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RIA - RENAL > kidnay > Flashcards

kidnay Flashcards

1
Q

where is macula densa located?

A

they are modified cells of the tubular epithelium located @ point where afferent arteriole enters the glomerulus & efferent glomerulus leaves

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2
Q

what does macula dense repond to?

A

low Sodium which reflects a low GFR therefore responds by releasing NO & prostaglandin to decrease resistance to blood flow in afferent arteriole and increase GFR

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3
Q

what triggers release of renin?

A

low intravascular volume

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4
Q

what are the 4 walls of ureter?

A

1) Epithelium
2) Lamina propria
3) Muscularis
4) Adventia

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5
Q

what level are kidneys located at?

A

T12 to L3

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6
Q

what is reflux nephropathy?

A

bedwetting in childhood

Recurrent urine backflow from bladder towards the kidney can result in small scarred kidneys during first 5 years of life in childhood

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7
Q

4 causes of low albumin?

A
  • malnutrition
  • IBD
  • Liver failure
  • nephrotic syndrome
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8
Q

list the CKD 5 stagesa

A 
G1 > 90 
G2: 60-89 
G3a: 45-59 
G3b: 30-44
G4: 15-29
G5: < 15
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9
Q

list the ACR classification

A

A1: < 3
A2: 3-30
A3: >30

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10
Q

3 majority causes of CKD?

A
  • Hypertension
  • Diabetes
  • Glomerulonephritis
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11
Q

most common glomerulophritis causing CKD?

A

IgA nephropathy

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12
Q

acid balance imbalance seen in CKD & why

A

metabolic acidosis due to decreased excretion of H+ ions

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13
Q

what eGFR reflects end stand renal disease

A

eGFR < 15

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14
Q

Blood tests for investigating CKD (9)

A
  • FBC
  • U &E
  • Bone profile
  • PTH
  • Bicarbonate
  • LFTs
  • Lipid profile
  • Autoimmune screen
  • Myeloma screen
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15
Q

what investigation should be offered to patients with visible or persistent non visible haematuria?

A

Renal ultrasound scan

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16
Q

how to identify intrinsic causes of CKD?

A

renal biopsy

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17
Q

side effect of ciclosporin

A

gum hypertrophy

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18
Q

symptoms of CKD

A
  • pruritus
  • muscle cramps
  • peripheral neuropathy
  • Hypertension
  • oedema
  • loss of apeitite
  • nausea
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19
Q

5 main complications of CKD

A

1) anaemia
2) peripheral neuropathy
3) renal bone disease
4) Dialysis related problems
5) CVD

20
Q

bone softening

A

osteomalacia

21
Q

osteoporosis

A

brittle bones

22
Q

osteosclerosis

A

hardening of bones

23
Q

3 different criteria for which renin-angiotensin system antagonists are indicated in:

A

1) Diabetic + ACR or 3 or more
2) Hypertensive & ACR of 30 or more
3) ACR greater than 70

24
Q

what produces EPO?

A

fibroblast like cells in kidneys

25
Q

foods high in phosphate

A
  • milk
  • cheese
  • eggs
26
Q

medication to be stopped in AKI

A

ACEi & ARB

27
Q

what initial rise in creatinine is acceptable in starting ACEi & ARB

A

rise of 25-30%

28
Q

calcitriol is?

A

Vitamin D

29
Q

type of parathyroidism in CKD

A

secondary

  • hypocalcaemia
  • hyperphosphataemia
  • high PTH
  • Low Vit D
30
Q

what is acid base imbalance seen in CKD & why & management

A

acidosis due to kidneys retaining H+ ions

give bicarbonate

31
Q

the 3 forms of renal replacement therapy

A
  • Haemodialysis
  • Peritoneal dialysis
  • Renal transplant
32
Q

management of hyperphosphataemia

A
  • phosphate binders

- phosphate dietary restriction

33
Q

RRT gold standard

A

renal transplant

34
Q

name a phosphate binder

A

Calcichew

35
Q

how should calcichew be taken?

A

taken & chewed 10-15 mins before meals,

36
Q

side effects of calcichew

A
  • chalky taste in mouth
  • constipation
  • diarrhoea
  • nausea
  • indigestion
  • flatulance
37
Q

definitive management of tertiary hyperparathroidism

A

parathyroidectomy

38
Q

how does secondary hyperparathyroidism develop in CKD?

A

Kidneys activate Vitamin D and vitamin D absorbs calcium levels
therefore…

low levels of Vit D lead to low levels of Calcium… PTH rises to try to increase calcium levels which results in osteoclast activity causing osteomalacia

39
Q

Vitamin D3 is converted to what & wherre?

A

Liver converts Vitmain D3 to calcidol and stored in liver

40
Q

how are phosphate levels affected in CKD & why?

A

kidneys are involved in excretion of phosphate so phosphate levels rise in CKD

41
Q

contraindications for Pertioneal dialysis?

A
  • IBD
  • abdominal abscess
  • abdo hernia
  • obesity
42
Q

side effect of tacrolimus

A

tremor

43
Q

indications for acute dialysis (AEIOU)

A 
A - acidosis 
E - 
I - Intoxication 
O - pulmonary Oedema 
U - Uraemia symptoms e.g. seizures/LoC
44
Q

4 things to assess when examining an AV fistula

A
  • Skin integrity
  • Aneurysma
  • Palpable thrill
  • Machinery murmur on auscultation
45
Q

what is STEAL syndrome? and what is it s a complication of?

A

complication of AV fistula

inadequate blood flow to the distal limb causing distal ischaemia

RIA - RENAL (7 decks)

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