Brainscape's Knowledge GenomeTM

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


See full index

Semester 3-Urinary > Lecture 22-CKD > Flashcards

Lecture 22-CKD Flashcards

1
Q

True or false: adult polycystic kidney disease (APCKD) is autosomal recessive

A

FALSE - autosomal dominant

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

Which gene is mutated to cause APCKD?

A

PKD1 or PKD2

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

What are the secondary complications of APCKD?

A
  • pain
  • bleeding into cyst
  • infection
  • renal stones
  • hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is CKD?

A

Irreversible and sometimes progressive loss of renal function over months to years. Renal injury -> renal tissue is replaced by extracellular matrix

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

What are the causes of CKD?

A
  • diabetes
  • hypertension
  • immunologic
  • infection (pyelonephritis)
  • genetic (APCKD)
  • obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which investigations are used to confirm a diagnosis of CKD?

A
  • BP
  • urine dipstick
  • bloods: LFT, U&E, FBC, CRP, iron
  • ultrasound for kidney size and obstruction
  • kidney biopsy
  • CT
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can CKD be prevented?

A
  • stop smoking
  • exercise
  • lose weight
  • stop PPIs and NSAIDs
  • control diabetes and hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the complications of CKD?

A
  • fluid overload
  • acidosis
  • hyperkalaemia
  • accumulation of waste products
  • altered drug metabolism
  • anaemia
  • mineral bone disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does CKD affect water/salt handling?

A

Reduces GFR -> lose ability to maximally dilute and concentrate urine, smaller glomerular filtrate but same solute load -> osmotic diuresis -> nocturia, low volime of filtrate decreases maximum ability to excrete urine therefore maximum urine volume is reduced

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

How is acidosis caused by CKD treated?

A

NaHCO3 tablets

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

How can hyperkalaemia caused by CKD be treated?

A
  • stop ACE-I, Ang receptor blocker
  • avoid drugs that increase K+
  • avoid foods with high K+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which drugs should be avoided to prevent hyperkalaemia?

A

Amiloride, trimethoprim, spironolactone

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

What can an accumulation of waste products caused by CKD lead to?

A
  • decreased appetite
  • pruritis
  • nausea and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of anaemia caused by CKD?

A
  • reduced EPO
  • iron deficiency
  • high hepcidin so cannot absorb iron from gut
  • blood loss
  • uraemia
  • CKD mineral and bone disorder
  • medication eg ACE-I
  • vit B12 and folate deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is anaemia treated?

A

If iron low, replace iron and when iron okay, start EPO treatment

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

What can mineral bone disease cause?

A
  • renal osteodystrophy: bone loss from important bones and calcification in important places
  • non-bone calcification: phosphate and calcium complex and can calcify blood vessels, deposit in joints and ulcerate skin (high mortality)
17
Q

How can mineral bone disease be treated?

A
  • decrease phosphate intake
  • phosphate binders
  • 1 alpha calcidol
18
Q

When is renal replacement therapy used?

A

When native renal function is reduced to a level that is no longer adequate to support health, usually when eGFR is 8-10 ml/min

19
Q

What is established end stage renal failure?

A

When death is likely without renal replacement therapy

20
Q

What are the symptoms of end stage renal disease?

A
  • tiredness, physical and mental
  • difficulty sleeping
  • oedema
  • nausea and vomiting
  • restless legs
  • pruritis
  • sexual dysfunction
  • increased infection
21
Q

What are the three treatment options for when kidneys fail?

A
  • haemodialysis
  • peritoneal dialysis
  • transplant
22
Q

What are the advantages of haemodialysis?

A
  • less responsibility

- days off (done 3 times a week)

23
Q

What are the disadvantages of haemodialysis?

A
  • travel time/waiting
  • big restriction of food intake
  • tied to dialysis times (4 hours)
  • 19 tablets a day
24
Q

What are the complications associated with haemodialysis?

A
  • infections in lines
  • thrombosis, bleeding
  • CVS instability
  • chronically unwell
25
Q

What are the advantages of home/nocturnal haemodialysis?

A
  • more hours but at home

- feel better and need fewer medications

26
Q

What are the advantages of peritoneal dialysis?

A
  • independence
  • less fluid/food restrictions
  • easy to travel with
27
Q

What are the disadvantages of peritoneal dialysis?

A
  • frequent daily exchanges

- responsibility

28
Q

What are the complications of peritoneal dialysis?

A
  • peritonitis
  • ultrafiltration failure
  • hernias
29
Q

What are the advantages of transplant?

A
  • decreased mortality and morbidity

- better QoL

30
Q

What are the disadvantages of transplant?

A
  • malignancy risk
  • infection risk
  • risk of diabetes and hypertension

Semester 3-Urinary (19 decks)

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