Clinical Symposia

Question 1

How can hypertension affect kidneys?

Answer 1

Uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden (scarring). These damaged arteries are not able to deliver enough blood to the kidney tissue.

• Nephrons don’t receive the oxygen and nutrients they need to function well.
• Kidneys are not able to remove all wastes and extra fluid from your body.

Extra fluid in the blood vessels can raise your blood pressure even more.

Question 2

What is diabetic nephropathy?

Answer 2

Diabetes that leads to kidney disease

Affects about 20-30% of diabetics

Question 3

How can diabetes lead to nephropathy?

Answer 3

High blood glucose can damage the blood vessels in your kidneys. Many people with diabetes also develop high blood pressure, which can also damage your kidneys.

Question 4

What is an easy test used to confirm diabetic nephropathy?

Answer 4

Urinalysis –> proteinuria

Question 5

What does proteinuria reflect?

Answer 5

Glomerular injury and increased glomerular permeability to macromolecules

Question 6

Why is it important to examine feet in diabetic patients?

Answer 6

Peripheral arterial disease (PAD) and/or sensory neuropathy affecting diabetic patients

Don’t feel when they injure feet –> lead to ulcers

Question 7

What is C Reactive protein?

Answer 7

A substance produced by the liver in response to inflammation.

Question 8

What is a C reactive protein test used for?

Answer 8

A high level of CRP in the blood is a marker of inflammation or infection.

Question 9

What is hydronephrosis?

Answer 9

The swelling of a kidney due to a build-up of urine. It happens when urine cannot drain out from the kidney to the bladder from a blockage or obstruction.

Question 10

How can NSAIDs be nephrotoxic?

Answer 10

Block prostaglandins, natural body chemicals that normally dilate blood vessels leading to the kidneys.

Blocking prostaglandins may lead to decreased blood flow to the kidneys, which means a lack of oxygen to keep the kidneys alive. That can cause acute kidney injury.

Question 11

What is hypovolaemia? What does it lead to?

Answer 11

A state of decreased intravascular volume. This may be due to either a loss of both salt and water or a decrease in blood volume (DON’T CONFUSE WITH DEHYDRATION)

Causes low cardiac output and hypotension by decreasing the preload.

Question 12

What are crystalloids used to treat?

Answer 12

Mainly used to increase the intravascular volume when it is reduced

Question 13

What is the most commonly used crystalloid?

Answer 13

Sodium chloride 0.9%, more commonly known as normal saline 0.9%

Question 14

What are the fundamental of septic shock?

Answer 14

Vasodilation, increased permeability, hypovolaemia, ventricular dysfunction

Question 15

When does Sepsis Six need to be performed?

Answer 15

During first hour

BUFALO

Question 16

What conditions require fluid resuscitation?

Answer 16

Almost all circulatory shock states require large-volume IV fluid replacement, as does severe intravascular volume depletion (e.g. diarrhoea, heatstroke)