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3rd Year > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What are the predominant cations and anions of the intracellular fluid 28L

A

Cations= potassium and magnesium
Anions = proteins and phosphates

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2
Q

What are the predominant anions and Cations in extracellular fluid 14L

A

Cations= sodium
Anions= chlorine and bicarbonates

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3
Q

What are the results of a disturbed sodium balance disorder

A

Hyponatrema and hypernatremia

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4
Q

What determines the plasma osmolarity

A

Plasma sodium concentration

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5
Q

What is the most common electrolyte disorder

A

Hyponatremia

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6
Q

What is hyponatremia

A

Plasma Na concentration <135 mEq/L
Detected in 16-20% patients in urgency
Decrease in serum Na concentration and not serum sodium

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7
Q

What are the three
Types of hypotonic hyponatremia

A

Hypovolemic hyponatramia
Normovolemic hyp
Hypervolemic hyponatremia

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8
Q

What is hypokalemia and hyoerkalemis

A

k<3.5
K>5.5

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9
Q

Define isotonic,hypotonic ,hypertonic dehydration

A

Istonatremic dehydration= both loss of fluid and Na is similar
Hyponatremia dehydration= more Na is lost then water
Hyoernatremia= less Na then water is lost

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10
Q

Which patients are high risk for dehydration

A

Children
Elderly patients
Mental illness
Hospitalized in intensive care units
Are serious and can lead to death

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11
Q

Vasoconstriction decreases in the GFR IN

A

Afferent arteriole

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12
Q

Vasoconstriction increases GFR in

A

Efferent arteriol

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13
Q

What’s polyuria

A

Urine outgrowth exceeding 3L/ day

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14
Q

Oliguria

A

Low urine output 100-400 ml

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15
Q

Anuria

A

RO LESS THEN 100ml/day

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16
Q

Nocturia

A

Need to awake more then 1 time per night to void

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17
Q

Causes of hematuria

A

Tumor
Tuberculosis
Kidney stones

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18
Q

What is the early marker for a cardiovascular disease and diabetic nephropathy and vascular damage

A

Microalbuminnuria=30-399 albumin excretion a day

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19
Q

Glycosuria

A

When blood glucose exceeds 180mg/dl in the urine

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20
Q

Leukocyturia

A

More then 5 leukocytes in the urine
Sign for kidney infection

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21
Q

For diagnosis what is important

A

History taking
Physical examination
Lab tests

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22
Q

What are some physical examinations for any PCK DISEASE

A

Bimanula palpaption
Blood pressure
Anemia
Conjunctival pallor
Hyoervolemiam
Heyper volmia
Pruritus
Palpable purpura
Malar rash
Raynaud phenomenon

23
Q

If there is palpable kidneys in the abdomen it is 6 kg each

A

POLYCYSTIC KIDNEY DISEASE

24
Q

What should be cheeked for pylenoneohritis or inflaming of the kidneys

A

Check the costovertebal angle tenderness

25
What is the acid base homeostasis
Tight regulation of Hydrogen
26
What is the most important extracelluar buffer
Bicarbonate buffer
27
What is the most important intracelluar bufffer
Phosphate
28
What are the function of the renal acid base handling
Bicarbonate reabsorption Net acid secretion
29
Clinical presentations of acidemia
Hyperventilation kusmmaul breathing
30
Clinical presentation of alkalamia
Paresthesias and tetany ionized ca decreased
31
What is the hallmark of metabolic acidosis
Decrease in bicarbonate ACID PH
32
Metabolic alkalosis
PH ALKALINE HIGH BIRCARBONATE
33
Increased anion gap metabolic acidosis
KETOACIDOSIS DIABETIC UREMIA RENAL FAILURE SALICYKAYE INTOXICATION SARVATION METHANOL INTOXICATION ALCOHOL KETOACIDOSIS UNMEASURED OSMOLES LACRTIC ACIDOSIS
34
Compensatory response
Pco2 decreases Compensatory response after 15-30 minutes 5 days up to maximal
35
What is the most common acid base disorder
Respiratory alkalosis Bad prognosis PCo2 desrecese Ph decreases
36
What are the 3 types of acute kidney injury
1- prerenal AKI 60% 2- renal intrinsic AKI 30-35% 3- postrenal AKI 5%
37
Causes of prerenal AKI
1- hypovolemia 2- decrease in cardiac output 3- systemic vasodilation 4- renal vasoconstriction 5- drugs that impair autoregulation and GFR
38
Causes of the renal AKI
1- most common is ischemic and toxic acute tubular necrosis 2- macrobascukar causes 3- glormeruli and renal microvasculature ( glomerulonephritis) 4- tubulointerstitium
39
Causes of postrenal AKI
Upper urinary tract obstructions( nephrolithiasis) and lower urinary tract obstruction( benign prostatic)
40
What are the three basic structures damaged in the filtration barrier in a glomerular disease
1- capillary endothelium 2- glomerular basement membrane 3- podcytes visceral epithelium of the bowman’s capsule
41
Factors causing edema in nephrotic syndrome
1- decrease oncotic pressure 2- RAAS stimulation 3#-disturbance in sodium excretion
42
Primary nephrotic syndrome
Minimal change disease Membranous glomerulonephritis Focal segmental glomerulonephritis
43
Secondary nephrotic syndrome
Diabetic nephropathy SLE AMYloidosis Infections
44
Most common clinical finding for nephrotic syndrome
Edema
45
WHAT IS CHRONIC KIDENY DISEASE
Loss of kidney function>3 months GFR =< 90 ml/ min
46
What is the most common cause of CKD
Diabetic nephropathy
47
Causes of the CKD
1- efferent arteriole constriction 2- increase in the intraglomerular pressure 3- arteriolosclerosis at the efffrernt arteriole
48
Second common cause of CKD
Hypertension # glom and tubular thinking of the walls # hyalinization # oxygen supple diminished # ischemia and necrosis # mesangial cell try to protect and secrete TGF BETA
49
3- cause of CKD
Glomerulonephritis GBM ALTERATION POROSITY
50
4 th cause
Polycystic kidney disease Cysts compared the arterials of nephrons Obstruction of blood and oxygen supply
51
Electrolytes cause CKD
Hyperphosphatemia High postiassium Hypocalcemia Aloha 1 hydroxulase Cholecalciferipo, vit d Dilutional hyponatremia Azotemia Uremia Albuminuria
52
Hormones of CKD
Erythropoietin RAAS ALPHA 1 hydroxylase Metabolic acidosis
53
What are the predictors of the CKD
GFR Albuminuira

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