Day 1: Dr Dey

Question 1

What is the avg GFR for an adult?

Answer 1

120-130ml/min

180L/day

Avg urine = 1-1.5 L/day = 99% gets reabsorbed

Question 2

What is the equation to find Clt?

Answer 2

This s the total body clearance

Clt = k*Vd

Question 3

What is the importance of the extraction ratio of a drug?

Answer 3

Extraction is the done by the liver and its when it takes a large chunk of of a drug even tho it gets absorbed quickly.

EX: a drug has an oral bioavailability of 46% and it is rapidly and completely absorbed, how can you explain this poor bioavailability? It’s due to the liver metabolizing the drug and make it into a non active form and giving a poor bioavailability

ER = 1 - F

Question 4

What happens when drugs have a low ER?

Answer 4

They have very little first pass and it gives them a High F value

Question 5

What happens to drugs that have a high ER value?

Answer 5

It means they have extensive first pass and will have a low F value

Question 6

What is a restrictive clearance

Answer 6

It means the drug is likely to be protein bound and that makes it DEPENDENT on protein binding

Question 7

What does non-restrictive clearance mean?

Answer 7

It means that they drug is not likely to be bound to protein so it is INDEPENDENT of protein binding

Question 8

What is stage 1 of CKD?

Answer 8

Description : Kidney dmg, with normal of inc GFR

GFR: >90

Action: Diagnosis and treatment, Treatment of comorbid conditions, Slowing progression, CVD risk reduction

Question 9

What is stage 2 of CKD?

Answer 9

Description: Kidney dmg, with mild dec in GFR

GFR: 60-89

Action: estimating progression

Question 10

What is stage 3 of CKD?

Answer 10

Description: Moderate dec in GFR

GFR: 30-59

Action: Evaluating and treating complications

Question 11

What is stage 4 of CKD?

Answer 11

Description: Severe dec in GFR

GFR: 15-29

Action: Preparation for kidney replacement therapy

Question 12

What is stage 5 of CKD?

Answer 12

Description: Kidney Failure

GFR: <15 (or dialysis)

Action: Kidney replacement

Question 13

What’s the equation for a male for the Cockroft-Gault Method?

Answer 13

Clcr = [140-age]xIBW / 72(Scr)

If ABW < IBW use the ABW

If ABW > IBW use but less than OBW use the IBW

If ABW > IBW and ABW is greater than OBW use adjusted body weight

Question 14

What is the equation of IBW for a male?

Answer 14

IBW = 50+2.3(Height in inches - 60)

Question 15

What is the equation for IBW for women?

Answer 15

IBW = 45+2.3(height in inches -60)

Question 16

How do you find OBW?

Answer 16

IBW * 1.3 will tell you a persons OBW

Question 17

What is the equation for female Clcr using the Cockcroft-Gauls Method?

Answer 17

Clcr = ([140-age]xIBW / 72Sr) * 0.85

Question 18

How is Cirrhosis defined?

Answer 18

Replacement of liver tissue by scare tissue leading to loss of liver function

• ## Alcoholic cirrhosis is th worst

Question 19

What is the Child-Pugh (CTP) score?

Answer 19

Use to assess the prognosis of chronic liver disease, primarily cirrhosis and the necessity of liver transplantation

Question 20

What is Class A of the Child-Pugh (CTP) score?

Answer 20

5-6 points

Life expectancy is 15-20 years, Abdominal surgery peri-operative mortality: 10%

Two year survival: 85%

Question 21

What is class B of Child-Pugh (CTP) score?

Answer 21

7-9 points

Ready for liver transplantation

Abdominal surgery peri-operative mortality: 30%

Two year survival: 57%

Question 22

What is class C Child-Pugh (CTP) score?

Answer 22

10-15 points

Life expectancy 1-3 years

Abdominal surgery peri-operative mortality: 82%

Two year survival: 35%

Question 23

What is the MELD?

Answer 23

Model for end-stage liver disease

Scoring system to assess severity of liver disease

Useful to prioritizing patients for liver transplantation

The higher the score means a higher 3 month mortality

**higher the score means more likely to die