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BDS3 BAMS Special Care Dentistry > Liver and Renal Disease > Flashcards

Liver and Renal Disease Flashcards

1
Q

What is function of the Loop of Henle ?

A

Water leaves by osmosis.

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2
Q

What is the function of the collecting tubule ?

A

Surplus or waste ions and molecules flow out as urine.

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3
Q

What is the function of distal convoluting tubule ?

A

Sodium uptake by active transport and water loss by osmosis.

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4
Q

What is the function of the proximal convoluting tubule ?

A

Reabsorbs glucose, amino acids, uric acid, inorganic salts.

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5
Q

When should dental treatment be scheduled after renal dialysis ?

A

The day after receiving.

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6
Q

What anticoagulant will a patient requiring renal dialysis be on ?

A

Heparin.

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7
Q

How is heparin administered ?

A

Injection.

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8
Q

What is the action of heparin as an anticoagulant ?

A

Activates antithrombin.

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9
Q

Describe haemodialysis.

A

Blood filtered outside the body to remove waste products.

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10
Q

How many time weekly is haemodialysis normally carried out ?

A

3x weekly.

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11
Q

Describe peritoneal dialysis.

A

Fluid put into the abdomen through catheter to remove waste products.
Drained and then replaced with new fresh fluid.

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12
Q

What is the benefit of peritoneal dialysis ?

A

Can be carried out at home.

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13
Q

What is a arteriovenous fistula used for ?

A

Above the wrist haemodialysis - surgical connection made by joining artery and vein to allow increased flow access site for dialysis.

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14
Q

How is Hep A transmitted ?

A

Faeco-oral route.

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15
Q

What particle is present in Hep B serum ?

A

Dane particle.

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16
Q

What treatment is given to patient with Hep C ?

A

Solosbuvir.

17
Q

What is an example of a drug which can cause drug-induced hepatitis ?

A

Halothane - previously used for GA.

18
Q

What is the primary type of malignancy in the liver ?

A

Hepatocellular carcinoma.

19
Q

What is another name for non-alcoholic fatty liver disease ?

A

Non-alcoholic steatohepatitis.

20
Q

What other conditions is non-alcoholic steatohepatitis commonly related to ?

A

Obesity and type 2 diabetes.

21
Q

Describe liver cirrhosis.

A

Liver cell necrosis and inflammation followed by -
- Replacement with fibrotic tissue.
- Vascular derangement.
- Regenerating nodules of hepatocytes.

22
Q

What is UKELD score ?

A

Scoring system used to decide who might benefit from a liver transplant for most patients.

23
Q

What is the minimum UKELD score required to be placed on liver transplant waiting list ?

A

49.

24
Q

What glycoprotein hormone regulates platelet production ?

A

Thrombopoietin.

25
Q

What glycoprotein hormone regulates RBC production ?

A

Erythropoietin.

26
Q

What clotting factors are produced in hepatocytes ?

A

I, II, VII, IX, X, XI, prothrombin, fibrinogen, protein C and S.

27
Q

What clotting factors are produced in sinusoidal cells ?

A

VW factor and VIII.

28
Q

What is the first line analgesia which should be recommended for patient with liver cirrhosis ? Why ?

A

Paracetamol.
NSAIDs impair renal function.

29
Q

What LA should be used for patients with advanced liver disease ? Why ?

A

Articaine - metabolised (90-95%) in tissues (compared to lidocaine which is predominantly metabolised in the liver).

30
Q

What are common signs of liver disease ?

A

Spider navei - particularly with alcoholic liver disease.
Jaundice.
Bruising.
Fatigue.
Malnutrition.
Finger clubbing.
Erythema migrans.

31
Q

Name some causes of liver disease ?

A

Excessive alcohol.
Paracetamol overuse.
Drug intoxication.
Hepatitis viral infection.
Obesity - NAFLD.
Genetic conditions.
Autoimmune disease.
Hepatocellular carcinoma.

32
Q

What are 2 genetic conditions/autoimmune conditions which can affect the liver ?

A

Primary biliary cirrhosis.
Haemochromatosis - excess iron deposited all around the body.

33
Q

What is the progression of liver disease ?

A

Healthy liver.
Hepatitis.
Cirrhosis.
Compensated liver disease.

34
Q

What drugs are contraindicated in liver-kidney disease ?

A

Lidocaine.
NSAIDs.
Systemic antifungals.
Metronidazole.

BDS3 BAMS Special Care Dentistry (7 decks)

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