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GU Flashcards

1
Q

Nephrotic Syndrome tx?

A

Immunosuppressive, ACE inhibitors, lipid lowering agents, mild diuretics to control edema, sodium restriction.

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2
Q

Complications of CKD?

A

fluid overload, metabolic acidosis, arrhythmias, anemia, uremic syndrome

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3
Q

Sx of acute GN?

A

edema, decreased urine output, HTN, sx of fluid overload, uremia

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4
Q

What is stage 2 CKD?

A

MILD LOSS of kidney function; GFR is 60-89

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5
Q

CKD sx caused by altered calcium and P?

A

Bone breakdown, osteodystrophies, defective bone development

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6
Q

What is stage 1 of CKD?

A

kidney damage w/ NORMAL function; GFR>90

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7
Q

Which AV access matures faster but does not last a long time?

A

AV graft

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8
Q

Common labs and diagnostics for CKD?

A

creatinine, BUN, electrolytes, H/H, GFR, urinalysis, X ray, CT scan

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9
Q

Sx of CKD caused by sodium and fluid imbalance?

A

HTN, heart failure, pulmonary edema

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10
Q

What are the advantages of PD?

A

less hazardous, more flexibility, may have less fluid and dietary restrictions.

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11
Q

Which AV access takes longer to mature and lasts a long time?

A

AV fistula

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12
Q

What is stage 5 CKD?

A

Kidney FAILURE; GFR <15

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13
Q

How is GFR calculated?

A

From serum creatinine levels and creatinine clearance levels from a 24 hour urine test

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14
Q

What causes oliguria or anuria in kidney stones?

A

obstruction at the bladder neck or urethra

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15
Q

What are examples of a complicated UTI?

A

UTI with pregnancy, obstruction, chronic kidney disease, drug resistant organism, men

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16
Q

How is fluid volume managed in CKD?

A

renal replacement therapies, diuretics, fluid restriction, sodium restriction.

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17
Q

Which foods should be avoided to prevent kidney stones?

A

foods high in oxalate, such as rhubarb, chocolate, tea, coffee, and nuts.

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18
Q

Contraindications for kidney transplant?

A

Active cancer, current infection, active psychiatric illness, active substance abuse, non-adherence with dialysis or medical regimen.

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19
Q

Abnormal lab findings of acute GN?

A

protein, blood, WBC casts in urine; elevated BUN/creatinine

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20
Q

Why is calcium gluconate IV administered w/ hyperkalemia?

A

to reduce myocardial irritability

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21
Q

What are early sx of CKD?

A

malaise, fatigue, pruritis, dry skin, weight loss, anorexia, nausea

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22
Q

CKD endocrine sx?

A

Infertility, amenorrhea, hyperparathyroidism, thyroid abnormalities

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23
Q

Which labs will be altered if there is a lot of protein in the system?

A

BUN and creatinine will be elevated

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24
Q

What is the normal GFR for a young adult?

A

125mL/min

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25
Q

What is PKD?

A

Genetic progressive kidney disorder characterized by fluid filled cysts in the kidneys.

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26
Q

Common diagnostics for PKD?

A

urinalysis, BUN, creatinine, US, MRI, IV pyelogram, CT

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27
Q

Dietary modifications needed with CKD?

A

protein, K, Na, and P restriction; sufficient carbohydrate calories, ; fluid restriction; calcium supplementation; iron, vitamin B12, and folic acid supplementation.

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28
Q

S/sx of uremic syndrome?

A

N/V, AMS, uremic frost, halitosis, stomatitis, metabolic acidosis, electrolyte imbalance, cardiac arrhythmia, abnormal bleeding.

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29
Q

What abx are 1st line for uncomplicated bacterial UTI?

A
  1. Nitrofurantoin (Macrobid, Macrodantoin)

2. Trimethoprim/Sulfamethoxazole (Bactrim)

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30
Q

Which medication will slow the progression to ESRD?

A

Tolvaptan

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31
Q

What is Epogen?

A

Synthetic version of erythropoietin

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32
Q

Sx of chronic GN?

A

proteinuria, hematuria, hypertension, fatigue, edema

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33
Q

How many units of heparin does the central venous catheter contain to avoid clotting?

A

10,000 units

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34
Q

What is stage 4 CKD?

A

SEVERE loss of function; GFR is 15-29

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35
Q

What are the 2 forms of PKD?

A

childhood and adult

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36
Q

What are surgical options for pyelonephritis?

A

pyelolithotomy, urethral diversion/ re-implantation of ureters, nephrectomy

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37
Q

Diagnostics for complicated UTI?

A

Pelvic US or CT, voiding cystourethrography, cystoscopy.

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38
Q

What is glomerulonephritis (GN)?

A

group of kidney disorders characterized by injury and inflammation to the glomeruli caused by immunity response.

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39
Q

Difference between fistula and graft?

A

both involve the combination of artery and vein but graft uses a synthetic tube to combine them

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40
Q

What causes chronic anemia in CKD?

A

kidneys not able to make erythropoietin

41
Q

Are we allowed to flush the central venous catheters?

A

No; only dialysis trained nurses. However, we should monitor for sx of infection or occlusion.

42
Q

Causes of secondary GN?

A

multi-system disease like lupus, HIV, amyloidosis

43
Q

What is a normal BUN/creatinine ratio?

A

6-25

44
Q

Common diagnostics for acute GN?

A

urinalysis, 24hr urine collection, serum albumin, serum creatinine, BUN, GFR, CBC, kidney biopsy

45
Q

S/sx of chronic pyelonephritis?

A

1/. s/s of infection, however less dramatic presentation.

  1. Repeated low grade fevers.
  2. Hypertension
  3. Inability to conserve sodium, hyperkalemia.
  4. Nocturia
46
Q

Which drugs should be avoided with CKD?

A

nephrotoxic (NSAIDs, aminoglycosides) and Mg containing like Malox

47
Q

Meds used for kidney stone tx?

A

analgesics; abx; combination of Thiazide diuretic, allopurinol and high fluid intake; alpha adrenergic blockers and calcium channel blockers; citrate.

48
Q

How to manage hyperkalemia with CKD?

A

K restriction.

Emergent: Kayexalate, Calcium gluconate, regular insulin

49
Q

Urolithiasis risk factors?

A

family hx, hx of kidney stone, hx of diabetes, gout, and obesity, increased Na intake

50
Q

How to manage hyperphosphatemia with CKD?

A

Low P diet.

Phosphate binders: Sevelemar carbonate (Renvela) and calcium carbonate

51
Q

What abx is used to treat fungal UTI?

A

Fluconazole (Diflucan)

52
Q

Sx of PKD?

A

HTN*, hematuria, flank pain, dysuria, HA, abd pain/distention, nocturia, frequent UTIs, cerebral aneurysms (some cases)

53
Q

What is hydronephrosis?

A

Distention of the renal pelvis and calices caused by obstruction in the upper part of the urete.

54
Q

What is GFR?

A

The rate at which the glomeruli filter blood

55
Q

What is CKD?

A

Slow, progressive, irreversible loss in kidney function, with a GFR = 60mL/min for 3 months or longer.

56
Q

What is hydroureter?

A

distention of the ureter caused by obstruction in lower part of the ureter

57
Q

Sx of CKD caused by altered potassium excretion?

A

lethal arrhythmias

58
Q

HD is often required when GFR level is what?

A

< 10-15mL/min

59
Q

Sx of CKD caused by impaired metabolic waste elimination?

A

N/V, anorexia, neurological sx

60
Q

Complications of kidney transplant?

A

organ rejection, infection, cancers, corticosteroid related sx.

61
Q

What is a nephrolithotomy?

A

direct access is obtained to the kidney percutaneously, allowing a nephroscope to identify and remove the offending stone.

62
Q

CKD sx caused by decreased acid clearance and bicarbonate production?

A

Metabolic acidosis

63
Q

Which foods can prevent the formation of kidney stones?

A

citrate rich foods like lemons

64
Q

Complications associated with peritoneal dialysis?

A

infection, peritonitis, fluid/electrolyte imbalance, more protein loss than HD.

65
Q

What are the common types of PD?

A

Continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD)

66
Q

Do people on dialysis also have protein restrictions?

A

Will need more protein because a lot of it is getting filtered out during dialysis

67
Q

Assessment for PD?

A

drained effluent, abd pain, hyperactive BS, diarrhea, abd distention, PD catheter site.

68
Q

What is stage 3B CKD?

A

MODERATE TO SEVERE loss of function; GFR 30-44

69
Q

How to improve cardiac function with CKD?

A

antihypertensive and lipid lowering agents

70
Q

What kind of vascular access is used for long-term HD?

A

AV fistula and AV graft

71
Q

S/sx of disequilibrium syndrome after dialysis?

A

N/V, changes in mental status, HA, twitching, seizure,

72
Q

What is stage 3A CKD?

A

MILD TO MODERATE loss of function; GFR is 45-59

73
Q

Late signs of CKD?

A

oliguria/anuria, drowsiness, confusion, excessive thirst, s/sx of uremic syndrome.

74
Q

How much water should PKD patients drink?

A

3L/day to slow cyst growth only if poor kidney function has not been developed.

75
Q

What are the 2 main causes of CKD?

A

HTN and DM

76
Q

T/F. Chronic GN always leads to ESRD?

A

True

77
Q

What is a normal creatine level?

A

0.6-1.2mg/dL

78
Q

How many stages of CKD are there?

A

5 based on GFR category

79
Q

What other sx can be seen in NS?

A

lipiduria; HLD; HTN; edema; delayed clotting/increased bleeding/high PT/INR; increased BUN/creatinine, decreased GFR

80
Q

Contraindications for PD?

A

hx of peritoneal adhesions, extensive GI surgery, currently obese

81
Q

Risk factors for CKD?

A

DM, HTN, HLD, smoking, recreational drug use, NSAIDs, obesity

82
Q

How to manage hypocalcemia with CKD?

A

vitamin D and calcium supplementation, manage hyperP

83
Q

Standard diagnostic for confirming presence of kidney stones?

A

Non-contrast helical CT scan of the abd and pelvis

84
Q

What kind of vascular access is used for short-term HD?

A

central venous catheter

85
Q

How to manage PKD?

A

Manage BP, pain; prevent constipation; manage UTIs and prevent complications of infection; slow progression to ESRD; dialysis.

86
Q

How is anemia managed in CKD?

A

Epogen (Procrit); iron, vitamin B12, and folic acid supplements.

87
Q

Common complications associated with HD vascular access?

A
  1. Thrombosis/stenosis
  2. Infection
  3. Aneurysm formation from increased pressure.
  4. Ischemia
88
Q

Causes of primary GN?

A

infectious agent

89
Q

Why should foods high in animal protein be limited for the prevention of kidney stones?

A

to reduce acidic urine and prevent calcium precipitation

90
Q

Life expectancy after renal transplant?

A

Cadaver kidney: 8-12 years

Live donor kidney: 12-20

91
Q

What is a normal BUN level?

A

10-20mg/dL

92
Q

What is a ureteroscopy?

A

A flexible scope is inserted through the urethra, bladder, and ureter to identify and remove the stone.

93
Q

What is nephrotic syndrome (NS)?

A

kidney disorder characterized by massive proteinuria, hypoalbuminemia, and edema.

94
Q

When should we notify the provider after bladder scan?

A

if bladder has more than 300cc

95
Q

Most common risk factor of urolithiasis?

A

Dehydration

96
Q

Complications of kidney stones?

A
  • Pyelonephritis
  • Urosepsis
  • hydronephrosis and hydroureter
  • Irreversible renal damage
97
Q

Complications of re-current pyelonephritis?

A

scaring, permanent renal damage, CKD, sepsis

98
Q

What is uremic syndrome?

A

when urea and waste products build up because the kidneys are unable to excrete them

99
Q

What causes disequilibrium syndrome?

A

rapid removal of solutes from the body during HD

AG (30 decks)

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