Brainscape's Knowledge GenomeTM

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


See full index

302- metabolic and renal > kidney tests and diseases > Flashcards

kidney tests and diseases Flashcards

1
Q

what is the hierarchy of kidney function tests from low to high?

A
  • serum- urea
  • 24hr creatinine clearance
  • serum creatinine
  • EGFR estimated from serum creatinine
    (this is done using the EPI, MDRD or cockcroft-gault formulas)
  • direct GFR measurement is the most accurate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the relationship between plasma creatinine and GFR?

A
  • creatinine has poor sensitivity for GFR and it only starts to rise once 50% of the glomeruli are lost
  • so if EGFR is raised then it means GFR has already halved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what happens to potassium levels if your kidneys are not functioning well?

A

you get hyperkalaemia

as kidney function decreases the kidneys cannot filter out the potassium

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

what is normal EGFR?

A

90 or higher
an EGFR above 60 is okay for those above 60
an EGFR below 60 is abnormal

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

what is normal serum urea level?

A

2.5 – 7.8 mmol/L

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

what is the normal serum creatinine level?

A

60 to 110 micromoles per liter (μmol/L)

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

what is the na+ range?

A

133-146mmol/L

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

what is the K+ range?

A

3.5-5.3mmol/L

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

what is the mg2+ range?

A

0.7-1mmol/L

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

what are the major intracellular cations and anions ?

A
  • potassium
  • magnesium

anions:
protein
ATP

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

what is are the major extracellular anions and cations?

A

cations:
- sodium
anions:
- chloride and bicarbonate

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

what is the effect of insulin potassium?

A

insulin increases the activity of the sodium/potassium ATPase so more potassium enters inside the cells- increasing intracellular potassium concentration, so decreasing the serum potassium levels

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

what is the normal range for creatinine kinase?

A

30-170iu/l

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

what happens to potassium during metabolic alkalosis?

A

the PH of the ECF increases, so hydrogen ions move from inside cells to the extracellular fluid to try to balance the PH.

the charges need to be balanced so the positive hydrogen leaving the cell is swapped fora positive potassium entering the cell

this results in hypokalaemia

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

what happens to potassium during metabolic acidosis?

A

hydrogen leaves extracellular fluid and enters the cells. The hydrogen is swapped for a potassium which results in hyperkalaemia

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

what does albuminuria suggest?

A

nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the best method to evaluate albuminuria?

A

measure the albumin to creatinine ratio

18
Q

what are the different types of stones that can form?

A
  • > calcium oxalate
  • > calcium phosphate
  • > uric acid
  • > cystine
  • > struvite
19
Q

what is renal tubular acidosis?

A

Renal tubular acidosis (RTA) is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine.

20
Q

what are causes of calcium oxalate stone formation?

A 
urinary factors:
- high urine calcium 
- high urine oxalate 
- high urine citrate 
dietary factors:
- low calcium diet 
- low potassium 
- low fluid intake 
- high oxalate diet 
- high animal protein intake
21
Q

what causes calcium phosphate stones to form?

A

renal tubular acidosis

22
Q

what is the cause of uric acid crystal formation?

A

if uric PH is <5.5

this can be due to chronic diarrhoea, gout, diabetes and obesity

23
Q

what is the cause of cystine crystal formation?

A

occurs when someone has cystinuria- genetic condition where too much cystine is excreted

24
Q

struvite stones cause?

A

made from magnesium ammonium phosphate

- caused by UTI by proteus and klebseila as they increase urease and increase Ph making it favourable for precipitation

25
Q

what blood results suggest calcium phosphate stone?

A
  • low bicarbonate

- low potassium

26
Q

what blood results suggest calcium oxalate stone?

A
  • serum calcium >10mg/dl
27
Q

what blood results suggest uric acid stone?

A

uric acid >6mg/dl

28
Q

what test would suggest struvitw stone?

A
  • haematuria

- UTI

29
Q

what are ways in which decompression can be preformed?

A
  • percutaneous nephrostomy

- ureteral stenting

30
Q

why would you preform decompression of the kidney?

A
  • if there is bilateral obstruction and AKI

- sign of sepsis

31
Q

what is an indirect sign of obstruction on imaging?

A

hydronephrosis- swelling up of the kidney

32
Q

when is a renal stone treated with medical expulsive therapy?

A
  • if it is less than 10mm

- if symptoms are controlled

33
Q

what can be given medically to hep to expel renal stones?

A
  • increase fluid intake to 2l/day
  • give NSAID
  • give antiemetic (metoclopramide)
  • aloha blocker (tamsulosin)
  • CCB (nifedipine)

this can be done for up to 6 weeks

34
Q

what is the treatment of acute renal colic?

A

NSAIDS
opioids
avoid giving fluid as it can make pain worse

35
Q

what is the cause of type 1 renal tubular acidosis?

A

the hydrogen ATPase pump doesn’t work and hydrogen ions are not excreted

36
Q

why can RTA cause calcium phosphate kidney stone formation?

A
  • because it results in metabolic acidosis
  • which causes an increase in calcium excretion without calcium absorption
  • this can lead to increased bone turnover to increase the calcium
  • this increases the risk of forming calcium phosohate stones
37
Q

what is the cause of type 2 RTA?

A

brush border cells of the proximal tubule are unable to re absorb bicarbonate

so bicarbonate is lost in the urine, and there is not enough to counter balance h+

38
Q

what happens in type 4 RTA?

A

proximal tubule doesn’t respond to aldosterone

so sodium potassium pump won’t work efficiently and there will be hypponatremia and hyperkalaemia in the blood

less h+ and ammonium will be released in the urine

39
Q

what are features of type 2 RTA?

A
  • proximal tubule unable to reabsorb HCO3-
  • > Metabolic acidosis
  • > hypokalaemia
  • > urine ph <5.5
40
Q

what are features of type 1 RTA?

A
  • distal tube unable to secrete H+
  • metabolic acidosis
  • hypokalaemia
  • urine PH >5.5
41
Q

what are features of type 4 RTA?

A

aldosterone resistance in distal tube

  • metabolic acidosis
  • hyperkalaemia
  • urine PH <5.5

also get decreased ammonia excretion

42
Q

what are treatments of RTA?

A

potassium citrate

correct acidosis, potassium

302- metabolic and renal (8 decks)

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