HD 2- Renal disorders and DENTISTRY

Question 1

Best day to treat dialysis patient on heparin?

Answer 1

Day after dialysis

Question 2

What are some signs of Nephrotic syndrome?

Answer 2

Bilateral periorbital oedema- Eadie stung by a bee

Loads of protein loss, less protein in IV compartment, no oncotic pressure, leaks out and forms oedema.

These patients will be on long term steroids.

Question 3

Potential adverse effects after renal transplant?

Answer 3

Predisposition to oral infections- candidiasis, herpes simplex

Greatly increased chance of malignancy, be suspicious of skin cancer

Question 4

Describe diabetic neuropathy?

Answer 4

Most common cause of renal problems.

Diabetes induced damage to kidney blood vessels.

Rampant PD in good OH.

Question 5

Describe Renal Osteodystrophy?

Answer 5

WASTING AWAY OF BONE DUE TO KIDNEY DISEASE.

INCREASE PHOSPHATE ->DECREASED CALCIUM -> INCREASED PTH

Bone disease may also be secondary to steroid therapy

Question 6

Why can renal disease cause bleeding problems?

Answer 6

Failure production of EPO by the kidney.

Reduced RBC production.

Poor platelet production and adhesiveness.

Question 7

What is an Arterio-Venous Fistula?

Answer 7

Abnormal connection of a vein and an artery for use in dialysis.

Question 8

Examination of a patient with CKD, signs?

Answer 8

Oedema
Moon face
Pulmonary/cardiac effusions
Bone pain- Renal Osteodystrophy, may present as TMD

Question 9

What is sialosis?

Answer 9

Painless, non-neoplastic/infective swelling of major salivary glands.

Secondary in renal failure.

Question 10

Prescribing a patient with renal disease?

Answer 10

Gentamycin- nephrotoxic- AVOID
Erythromycin- contraindicted to ciclosporin- AVOID.
Dose reduction with amox ect
NSAIDS avoided unless mild kidney impairment

Question 11

Describe what happens in acute kidney injury?

Answer 11

Seen in hypovolaemia.
Build up of waste product in the blood.
Potassium levels dangerously high.
Potassium will need to be taken out the blood.