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Neo Boards > FEN/Renal > Flashcards

FEN/Renal Flashcards

1
Q

What is the percentage of body water at 24 weeks?

What percent is extracellular vs intracellular?

A

90%

65% Extracellular

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2
Q

What is the percentage of body water at 24 weeks?

What percent is extracellular vs intracellular?

A

90%

65% Extracellular 25% Intracellular

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3
Q

What is the percentage of body water at term?

What percent is extracellular vs intracellular?

A

80%

45% Extracellular 35% Intracellular

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4
Q

What is the percentage of body water at 1 year of age?

What percent is extracellular vs intracellular?

A

65%

20% Extracellular 45% Intracellular

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5
Q

TBW and ECF _______ with increasing gestational age.

A

decreases

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6
Q

ICF _________ with increasing gestational age.

A

increases

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7
Q

Normal UOP is _____ml/kg/hr

Stool water content is _______ ml/kg/d

A

1-3

5-10

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8
Q

Hypernatremia correction:
_____ for Na over ______
_____ for Na over ______

A

4ml/kg free water for every 1mEq/L Na >145

3ml/kg free water for Na >170

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9
Q

Where and at what proportion does evaporative water loss occur?

A

1/3 via respiratory tract

2/3 via skin

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10
Q

Factors increasing insensible water loss

A 
Increased environmental and body temperature
Decreasing gestational age
Skin breakdown
Congenital skin defects
Radiant warmer
Phototherapy
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11
Q

Factors decreasing insensible water loss

A

Humidity

Plastic heat shield

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12
Q

ADH produced by fetus at

A

11 weeks

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13
Q

ADH is produced _______ and stored in the _______

A

Hypothalamus

Posterior pituitary gland

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14
Q

Osmolality calculation:

A

2(Na) + glucose/18 + BUN/2.8

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15
Q

Nephrogenic DI is caused by

A

Renal tubule ADH insensitivity

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16
Q

Congenital nephrogenic DI is due to either

A

Vasopressin- receptor defect (X-linked recessive)

Aquaporin defect (autosomal)

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17
Q

Increased urine concentration is accomplished in nephrogenic DI through administration of

A

Thiazides

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18
Q

Body fluid with the highest potassium content is

A

Diarrheal stool

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19
Q

Body fluid with the highest chloride content is

A

Stomach

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20
Q

Body fluids with the highest sodium content are

A

Small intestine

Bile

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21
Q

False hypernatremia can occur with

A

Hyperlipidemia
Hyperproteinemia
Hyperglycemia

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22
Q

Na correction calculation

A

(Na desired - Na current) x 0.6 x weight

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23
Q

Carbonic anhydrase is an enzyme that contributes to

A

Acid base balance

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24
Q

pH is _________ correlated to potassium level.

A

Inversely

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25
Q

Acid base balance is regulated by transportation of _____ by the ________ and increased clearance of _____ by the ______

A

HCO3 - kidneys (to increase base)

CO2 - lungs (to decrease acid)

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26
Q

Renal tubular acidosis is caused by

A

Decreased renal tubular H+ secretion

OR

Decreased HCO3 reabsorption

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27
Q

Electrolyte abnormalities in RTA are

A 
Hypercalciuria
Hypokalemia (d/t increased aldosterone)
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28
Q

RTA 1 is identified by:

A

Autosomal dominant
Genetic/autoimmune disease

Inability to secrete H+ in distal tubule
Urine pH >6.2

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29
Q

RTA 2 is identified by:

A

Autosomal recessive
Fanconi, cystinosis, tyrosinemia, Lowe
Prematurity

Decreased original tubular HCO3 reabsorption
Urine pH <5.3

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30
Q

RTA 3 is identified by:

A

Aldosterone deficiency/resistance
Hyperchloremic/hyperkalemic
Metabolic acidosis

Poor growth, FTT

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31
Q

Renal juxtaglomerular hyperplasia/hypertrophy is

A

Bartter syndrome

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32
Q

Bartter syndrome is marked by

A

Defective ascending loop chloride transport–>

Increased renin
Increased aldosterone
Hypokalemic metabolic acidosis

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33
Q

Kidneys are formed from

A

Mesoderm

34
Q

Three morphologic stages of embryonic kidneys are

A

Pronephros, mesonephros, metanephros

35
Q

Nephrogenesis continues until

A

35 weeks

36
Q

Urine production begins at

A

10 weeks

37
Q

Preterm infant maximum osmolality is 500 due to

A

Tubule insensitivity to vasopressin-
Short loop of Henle
Limited na reabsorption in thick ascending loop

38
Q

Renal blood flow shifts from ____ of cardiac output in utero to ____ after birth

A

3%

12%

39
Q

Neonatal GFR doubles by

A

2 weeks of age

40
Q

Most sodium is reabsorbed in the

A

Proximal tubule

Remaining in ascending loop and distal tubule

41
Q

FeNa calculation

A

Urine Na x plasma creatinine/

Urine creatine x plasma Na x100

42
Q

FeNa suggestive of prerenal failure is

A

1-2.5%

43
Q

Potassium is reabsorbed in

A

Proximal tubule and ascending loop of Henle

44
Q

Bicarbonate in excess of the threshold is secreted in the

A

Proximal tubule

45
Q

Calcium reabsorption occurs in the

A

Proximal tubule and loop of Henle (passive)

Distal tubule and collecting ducts (active)

46
Q

80% phosphorus is reabsorbed in

A

Proximal tubule

47
Q

Tubular reabsorption of phosphorous calculation:

A

1- ((UrPh x PCr)/ (UrCr x PPh)) X100

48
Q

65% magnesium reabsorption in

A

Proximal tubule and thick ascending loop

49
Q

RAAS pathway is

A

Angiotensinogen vasoconstriction, ADH

Aldosterone –>^ Na, Cl, K, H, retain water

50
Q

Pseudohypoaldosteronism

A

X linked recessive
Renal tubule aldosterone resistance
Incr aldosterone, renin but still with low Na, high K

51
Q

Large placenta associated with

A

Congenital nephrotic syndrome (+ incr AFP)

Syphilis

52
Q

GFR calculation

A

0.45 x height (cm)/
PCr

Preterm, 0.33 instead of 0.45

53
Q

Protein reabsorption occurs

A

Proximal tubule

54
Q

Myoglobinuria is due to

A

Rhabdomyolysis

55
Q

Kidney length is approximately equal to

A

Gestational age in weeks

56
Q

Congenital nephrotic syndrome signs

A

Proteinuria
Hypoproteinemia
Hyperlipidemia
Edema

Autosomal recessive
Finnish (CNF) - 19q13.1, NPHS1- large placenta

Diffuse mesangial sclerosis (DMS) - normal placenta

57
Q

AR PKD signs

A 
Chr 6p21
Snowstorm cysts
Liver involvement increases with age
Hepatic fibrosis
Biliary dysgenesis
Severe hypertension
58
Q

AD PKD signs

A

Chr 16,

  • PKD1 16p13.3 polycystin 1
  • PKD2 4q. Polycystin 2

Cysts: renal, liver, pancreas, spleen
Hypertension
Cerebral aneurysms

59
Q

Fanconi syndrome signs

A 
Autosomal dominant
Associated with Lowes syndrome
Proximal tubule dysfunction --> urinary losses
Polyuria
Low phosphorous, potassium
60
Q

Autosomal recessive defective cystine transport is

A

Cystinosis

61
Q

Progression of cystinosis is from ____ in infants to _____by ____ age

A

FTT, V/D
ESRD
9 years

62
Q

Findings in cystinosis are

A

Normal plasma cystine

Increased cystine in lysosomes and crystals in slit lamp

63
Q

Oculocerebrorenal syndrome is also called

A

Lowe’s syndrome

64
Q

Lowe’s syndrome is inherited

A

X linked recessive

65
Q

Lowe’s syndrome is caused by

A

Enzyme deficiency due to gene defect, defective Golgi

66
Q

Lowe’s syndrome signs

A 
Cataracts, glaucoma
Mental deficiency
Hypotonia
Renal tubular dysfunction
\+/- Congenital nephrotic syndrome
Cryptorchidism
67
Q

Neonatal UTI is associated with

A

40% risk of reflux

68
Q

Ectopic ureterocele is

A

Duplicated renal pelvis and ureter
Renal upper pole drained by duplicate ureter abnormally developed
Demonstrated on VCUG
Excision indicated

Females 6:1

69
Q

Cloacal exstrophy is caused by

A

Failed cloacal septation with ureters, ileum and rudimentary hindgut connected to common cloaca

70
Q

Clinical signs of cloacal exstrophy are

A 
Bladder exstrophy
omphalocele
hydromelia
cryptorchidism
GU anomalies
Limb deformities
Hip dislocation
71
Q

Bladder exstrophy causes

A

Defect in infraumbilical mesoderm migration with exposed posterior bladder wall, epispadias, +/- inguinal hernia

Male»female

72
Q

Sacral/lumbar hypoplasia, neurogenic bladder, VUR, and renal agenesis can be

A

Caudal dysplasia syndrome

73
Q

Cerebrohepatorenal syndrome is also

A

Zellweger syndrome

74
Q

Glaucoma, brain anomalies, chrondrodystrophy, and cortical renal cysts describe

A

Zellweger syndrome

Autosomal recessive

75
Q

An autosomal recessive syndrome with small thoracic cage and pulmonary hypoplasia, cystic tubular dysplasia and glomerulosclerosis is

A

Jeune syndrome

76
Q

Polycystic or dysplastic kidneys with encephalocele, polydactyly, cryptorchidism and cardiac anomalies is ____, inherited ____

A

Meckel-Gruber

Autosomal recessive

77
Q

Tuberous sclerosis is inherited _____ and includes

A

Autosomal dominant

Fibrous angiomatous lesions, intracranial calcifications, polycystic kidneys and renal angiomyolipomata

78
Q

Congenital cause of nephritic syndrome is

A

Nail-patella syndrome (autosomal dominant)

Hypoplastic-absent patella

79
Q

Palpable kidney, hematuria, and renal failure suggest

A

Renal vascular thrombosis

80
Q

Hypercalciuria can contribute to nephrocalcinosis in ____% of neonates >____ weeks

A

25-60%

32 weeks

81
Q

Risk factors for nephrocalcinosis

A 
Loop diuretics
Williams syndrome
Type 1 RTA
primary hyperparathyroidism
Bartter's syndrome

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