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Clin Med II - Exam 4 > Paulson - Kidneys 102 > Flashcards

Paulson - Kidneys 102 Flashcards

1
Q

kidney damage or decreased kidney fxn for 3 or more months

A

ckd

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2
Q

2 mc causes of ckd

A

DM

HTN

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3
Q

leading cause of death in CKD pt’s

A

CVD

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4
Q

rf for ckd (lots!)

A

60 yo or older

htn

DM

CVD

fh ckd

recurrent UTIs

previous AKI

nephrolithiasis

transplant

AI

smoking

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5
Q

creatinine is a product of __ metabolism

and is excreted by __

A

muscle

kidneys

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6
Q

nl Cr

A

0.6-1.2 mg/dl

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7
Q

GFR represents

A

plasma filtration by glomerulus

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8
Q

nl GFR

A

90 ml/min/1.73 m2 or higher

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9
Q

gs measurement for gfr

A

inulin clearance

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10
Q

2 equations used for GFR measurement

A

MDRD

cockroft-gault

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11
Q

which GFR equation should NOT be used in AKI pt’s

A

MDRD

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12
Q

IBW should be used in GFR equations for (2)

A

obese

fluid overloaded

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13
Q

all types of proteins that might be in urine

A

proteinuria

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14
Q

nl proteinuria

A

less than 150 mg/dl

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15
Q

gold standard proteinuria measurement

A

24 hr urine → urine protein to creatinine ratio

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16
Q

causes of proteinuria

A

tubular damage

diabetic nephropathy

glomerulonephritis

rhabdo

bence-jones proteins

exercise

orthostatic proteinuria

acute sickness

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17
Q

proteinuria that is specific to CKD and pathopgnomonic to kidney damage

A

albuminuria

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18
Q

test that detects early CKD

A

albuminuria

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19
Q

preferred screening for albuminuria

A

yearly urine albumin to Cr ratio

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20
Q

nl albuminuria

A

less than 30 mg/d

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21
Q

microalbuminuria parameter

A

30-300 mg/day

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22
Q

macroalbuminuria parameter

A

higher than 300 mg/day

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23
Q

higher albuminuria is associated w.

A

quicker progression to kidney failure

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24
Q

tx for early detection of moderate-severe albuminuria in diabetics

A

ACEI

OR

ARB

→ decrease amt of albuminuria

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25
Q

CKD stages factor in (2)

A

GFR

albuminuria (albumin:Cr ratio)

26
Q

classification of CKD using GFR and ACR categories gives info about

A

risk of adverse outcomes

27
Q

ACR indicative of normal-mildly increased risk

A

A1: less than 3

28
Q

ACR indicative of moderately increased risk

A

A2: 3-30

29
Q

ACR indicative of severely increased risk

A

A3: 30 or higher

30
Q

diagnostic test for CKD

A

US

31
Q

normal kidney size on US

A

10 cm

32
Q

what US finding suggests CKD

A

shrunken kidney

33
Q

US can help differentiate btw __

and __ kidney issues

A

acute

chronic

34
Q

common meds that need renal dosing

A

NSAIDs

contrast

Mg (laxatives)

phosphorous (Fleet’s enemas)

aluminium (maalox, rolaids)

antimicrobials

diabetic meds

decongestants

antihypertensives

opioids

gabapentins

35
Q

7 complications of ckd

A

htn

hyperphosphatemia

hyperparathyroidism

anemia

hyperkalemia

acidosis

uremic encephalopahy

36
Q

tx for hyperphosphatemia (2)

A

phosphate binders → sevelgmer

diet

37
Q

tx for hyperprathyroidism

A

vit D

38
Q

tx for anemia

A

erythropoietin

argnesp

iron supplements

39
Q

goal for hgb in ckd

A

10-11

40
Q

tx for hyperkalemia (3)

A

diet

kayexelate

dialysis

albuterol

Ca

insulin

41
Q

serum K > __ indicates hyperkalemia

A

5

42
Q

sx of hyperkalemia

A

intestinal colic

diarrhea

muscle weakness

paralysis

43
Q

ekg findings of hyperkalemia

A

peaked t waves

cardiac dysrhythmia

44
Q

indications for dialysis (3)

A

gfr 10-15

unable to control volume status

hyperkalemia

45
Q

what is an avf

A

arteriovenous fistula

46
Q

avf takes __ months to mature

A

2

47
Q

types of dialysis (2)

A

hemodialysis (HD)

peritoneal (PD)

48
Q

which dialysis is given 3x/week

A

HD

49
Q

types of PD

A

continuous ambulatory (CAPD)

continuous cyclic (CCPD)

50
Q

CAPD is given

A

4-5 x/day

51
Q

CCPD is given

A

at night while asleep

52
Q

squamous epithelial cells on urine microscopy suggest

A

contaminated sample

53
Q

renal tubular cells/casts on urine microscopy suggest

A

ATN or AIN

54
Q

RBC casts on urine microscopy suggest

A

glomerulonephritis

AIN

vasculitis

55
Q

WBC casts in urine microscopy suggest

A

interstitial nephritis

pyelonephritis

inflammation

56
Q

fatty casts on urine microscopy suggest

A

nephrotic syndrome

57
Q

hyaline casts can be

A

normal

58
Q

muddy brown casts on urine microscopy suggest

A

ATN

59
Q

quad of nephrotic syndrome

A

edema

foamy urine → massive proteinuria

hypoalbuminuria

hyperlipidemia

peripheral edema

60
Q

causes of nephrotic syndrome (4)

A

DM

minimal change dz

fsgs (focal segmental glomerular sclerosis)

membranous nephropathy

61
Q

nephritic syndrome triad

A

htn

hematuria

proteinuria → less than nephrotic syndrome

coca cola urine

glomerulonephritis

oliguria

62
Q

3 causes of nephritic syndrome

A

post-infectious glomerulonephritis

IgA nephropathy

membranoproliferative glomerulonephritis

Clin Med II - Exam 4 (20 decks)

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