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Kidney Week 1 > HLK week 5 > Flashcards

HLK week 5 Flashcards

1
Q

AKI

A
  • definition: over hours to days, decrease in GFRby 25-50%, decrease in SrCr by 75-100%
  • S/S: oliguric, normal to large size kidneys, hypervolemia, , maybe uremic syndrome for severe
  • MGMT: determine cause and treat, d/c nephrotoxic drugs
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2
Q

Azotemia

A
  • definition: build up of waste products in blood, mostly urea
  • s/s: myoclunus, oliguria, fatigue, asterics
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3
Q

uremia

A
  • definition: severe build up of urea

* s/s: urinous breath, pericardial rub, malaise, altered LOC, pale conjuctiva, HTN, SOB

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4
Q

CKD

A
  • definition: over 3 months of kidney dysfunction, decreased GFR
  • s/s: asymtomatic until later stages, small kidneys
  • causes: diabetes and HTN/ CVD
  • staged 1-4, then ESRD
  • stage 1: normal or elevated
  • stage 2: 60-89
  • stage 3a: 45-59
  • stage 3b: 30-44
  • stage 4: 15-29
  • ESRD:
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5
Q

AKI types

A
  • Types: pre-renal, renal, post renal
  • most common type: pre-renal
  • intrinsic: tubular necrosis, interstitial nephritis, acute glomerulonephritis
  • Post-renal: obstruction, males, anticholinergic
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6
Q

CKD Bone changes

A
  • CKD can cause hypocalcemia, hyperphosphorous,
  • osteitis fibrosa cystica: hyperparathyroidism (osteoclast activation)MOST COMMON, bone pain, proximal muscle weakness
  • osteomalacia: bones done’ mineralize bone pain, or asymptomatic, difficulty walking
  • adynamic bone disease: opposite of fibrosa cystica
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7
Q

Kidney transplant life expectancy

A

living donors: 1-5 yr: 95-80%

Deceased donors: 1-5 yr: 89-66%

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8
Q

nephrotic characteristics

A
  • PROTEINuria! >3 g day in urine
  • so no protein in blood – hypoalbumineia
  • massive edema
  • can be normotensive
  • hyperlipidemia
  • mechanical issue
  • frothy urine
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9
Q

nephritic characteristics

A
  • periorbital and scrotal edema
  • HTN!!!
  • RBC casts in urine
  • injury/ infection issue– angry
  • RPGN is severe end
  • 1-3 g/ day proteinuria
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10
Q

nephritic examples

A 
post infectious GN -- strp 
IGA nephropathy-- Berger's-- Asi---- Henouch
goodpastures --basement membrane
SLE
Hep C
Pauci-immune --/ all polyangititis
interstitial nephritis
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11
Q

nephrotic examples

A 
minimal change disease -- common in kids
focal segmental glomerular sclerosis
diabetic nephropathy
HTN nephropathy
amyloidosis
HIV assc. nephropathy
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12
Q

goodpasture

A 
basement membrane
men>women, think young men 30-40
pulmonary renal syndrome,  
alveolar hemmoraging/ hemoptysis, RPGM
URI can preceed
treat w/ plasma exhance
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13
Q

IGA nephropathy (nephritic)

A 
Asians
1-2 days after URI
gross hematuria
asymptomatic to RPGN
can resolve or progress
treat w/ ACE/ARB
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14
Q

post-infx GN (nephritic)

A

1-3 weeks after infx
strep!
hematuria, proteinuria, NEPRHITIC Symptoms
HUMPs on microsopy
treat : supportive, anti-HTN, NO steroids

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15
Q

henouch (nephritic, IGA type)

A

kids
palpable purple purpura on legs, buttocks
males
GI symptoms, arthralgia
treat w/ aspirin (only time you treat kids w/ this), Rituimab

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16
Q

pauci-immune (nephritic)

A 
all the polyangiitis'
ANCA+
can present w/ nodules
hemptysis -> hospital
refractory sinus infx= wegeners
treatment= high dose corticosteroids, plasma exchange
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17
Q

minimal change (nephrotic)

A 
kids
90% of GN in kids in this
treat w/ steroids
no podocytes
in adults= secondary = lymphoma, lithium, NSAIDs
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18
Q

Focal Segmental (nephrotic)

A 
adults
no podocytes FOCALLY
genetic: Africans
treat: symptoms diuretics/ ACE/ARB, statins
can develop ESRD
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19
Q

Analgesic Nephropathy (intrinsic AKI)

A

too many analgesics
s/s: sloughed papilla in urine, ringed shadow sign, volume depletion, hematuria, anemia, sterile pyruia, hyperkalemia. tubular and papilla damage
treat w/ d/c offending rx

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20
Q

intersitial nephritis (intrinsic AKI)

A

3.3.3.
3 causes: drugs, autoimmune, infx
of immune, 3 S;s: SLE, Sjogrens, sarcoidosis
triad presentation: arthalgias, fever, rash
WBC casts, hematuria, pyuria, proteinuria
treatment: dialysis, treat underlying cause

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21
Q

PKD (intrinsic AKI)

A

genetic
lots of cysts on the kidney
s/s: ABD flank pain, hematuria, kidney stones, UTIs, family history, HTN
treat: bed rest, supportive, ADH antagonists

22
Q

acute tubular necrosis (type of AKI)

A

most common intrinsic AKI
muddy brown casts
Uremia: pericardial effusion/ tamponade, arrhythmias
hyperkalemia, hyperphosphatemia,
treat: diuresis, dialyze, plasma filtration, protein restiction

23
Q

RAS (prerenal AKI)

A 
renal bruits
fibromuscular dyphasia in young woman -- HTN women under 40, beads on a string, 
asymetric kidney size
pre-renal AKI
new onset HTN, refractory HTN
treat- angioplasty,
24
Q

diabetic nephropathy

A

most common cause of ESRD

25
Q

Lupus nephritis (nephritic)

A

can be presenting cause of SLE

immune complex deposit? we don’t know – direct cell mediated injury

26
Q

HTN nephropathy (nephrotic)

A

HTN nephrosclerosis, from CHRONIC HTn, more common in Africans

27
Q

amyloidsosis (nephrotic)

A

protiens clog shit up

28
Q

cardiorenal syndrome

A

heart dx causes kidney dx or vice versa

29
Q

pulmonary renal syndrome

A

like goodpastures of SLE, wegeners, syndromes involving lung and kidney

30
Q

hepatorenal syndrome

A

AKI w/ liver disease, usually portal HTN, poor prognosis

31
Q

HIV assc nephROathy

A

African descent thing, can be presenting symptom of HIV

32
Q

hematuria definition

A

microscopic= 3 RBC/ HP field on more than 1 occasion
macroscopic= smokey urine
90% non-renal cause

33
Q

hematuria work up

A 
urine dipstick
if + then to UA
centerfuge
cytology
RBC casts= glomerulonephritis
CT, ultrasound
34
Q

hematuria Ddx

A

cancer
glomerular: Nephritic syndromes
non-glomerular: cysts, stones, intersitial nephritis,
lower GU tract

35
Q

proteinuria

A

> 3 g/ day = nephrotic
1 mg/ day = proteinuria
workup: dipstick, UA, protein/cr ratio, kidney biopsy
Function proteinuria: no tx benign
Overload proteinuria: too many proteins like BenceJones
glomerular proteinuria: diabetic nephropaty
tubular proteinuria: ATN, anything intrinsic

36
Q

creatinine

A

muscle byproduct, how we estimate GFR

37
Q

anion gap

A

normal is 12 +/- 4 –

tells you if acid/base balance is compensated

38
Q

BUN

A

blood urea nitrogen– made in liver, urea is nitrogenous waste product from ammonia
measures level of nitrogen in blood indirectly by measuring urea

39
Q

BUN/CR ratio

A

only done if BUN OR CR is elevated

40
Q

hypo natremia: Isotonic

A

causes: pseudohyponatremia d/t hyperlipidemia, hyperproteinemia, hyperglycemia

41
Q

hyponatremia: hypertonic

A

caused by hyperglycemia, mannitol, contrast agents

42
Q

hypo natremia: hypotonic

causes

A

check volume status:
hypovolemic: diarrhea, dehydration, hemmohage
Euvolemic: SIADH, beer potomania, ecstacy, polydipsia
hypervolemic: CHF, Cirrhosis

43
Q

hypo natremia s/s

A

HA, nausea/ vomitting, malaise, cerebral edema, CNS abnomalities
serum concentration

44
Q

hypernatremia

A

always hypovolemic, hyperosmolality
s/s: dehydration! orthostatic hypotension, oliguria, lethargy, irritability, seizures
serum concentration >145

45
Q

hypo kalemia

A

U waves,
diuretics, laxitive abuse, diarrhea, Increased aldosterone, polyuria
s/s: muscle weakness, fatigue, constipation, rhabdomyalisis, flacid paralysis
have to correct hypomagnesia to fix this
serum concentration

46
Q

hyper kalemia

A

Sharp T waves, wideQRS, PR prolongation,
hypoaldosteronisism, CKD 4/5, ACE/ARBs
arrhtmymias, muscle cramping, weakness, parathesias,
concentration >5

47
Q

hypo calcemia

A

s/s perioral numbness, paresthesias, chvostek/ trousseau signs, muscle tetany
prolonged QT interval, torsades
common cause – CKD.
alsohypoalbuminia, respiratory alkalosis, decreased active vitamin D, hypoparathyroidism
concentration

48
Q

hyper calcemia

A

causes: hyperparathyroidism, malignancy
s/s: stones, bones, groans, moans, psychiatric overtones
mild >10.5

49
Q

hypo phosphatemia

A

causes: alcoholism, alkalosis, diuretics, re-feeding syndrome
s/s/: respiratory failure, muscle weakness, hypoxemia, enchepholapathy
concentration

50
Q

hyper phosphatemia

A

causes: CKD, malignancy
s/s: hypocalcemia same
concentration >4.5

51
Q

hypo magnasemia

A

causes: diminished absorption/ intake, alcoholism, diabetes, pregnancy,
s/s: tremors, muscle weakness, cramps, babinski, nystagmus, tachycardia
serum

52
Q

hyper magnasemia

A

causes: antacid abuse, advanced CKD
s/s: mental obtundation, decreased DTRs, flacid paralysis, hypotension, cardiac arrest
serum >3

Kidney Week 1 (3 decks)

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