Kidney

Question 1

what influences the final concentration of urine?

Answer 1

collecting duct in kidney
ADH (secreted by pituitary gland)
low BP
diabetes insipitus

Question 2

what are the signs and symptoms of kidney dysfunction?

Answer 2

low urine output
increased urine output
dark urine
proteinuria
haematuria
oedema
hypertension

Question 3

what happens in acute kidney injury

Answer 3

decreased in urine output
decrease in secretory function

Question 4

what are the causes if AKI? (PIP)

Answer 4

pre-renal:, low BP, dehydration, heart failure
intra-renal: inflammation, embolism, damage to the nephron
post-renal: kidney stones or obstruction

Question 5

What is the management of Akute Kidney injury?

Answer 5

Refer early , be careful when you prescribe drugs, manage fluid balance

Question 6

How does Chronic Kidney Disease present?

Answer 6

Hypertension, NA retention, Heart Failure, Cant metabolise drugs, therefore avoid NSAIDS
Assosciated with Atherosclerosis, Hypertension and Diabetes
Microvascular disease
Inflammation
Scleroderma
Renal stones

Question 7

How do you investigate CKD?

Answer 7

BP , Blood Test, Urine analysis, Imaging, Ultra sound CT/MRI

Question 8

What are treatments of CKD?

Answer 8

Dialysis, Renal dialysis.. Through the arm Or PERITONEAL dialysis. Or renal transplant., and prescribe immunosuppresants

Question 9

Complications of Chronic Kidney Disease

Answer 9

1.Aneamia, Erythropoetin created by kidney so without that will lead to anemia
2. Calcium and bone metabolism, Vitamin D you get from diet and sun is converted into the active form in kidney so without that we can’t uptake calcium.
PTH is then released to cause Osteoclasts.
3. Bleeding risk - Abnormal platelet formation causing excess bleeding. (virchows Triad)

Question 10

What drugs act on kidney?

Answer 10

Diuretics

Question 11

When would thiazide diuretics

Answer 11

used in heart failure- to less passive reabsorption because you don’t want swelling.