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2 Renal > Interpreting U+Es > Flashcards

Interpreting U+Es Flashcards

1
Q

the creatinine baseline is highest physiologically in which people?

A

people with high muscle mass eg a bodybuilder

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2
Q

where is creatinine made?

A

liver

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3
Q

what is creatinine’s actual function?

A

is an energy store for fast twitch muscle fibres

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4
Q

what does creatinine phosphate break down into?

A

ATP and creatinine (waste product)

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5
Q

creatinine blood conc is used to determine….

A

the severity of kidney injury

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6
Q

where does the conversion of ammonia to urea take place?

A

liver

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7
Q

urea blood conc is used to determine kidney injury T or F

A

F

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8
Q

high urea would suggest..

A

dehydration
GI bleed
protein breakdown eg infection/drugs/trauma

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9
Q

low urea would suggest..

A

malnutrition
liver disease
pregnancy

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10
Q

how much higher than the baseline should creatinine be to confirm AKI?

A

> 50%

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11
Q

how low should urine output be and for how long for it to be a sign of AKI?

A

less than 0.5ml per kg per hr for 6hrs straight

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12
Q

what blood tests do all patients need if they are suspected to have an AKI?

A 
FBC
U+Es
CRP
PTH
VENOUS blood gas
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13
Q

immediate management of an AKI?

A 
prompt urinalysis
take blood and do a VBG
renal USS
start fluids 
insert catheter and monitor UO on a fluid balance chart
STOP any nephrotoxic drugs
manage the cause
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14
Q

patient has +++ urea and ++ creatinine, what type of renal failure do you suspect?

A

pre-renal

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15
Q

which form of renal failure is most likely to show blood and protein on urinalysis?

A

intrinsic renal

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16
Q

a urine protein-creatinine ratio under what value is considered normal?

A

15mg/mmol

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17
Q

a urine protein-creatinine ratio over what value indicates nephrotic syndrome?

A

> 300mg/mmol

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18
Q

if glomerulonephritis is suspected, what additional tests should be done?

A 
immunological screen:
ANA
ANCA
anti-GBM
complement
RF and other rheumatological Ab's
hepatitis serology

PLUS a renal biopsy

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19
Q

what test should be done if you suspect rhabdomyolysis?

A

CK

20
Q

if your patient is old, has an AKI and reports deteriorating symptoms over the past few months what additional test would you do?

A

myeloma screen

21
Q

uraemia is classed as a urea value over…

A

60

22
Q

potassium >__ indicates hyperkalaemia?

A

6.5

23
Q

if a patient is hypovolaemic, their Na levels will be __

A

low

24
Q

if Na is low in the body, will urinary osmolarity be high or low?

A

high because it will all be excreted in the urine

25
Q

urine sodium over _mmol/l indicates a renal cause for hypovolaemia

A

20

26
Q

what tests should be done to check Na levels and why?

A

plasma osmolality to confirm hyponatraemia

urine sodium to confirm/negate a renal cause

27
Q

aldosterone causes ___ of K+

A

excretion

28
Q

what 2 substances cause cellular K+ uptake?

A

insulin and catecholamines

29
Q

renal excretory causes of hypokalaemia?

A 
diuretics
conn's
cushing's
renal tubular acidosis
hypomagnesaemia
30
Q

what endocrine conditions cause hypokalaemia and why

A

cushings due to excess steroid

conn’s due to excess aldosterone

31
Q

Tx of hypokalaemia?

A

potassium chloride (tablets or IV depending on severity)

32
Q

renal retention causes of hyperkalaemia?

A

AKI
CKD
drugs eg K sparing diuretics, NSAIDs, ACEi
addison’s

33
Q

appearance of hyperkalaemia on ECG?

A

flat p waves
wide QRS
tall tented T waves

34
Q

why is insulin used in hyperkalaemia?

A

pushes K back into cells

35
Q

high ALP, high PTH and low Ca indicates __calcaemia. what could cause this result?

A 
hypocalcaemia;
loop diuretics
CKD
rhabdomyolysis
(basically any renal cause)
36
Q

PTH should ___ in response to hypocalcaemia

A

increase

37
Q

high ALP, low PTH and low Ca indicates __calcaemia. what could cause this result?

A

hypoparathyroidism
hypomagnesaemia
PTH resistance

38
Q

low ALP, high PTH and low Ca indicates __calcaemia. what could cause this result?

A

bisphosphonate use

vitamin d deficiency

39
Q

tests for hypocalcaemia?

A

renal function
PTH
ALP
magaesium

40
Q

what calcium level is the marker between a mild or severe hypocalcaemia

A

1,9mmol/l

eg if it was 2mmol/l it would be mild, if it was 1.8mmol/l it would be severe

41
Q

what drugs can act on the kidneys to cause hypercalcaemia?

A

thiazides

42
Q

dehydration would present with what 2 markers being raised?

A

urea

albumin

43
Q

if ALP and Ca are high, what should be suspected?

A

malignancy

44
Q

severe hypercalcaemia is a Ca level of…

A

3.5mmol/l or more

45
Q

low albumin indicates…

A

capillary leak from liver damage

46
Q

what causes high urea?

A

renal failure

excessive protein overload

2 Renal (34 decks)

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