Laboratory test that has variable rbc in the urine
Postrenal
48
What is Prerenal AKI caused by?
Volume
49
What is intrinsic AKI caused by?
Drugs
50
What is Postrenal AKI caused by?
Blockage
51
_____ lags behind true renal function in AKI
SCr

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