Brainscape's Knowledge GenomeTM

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


See full index

PCM - E2 > E2 > Flashcards

E2 Flashcards

1
Q

when can you conclude that the pt has AKI?

A

if sx are present for less than 3 months with GFR < 60 ml/min and/or markers of kidney damage present

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

what are the markers of kidney damage?

A

protein in urine

  • abnormal urinary sediment
  • abn kidney biopsy
  • abn renal imaging
  • electrolyte abn from tubular disorders
  • hx of kidney transplantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does chronic kidney disease entail?

A

1) GFR < 60 ml/min
2) markers of kidney damage

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

whats the prevalence of CKD in US?

A

around 15% of US adults have CKD (so, 1 in 7)

  • thats 37 million adults in US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the top CKD risk factors?

A
  • diabetes
  • hypertension
  • cardiovascular disease
  • acute kidney injury
  • family hx of kd
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the major etiology of CKD?

A

diabetes (38%) or HTN (26%)

t = 64%

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

what are some clinical presentations of CKD?

A
  • edema
  • HTN
  • decr urine output
  • foamy urine
  • hematuria
  • uremia (raised nitrogen levels)
  • pericardial friction rub
  • asterixis (hand thing)
  • uremic frost (powder foot)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 3 simple tests to id most CKD pts?

A
  • eGFR (estimated)
  • urine albumin-to-creatinine ratio; or urine protein-to-creatinine ratio
  • urinalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the limitations of eGFR>

A

not reliable in acute kidney injury

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

in diagnosing CKD, what are the renal ultrasound findings found?

A
  • atrophic kidneys
  • cortical thinning
  • incr echogenicity
  • elevated resistive indices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens to GFR with age?

A

GFR declines by 1 ml/min/year after the age of 30-40

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

what are the majority of deaths in ESRD patients?

A

cardiovascular (54%)

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

what are the indications for dialysis?

A

A: severe acidosis

E: electrolyte disrubances (usually hyperK)

I: ingestion (ethylene glycols, methanol)

O: volume Overload

U: uremia

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

define azotemia

A

elevated BUN without symptoms

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

define uremia

A

elevated BUN w sx (N/V, confusion, pruritus, metallic taste in mouth, fatigue, anorexia

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

what tells you AKI?

A

KDIGO guidelines of 2012

serum creatine vs urine output

-(which is worse)-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the major risk factors for AKI?

A

old age

  • proteinuria
  • CKD
  • HTN
  • DM
  • CVD
  • exposures to nephrotoxins
  • cardiac surgery
  • fluid overload
  • sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what drugs are associated with AIN?

A
  • antibiotics
  • NSAIDs
  • proton pump inhibitors
  • can be caused by drugs, inf, or autoimm. do’s
  • drugs account for >75% of all cases with antibiotics, NSAIDs and PPIs being the main culprits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some complications of AKI?

A
  • development of CKD
  • Progression of CKD
  • ESRD
  • CVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Whwat are some common diagnostic tests

A
  • UA with microscopy
  • urine albumin/cr ratio or protein/cr ratio
  • renal U/S
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what kidney disease does this urinary pattern suggest?

renal rubular epithelial cells, transitional epithelial cells, granular casts, or waxy casts?

A

ATN

acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what kidney disease does this urinary pattern suggest?

WBC, WBC cast, or urine eosinophils?

A

AIN

acute intersitial nephritis or pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what kidney disease does this urinary pattern suggest?

dysmophic RBCs, RBC casts

A

vasculitis or glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what kidney disease does this urinary pattern suggest?

proteinuria (<3.5 g/day), hematuria, dysmorphic RBC and RBC casts

A

nephritic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what kidney disease does this urinary pattern suggest?

heavy proteinurea (>3.5g/day), lipiduria, minimal hematuria

A

nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what kidney disease does this urinary pattern suggest?

hyaline cast

A

non-specific, prenatal azotemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what kidney disease does this urinary pattern suggest?

WBCs, RBCs, bacteria

A

urinary tract infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

FeNa or FeUrea is only valid in which type of patients, oliguric or non-oliguric pts?

A

oliguric pts only (<400-500 ml/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the purpose of ordering a FeNa or FeUrea?

A

to differentiate prerenal azometia from intrinsic renal injury (ATN usually)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

define anuria, oliguria, polyguria, numerically

A

a: <50 to 100 ml/day

O: <400-500 ml/day

P: >3K ml/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the dietary sources of Vitamin A?

A

eggs, dairy products,

meat, oily salt-water fish

  • dark green and yellow veggies
  • tomatoes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the dietary source of vitamin D?

A

fortified milk, orange juice, cereal;

cod liver oil

swordfish, salmon, herring, trout

egg yolks, muschrooms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the dietary source of Vitamin E

A

wheat germ, sunflower seeds, almonds, peanuts, sunflower oil, avocado,

abalone, atlantic salmon, rainbow trout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

sources of vit K?

A

green leafy vegetables

fruits

dairy products

vegetable oils and cereals

intestinal microflora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the source of B1

A

aka thiamin

  • whole and enriched grains, lean pork, legumes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the source of vitamin B2?

A

riboflavin

dairy products,

meat, poultry,

wheat germ,

leafy vegetables

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the source of B3?

A

aka niacin

  • meats, poultry, fish,
  • legumes, wheat

all foods except fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is the source of B6?

A

animal products, veggies, whole grains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the sources for B9?

A

folate

  • leafy veggies (destroyed in cooking)
  • fruits
  • whole grain, wheat germ
  • beans and nuts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the source for B12?

A

cobalamin

eggs, dairy products

liver and meats

none In plants; vegans need supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is the source for vitamin C?

A

fruits and veggies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are the sources for calcium?

A

dairy products

dark leafy veggies (collard, kale, spinach, swiss chard, turnip and mustard green)

tofu, broccoli, cauliflower, flax seed, beans and lentils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the source of iron?

A

dark leafy veggies (collards, kale)

broccoli, cauliflower

nuts, seeds, legumes (lentils and tofu), quinoa, fortified cereal (cream of wheat)

lean meat, clams, oysters, dried prunes and raisins

44
Q

what aids and what inhibits absorption of iron?

A

vitamin C aids in non-heme iron

caclium inhibits both heme and non-heme

45
Q

role of vitamin A

A

retinol/ retinoic acid

vision

  • embryo devel; maintenance of epithelia; cell growth, prolif and diff
46
Q

role of vitamin D

A

aka cholecalciferol; ergocalciferol

  • bone metabolism
  • calcium homeostasis
47
Q

role of vitamin E

A

tocopherols

ROS scavenger (membrane antioxidant)

48
Q

role of vitamin K

A

blood cotting factors ( II, VII, IX, X)

49
Q

Role of B1

A

aka thiamine

  • carb metabolism
  • aa metabolism
50
Q

role of B2

A

riboflavin

  • oxidoreductase, FMN, FAD
51
Q

Role of B3

A

niacin

  • oxidoreductase, NAD, NADP
52
Q

role of B6

A

pyridoxine

  • carb, lipid, and aa metabolism
  • synthesis of neurotransmitters, sphingolipids, and heme
53
Q

role of B9

A

folic acid

  • one-C-transfer rx
  • choline synthesis of aa
  • synthesis of purins and pyrimidine (thymine)
54
Q

what is the role of B12

A

cobalamin

  • heme structure, folate recycling
55
Q

role of Vitamin C

A

ascorbic acid

  • antioxidant fx
  • collagen synthesis
  • bile acid synthesis
  • nt synthesis
56
Q

role of calcium

A

muscle contraction, cell transport, bone metab

57
Q

role of iron

A

hemoglobin, myoglobin and cytochromes a, b, and c

58
Q

BMI ranges

A

obese >30

over weight 25-29.9

healthy 18-25

59
Q

how do you counsel pts about food choices?

A

follow healhty eating pattern

  • focus on variety, nutrient density and amount
  • limit calories from added sugars and saturated fats and reduce sodium intake
  • shift to healthier food and beverage choices
60
Q

vaccine

A

a product that stimulates a persons immune system to produce immunity to a specific disease, protecting the person from the disease

*initiates the immunization process

61
Q

vaccination

A

the process of getting a vaccine into the body or the act of introducing a vaccine into the body to produce immynity to a specific disease

  • needle; nose
62
Q

immunity

A

when a person is protected from getting a disease by virtue of receiving a vaccine or by previously having the disease in question

63
Q

immunization

A

the process whereby a person is made immune or resistant to an infectious disease either by receiving a vaccine or by having the infectious disease. immunization describes the actual changes the body goes through after receving a vaccine

64
Q

what is active immunization?

A
  • antigen is administered to host to induce formation of antibodies and cell-mediated immunity
65
Q

what are vaccines with sub-unit angtigens?

A
  • includes the “parts” that best stimulate immune response
66
Q

what type of vaccine are pathogens surrounded by a polysaccharide capsule and are immunogenic

A

conjugated vaccines

67
Q

facts on live attenuated vaccines

A

aka version of microbe weakened in lab

  • stronger mucosal immunity develops
  • not if immunocompromised
  • not if they have received blood products in recent past
68
Q

examples of conjugate vaccines

A

meningococcal

pneumococcal

haemophilus flu type B

HepB

Flu

HPV

69
Q

non-conjugate, inactivated or killed vaccines

A

HepA

Polio

rabies

70
Q

live, attenuated vaccines

A

MMR

Varicella

rotavirus

influenza

zoster

71
Q

toxoid vaccines

A

tetanus

diptheria

72
Q

what are preventitive services?

A

screenings

immunizations

general health guidance

counseling to reduce risk

73
Q

what is primary intervention and some examples

A

intervention to PREVENT disease

  • vaccines, diet counseling, tobacco counseling
74
Q

what is secondary intervention and examples

A

screening test for a disease early while pt may still be asymptomatic or before onset of diease

  • BP checks
  • Labs
  • mammograms
75
Q

what is tertiary prevention and examples

A

clinical intervention that prevent progression or disease or reduce complication (tx of pt condition)

  • medications
  • chemotherapy
76
Q

when should people get check ups?

A
  • every 3 yrs for people less than 49 yo
  • every year for >50 yo
77
Q

when should men and women consider colonoscopies?

A

50-75 yo

78
Q

screening for lung cancer, female and male

A

low dose lung CT for ages 55-74 yr w at least 30 pack years of smoking

79
Q

pap smear age

A

21-65

80
Q

breast cancer screen

A

50-65 but can start as early as 40yo

81
Q

CVS risk assesment

A

screen for diet, smoking, physical activity, HTN, dyslipemia, DM, obesity

pts aged 20+ should get screened every 3-5 years

82
Q

immunization age for Td/Tdap?

HPV?

Zozster vaccine

pneumococcal vaccine

hep b

A

every 10 years

up to age 26

50y and older

19-64 if at incr rate; all 65+

65+

83
Q

steps of Type I immediate hypersensitivity

A

step 1: antigen exposure

step 2: IgE cross-linking on mast cell/ basophile surfaces

step 3: histamine, leukotriene, prostaglandin, tryptase (mediators) release

step 4: symptoms of urticaria, rhinitis, wheezing, diarrhea, vomiting, hypotension, anaphylaxis within min of exposure

*may have sx return 4-8 hours after exposure

eg: pollen allergies, dust mite allergy, bee sting

84
Q

how to treat type I

A

antihistamines

85
Q

type II cytotoxic hypersensitivity

A

IgM or IgG ab destroys cells by:

  • opsonization
  • complement-mediated
  • ab-dependent cell cytotoxicity
    egs: ABO mismatch, grave’s dz, myasthenia gravis
86
Q

tx for type II

A

acetylcholinesterase inhibitors; plasmapheresis

87
Q

steps to Type III

A

step 1) antigen-ab complex formation

step 2) complexes activate complement and neutrophil infiltration of tissue

3) tissue inflammation leading to sx of fever, urticaria, generalized lymphadenoapthy, arthritis, glomerulonephritis, vasculitis

eg: SLE, RA, farmers lung

88
Q

tx for Type III

A

supportive, avoidance of antigen

89
Q

type IV cell-mediated hypersensitivity

A

step1: antigen exposure activates sensitized T-cells
steps2: T-cell activation leads to tissue inflammation 48-96 hours after exposure to antigen

eg: poison Ivy rash, PPD testing for TB

90
Q

HIV/AIDS presentation

A

flu-like sx: myalgias, fever, anorexia

91
Q

HIV.AIDS diagnosis

A

ELISA

western blot

HIV RNA viral load

92
Q

aids diagnosis

A

CD4 < 200 cells/mm3

93
Q

MS

presentation

diagnosis

tx

A
  • demyelination disorder of CNS

vision changes, vertigo, Lhermitte’s sign (flex neck + electricity)

MRI, CSF

immunosuppressive, IV steroids, PT

94
Q

psoriasis diagnosis

A

ausptiz sign: pinpoint bleeding after removal of scale

95
Q

RA

presentation

tx

A
  • inflm. dz affecting synovial membranes
  • jt swelling, warmth, red, and decr. ROM
  • morning stiffness > 1 hr
  • PIP, MCP, wrist, knee ankle
    tx: DMARDs, NSAIDs, steroids, PT
96
Q

Stiffness difference between RA and osteoarthritis

A

RA: morning

Osteo: “evening” stiffness

97
Q

what is the genetic component for SLE?

A

HLA-DR2 and -DR3

98
Q

SLE presentation

A
  • pleuritis, pericarditis, myocarditis
  • oral aphthous ulcers
  • arthritis
  • photosensitivity
  • hemolytic anemia
99
Q

what makes up motivational interviewing?

A
  • patient-centered
  • goal directed
  • non-confrontational
100
Q

general techniques for motivational interviewing

A

OARS

open-ended Qs

affirmations

reflective listening

summaries

101
Q

stages of change

A

precontemplation

contemplation

preparation

action

maintenance

102
Q

describe precontemplation

A

pt is NOT considering change

  • physicians goal: incr awareness of why they should consider change

**establish rapprt, ask permision to talk about shit, build trust, offer facts, express concern

103
Q

describe contemplation

A
  • pt is considering possibliity of making change, but still uncertain
  • physicians goal: acknowledge everyone is uncomfortable w change, weigh pros and cons, reinforce pts power in making choice
104
Q

describe preparation

A
  • pt is committed to making a change in the near future but still considering what to do
  • ps goals: offer advice and expertise regarding tx options, consider barriers and brainstorm steps in overcoming them, discuss whats worked in the past, encourage pt to let friends know
105
Q

describe action

A
  • pt is actively making changes
  • ps goals: acknowledge difficulties, identify high-risk situations, identify new reinforcers for positive change
106
Q

describe maintenance

A

pt has made change

ps goals: affirmation and develop plan for any regression

107
Q
A

PCM - E2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions