Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Intro to Renal Failure Lecture > Flashcards

Intro to Renal Failure Lecture Flashcards

1
Q

Urine
Serum
Radiography

A

3 ways to assess kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Goes up quickly in ARF due to ischemia and radio contrast (complication of x-ray dye studies such as IVP, CT scans)

  • Peaks 3-5d after contrast
  • Peaks 7-10d after ischemia
A

Creatinine

*not correlative with symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sodium reflets _____ status

A

volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

I&Os
Urine sodium
Body weight
Toxin levels

A

Ways to monitor kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can people with kidney disease concentrate their urine?

A

No..

urine concentration is low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Collectively, the measure of renal function
*If low, leads to azotemia
Can be estimated by serum creatinine
*Affected by age, sex, weight, fluid status, and medical condition (illnesses, nutritional status, drugs on board, etc.)

A

GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Creatinine is secreted in the….

A

proximal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Men:(140-age) x (wt in kg) divided by 72 x serum creatine

A

Cockcroft-Gault equation

*calculates GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Defined as excess of urea and nitrogenous compounds in blood

Due to breakdown of protein

A

Azotemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Metabolism of carbs and fats yields…

A

water and CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Best first radiographic test…

will exclude obstruction of kidney

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Non invasive
No risky contrast dye
Readily available

A

Advantages to ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Avoid contrast in…

A

ARF and CRF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Biopsy may be needed in ____ for intrinsic disease

A

ARF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Volume overload
Hyponatremia
Hypocalcemia (paresthesia, cramps, seizures, confusion)

A

Complications of ARF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Whats more common in renal failure, HyperNa or HypoNa?

A

HypoNa

17
Q
  • Hyperkalemia, phosphatemia, magnesemia
  • Metabolic acidosis
  • HTN
A

Complications of ARF

18
Q

ARF is usually….

A

reversible

19
Q

Due to renal hypoperfusion
Usually reversible if restoring renal blood flow (RBF)
Parenchyma usually not damaged
In severe cases, ischemia/injury

A

Prerenal azotemia

20
Q
  • Hypovolemia (Fluid loss, Decreased cardiac output, Decreased systemic vascular resistance)
  • Renal hypoperfusion
A

Prerenal azotemia

21
Q
  • Leads to epinephrine release and subsequent vasoconstriction
  • Also activations of renin angiotensin system–>Vasoconstriction
  • Release of arginine vasopressin (AVP)
A

Hypovolemia

22
Q
  • Renal vasoconstriction due to epinephrine
  • ACE inhibitors
  • Cyclooxygenase inhibitors (i.e.: NSAID’s)
  • Hyperviscosity syndromes
A

Can cause renal hypoperfusion

23
Q
  • Cirrhosis leads to intrarenal vasoconstriction
  • Sodium retention
  • Precipitated by bleeding, paracentesis, diuretics, vasodilation, cyclooxygenase inhibitors
A

Hepatorenal syndrome

24
Q

Symptoms: Thirst, dizzy
Signs: Low blood pressure, tachycardia, orthostasis, Low UOP

A

Pre-renal

25
Q
  • Renovascular obstruction..lg vessel dz

- Glomerular or microvascular diseases

A

Intrinsic renal failure

26
Q 
Glomerulonephritis
Vasculitis
Acute tubular necrosis
Ischemic or nephrotoxic
Interstitial nephritis
Renal allograft rejection
A

Glomerular diseases

27
Q

Ischemia from prerenal azotemia

A

Most common cause of acute tubular necrosis

28
Q 
Radiocontrast (Intrarenal vasoconstriction)
Aminoglycosides (Decrease GFR)
Cyclosporin
Chemotherapy (Cisplatin)
Solvents (ethylene glycol)
A

Nephrotoxins

29
Q

Mechanism: Intrarenal vasoconstriction resulting in acute tubular necrosis (ATN) abrupt onset 24-48h aftercontrast exposure

A

Radiocontrast induced nephropathy

30
Q

Biggest risk factor for radiocontrast induced nephropathy

A

Age**!

31
Q

Features: Decreased GFR, Sediment, Reversible, Elevation of BUN and creatinine
Avoidance: Use non ionic contrast (more expensive but safer
Outcome: Typically resolves in 1-2 weeks

A

Radiocontrast induced nephropathy

32
Q

Rhabdomyolysis (Due to crush, injury, ETOH)
Hemolysis (toxic to renal tubule)
Uric acid (Same thing that causes gout)
Myeloma (Plasma cell malignancy)
Hypercalcemia (Causes renal vasoconstriction)

A

Endogenous nephrotoxins

33
Q

Allergic (Antibiotics such as beta-lactams), NSAID’s, diuretics
Infection (Bacterial-pyelonephritis, viral-CMV, Fungus-Candidiasis)
Infiltration (Lymphoma, leukemia, sarcoidosis)
Idiopathic

A

Interstitial nephritis

34
Q

Symptoms-Often none
May have history of nephrotoxin exposure
Signs-Azotemia on lab testing
Nephritic syndrome (Oliguria, edema, HTN, Urine sediment)

A

intrinsic renal failure

35
Q

Oliguria, edema, HTN, urine sediment

A

Nephritic syndrome

36
Q

Microscopy:
Muddy brown casts (ischemia and nephrotoxic)
Red cell casts (acute glomerular injury or nephritis)
White cell casts (interstitial nephritis)
Eosinophilic casts (allergic nephritis)
Often no casts
Hematuria

A

Intrinsic renal failure lab results

37
Q

This can be seen in intrinsic renal failure and is due to impaired reabsorption at proximal tubules

A

Proteinuria

38
Q 
Prostate disease
Neurogenic bladder
I.e.: spinal cord injuries
Anticholinergics
Blood clots
Stones
Tumor or other extrarenal obstruction
A

Post renal

39
Q

Bladder distension
Abdominal pain-colic
Renal distension (ultrasound)
History of risk factors (prostate disease, stones, etc.)

A

Post renal signs and symptoms

Renal (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions