Clinical Introduction to Renal Disease

Question 1

Normal urine pH

Answer 1

7.35-7.45

Question 2

Normal urine pH

Answer 2

7.35-7.45

Question 3

Acidemia

Answer 3

7.35-7.4

Question 4

Alkalemia

Answer 4

7.4-7.45

Question 5

Acidosis

Question 6

Alkalosis

Answer 6

> 7.45

Question 7

Normal urine output

Answer 7

1.5L/24 hours

Question 8

Oliguria

Question 9

Anuria

Answer 9

Absence of urine output

Question 10

Polyuria

Answer 10

> 3 L/24 hours

Question 11

Azotemia

Answer 11

Elevation in renal indices

BUN (technically)

Question 12

Uremia

Answer 12

Syndrome
Accompanies kidney failure
Usually when advanced/severe
Fatigue, anorexia, nausea, mental status changes, itching
Serositis (pericarditis, pleural effusions)
Platelet dysfunction (anemia)

Question 13

Acute decline in renal function

Answer 13

Old school: Acute Renal Failure (ARF)

New: Acute Kidney Injury (AKI)

Question 14

Chronic decline in renal function

Answer 14

Old school: Chronic Renal Insufficiency (CRI)/ Chronic Renal Failure (CRF)
New: Chronic Kidney Disease (CKD)

Question 15

Most advanced renal dysfunction

Answer 15

Still called End Stage Renal Disease (ESRD)

Question 16

AKI

Answer 16

Acute Kidney Injury

Abrupt (within 48 hours) reduction in kidney function

Question 17

CKD

Answer 17

Chronic Kidney Disease
Progressive decline in GFR over time
Duration at least 3 months
with or w/o albuminuria

Question 18

Stage 2 CKD

Answer 18

Kideny damage with mild decrease in GFR 60-89

Question 19

Stage 2 CKD

Answer 19

Kideny damage with mild decrease in GFRY 60-89

Question 20

Stage 3 CKD

Answer 20

Moderate decrease in GFR 30-59

Question 21

Stage 5 CKD

Answer 21

Kidney failure GFR

Question 22

Stage 5 CKD

Question 23

Acidemia

Answer 23

7.35-7.4

Question 24

Alkalemia

Answer 24

7.4-7.45

Question 25

Acidosis

Question 26

Alkalosis

Answer 26

>7.45

Question 27

Normal urine output

Answer 27

1.5L/24 hours

Question 28

Oliguria

Question 29

Anuria

Answer 29

Absence of urine output

Question 30

Polyuria

Answer 30

> 3 L/24 hours

Question 31

Nephritic Syndrome

Answer 31

``` INFLAMMATORY renal biopsy Active urinary sediment (hematuria, dysmorphic RBCs, RBC casts) Variable proteinuria Azotemia, oliguria Mild/moderate HTN ```

Question 32

Uremia

Answer 32

Syndrome Accompanies kidney failure Usually when advanced/severe Fatigue, anorexia, nausea, mental status changes, itching Serositis (pericarditis, pleural effusions) Platelet dysfunction (anemia)

Question 33

Acute decline in renal function

Answer 33

Old school: Acute Renal Failure (ARF) | New: Acute Kidney Injury (AKI)

Question 34

Chronic decline in renal function

Answer 34

Old school: Chronic Renal Insufficiency (CRI)/ Chronic Renal Failure (CRF) New: Chronic Kidney Disease (CKD)

Question 35

Most advanced renal dysfunction

Answer 35

Still called End Stage Renal Disease (ESRD)

Question 36

AKI

Answer 36

Acute Kidney Injury | Abrupt (within 48 hours) reduction in kidney function

Question 37

CKD

Answer 37

Chronic Kidney Disease Progressive decline in GFR over time Duration at least 3 months with or w/o albuminuria

Question 38

Stage 1 CKD

Answer 38

Kidney damage with normal or increased GFR >90

Question 39

Stage 2 CKD

Answer 39

Kideny damage with mild decrease in GFRY 60-89

Question 40

Stage 3 CKD

Answer 40

Moderate decrease in GFR 30-59

Question 41

Stage 4 CKD

Answer 41

Severe decrease in GFR 15-29

Question 42

Stage 5 CKD

Question 43

Normal Urinary Protein

Answer 43

Total

Question 44

Nephrotic Range Proteinuria

Answer 44

Nephrosis | > 3-3.5 g/24 hours

Question 45

Nephrolithiasis

Answer 45

Kidney stone Present with moderate to severe colic Calcium oxalate and Ca phosphate Kidney's defense system causes ducts to contract to try and expel the stone, this is what causes the pain

Question 46

Epithelial Casts

Answer 46

Muddy brown casts | Acute tubular necrosis

Question 47

Fatty Casts

Answer 47

Lipiduria | Usually seen in nephrotic syndrome

Question 48

Granular Casts

Answer 48

Chronic kidney disease | Nonspecific finding otherwise

Question 49

Hyaline Casts

Answer 49

Dehydration Exercise Diuretic therapy

Question 50

Waxy Casts

Answer 50

Advanced kidney disease

Question 51

Nephrotic Syndrome

Answer 51

``` > 3-3.5 mg/24 hours protein Hypoalbuminemia Peripheral edema Hyperlipidemia (liver tries to compensate for decreased oncotic pressure by making more lipids) Thrombophilia Bland urinary sediment NONINFLAMMATORY renal biopsy ```

Question 52

Nephritic Syndrome

Answer 52

``` INFLAMMATORY renal biopsy Active urinary sediment (hematuria, dysmorphic RBCs, RBC casts) Variable proteinuria Azotemia, oliguria Mild/moderate HTN ```

Question 53

Intracellular Water

Answer 53

2/3 of TBW

Question 54

Extracellular Water

Answer 54

1/3 TBW

Question 55

Interstitial Space

Answer 55

3/4 ECW

Question 56

Plasma Volume

Answer 56

1/4 of ECW

Question 57

Intravenous Crystalloid solutions

Answer 57

Disperse across ECW 0.9% Normal Saline is used in internal medicine Lactated Ringer's Solution is used in surgery

Question 58

Intravenous Colloid solutions

Answer 58

Tend to remain in plasma volume Packed RBCs Albumin Synthetic solutions (costly and often impractical)

Question 59

Erythropoietin

Answer 59

Regulates HGB/HCT concentration

Question 60

Vitamin D

Answer 60

Regulates Ca absorption | Maintains normal levels of Ca and phosphorus

Question 61

Chronic Erythropoietin Deficiency

Answer 61

Advanced Kidney Disease Anemia of chronic disease, typically normocytic Iron transport/storage dysregulation also contributes

Question 62

Chronic Hyperphosphatemia

Answer 62

Decreased renal activation of vitamin D3 Hyperparathyroidism Renal Osteodystrophy