Nephrology

Question 1

what numbers diagnose AKI

Answer 1

rise of SCr by 26.5 within 48hrs or 1.5x baseline within 7 days
urine volume <0.5mL/kg/h for 6 hours

Question 2

what is oliguria? what is anuria

Answer 2

oliguria <400ml urine/ d
anuria <100ml urine/ d

Question 3

T or F: eGFR is reliable to diagnose AKI

Answer 3

F- eGFR not accurate in AKI

Question 4

instead of using IBW in obese pts, ______ should be used. If the pt is <IBW, then use ________

Answer 4

obese = adjBW
<IBW = use ABW

Question 5

how to prevent contrast induced AKI

Answer 5

pre and post op prophylaxis IV fluids

Question 6

how to prevent perioperative AKI

Answer 6

hold RAAS antagonists
volume reduction/ prevention of hypotension

Question 7

how to prevent AKI from cancer chemo and tumor lysis

Answer 7

hydration w/ IV fluids and allopurinol qd for a few days before chemo to prevent uric acid nephropathy

Question 8

what is considered severe hyperkalemia? what should be the first step to monitor?

Answer 8

K >6.5
cardiac monitoring for ECG changes (if yes -= start Calcium gluconate)

Question 9

what does calcium gluconate do in hyperkalemia

Answer 9

membrane stabilization in ECG changes

Question 10

what should you do in hyperkalemia if there are no ECG changes

Answer 10

salbutamol or insulin + dextrose IV
(both if severe >6.5)

then sodium bicarb IV if acidosis

Question 11

which agents shift K+ into cells

Answer 11

sodium bicarb, insulin, salbutamol

Question 12

how does sodium polystyrene work in hyperkalemia

Answer 12

eliminates K with sorbitol

Question 13

CKD is the progressive replacement of normal kidney structure with

Answer 13

interstitial fibrosis

Question 14

what are the numbers for dx of CKD

Answer 14

3 mths
CFR <60 or ACR >3mg/mmol
presence of markers of kidney damage with =>3 mths w/ or without decrease in GFR

Question 15

what is 1st line tx for BG control in CKD

Answer 15

metformin, SGLT2

Question 16

metformin should be avoided if CrCL is <

Answer 16

30

Question 17

what is 1st and 2nd line tx for BP control in CKD? what is the target?

Answer 17

1st = ACEi/ARB
2nd = DHP-CCB or diuretic

target 120

Question 18

what are the 3 CKD complications

Answer 18

hyperphosphatemia
secondary hyperparathyroidism
anemia + iron def

Question 19

waht is 1st line tx for hyperphosphatemia? what if the person had hypercalcemia as well?

Answer 19

calcium carbonate

hypercalcemia = noncalcium binders (sevelamer, lanthanum, sucroferric oxyhydroxide)

Question 20

what is the tx for secondary hyperparathyroidism

Answer 20

vit D analoges (alfacalcidol, calcitriol)
calcium mimetics (cinacalcet)

Question 21

T or F: cinacalcet has to be taken with food

Answer 21

T to improve bioavailability

Question 22

when should ESAs be started in CKD? what is the target?

Answer 22

if Hb 90-100
target 110

Question 23

what should be started before ESAs in CKD

Answer 23

iron to boost stores

Question 24

what is the earliest responding lab value to iron tx

Answer 24

reticulocyte count

Question 25

when to follow up about CKD

Answer 25

q3mths