Physiology - Pathophysiology of Acute Kidney Injury and Chronic Kidney Disease Flashcards
serum creatinine and serum urea are used to measure kidney function which is a more useful test
a.serum creatinine
b.serum urea
a.serum creatinine
freely filtered from the blood into the urine
rise indicates a fall in GFR
what is the equation for creatinine clearance
UV/P
urine creatinine x 24hr urine volume/ serum creatinine
put into formula using serum creatinine, age and gender
what happens to serum creatinine when GFR decreases
a.decreases
b.increases
b.increases
kidney dysfunction and an abrupt fall in GFR lasting hours to weeks is known as
a.acute kidney injury
b.chronic kidney disease
c.nephritic syndrome
d.nephrotic syndrome
a.acute kidney injury
patient in a and e experiencing breathlessness, and pitting oedema of the limbs as well as nausea and confusion patient has low blood pressure and urine dipstick test done and results show
increased urine osmolarity
increased urine specific gravity
reduced urine sodium conc
which diagnosis most likely
a.Pre renal AKI
b.renal AKI
c.post renal AKI
d.Chronic kidney disease
a.Pre renal AKI
cause =anything causing hypotension eg shock
reduced blood flow to glomerulus= reduced GFR
stimulates RAAS to try and expand ECF
increased sodium and water resorbtion
which type of AKI is caused by reduced blood pressure and perfusion to the glomerulus
a.pre renal
b.renal
c.post renal
a.pre renal
which type of AKI is caused by injury to the nephrons often after prolonged insult eg drug allergy/ autoimmune
a.pre renal
b.renal
c.post renal
b.renal
acute glomerulopnephritis
immunological injury to cells in the glomerulus
acute interstitial nephritis
toxin / drug injury to renal tubules
which type of AKI is caused by obstruction of urine in the urinary tracts `(ureters, bladder, urethra)
a.pre renal
b.renal
c.post renal
c.post renal
eg renal calculi, tumour, enlarged prostate gland
patient in a and e experiencing breathlessness, and pitting oedema of the limbs as well as nausea and confusion patient has recently started a new drug prescription, urine dipstick shows
reduced urine osmolarity
reduced urine specific gravity
increased urine sodium
bloods : hyperkalaemia, low CO2, low HCO3- and low pH
which diagnosis most likely
a.Pre renal AKI
b.renal AKI
c.post renal AKI
d.Chronic kidney disease
b.renal AKI
damge to nephron
hypoxic injury due to pre renal AKI
doesnt respond to RAAS
reduced urine osmolarity - ADH ineffective so a lot of dilute urine
reduced urine specific gravity
increased urine sodium - RAAS innnefective at increasing reabsorption
bloods : hyperkalaemia, low CO2, low HCO3- and low pH
less k+ excreted as RAAS ineffective
metabolic acidosis as less H+ excreted and less Bicaronate made
drug induced so acute interstitial nephritis
immunological induced = acute glomerulonephritis
patient in a and e experiencing breathlessness, and pitting oedema of the limbs as well as nausea and confusion patient has low blood pressure and urine dipstick test done and results show
increased urine osmolarity
increased urine specific gravity
reduced urine sodium conc
which treatment most appropriate
a.IV fluids, vasopressors
b. stop nephrotoxic drugs, limit sodium,potassiuma nd fluid intake
c.prednisolone and plasma exchange
d.stopping newly prescribed drug
e.remove obstruction and prevent UTIs
a.IV fluids, vasopressors
pre renal AKI
caused by hypotension
and treat cause of pump failure
patient in a and e experiencing breathlessness, and pitting oedema of the limbs as well as nausea and confusion
urine dipstick shows
reduced urine osmolarity
reduced urine specific gravity
increased urine sodium
bloods : hyperkalaemia, low CO2, low HCO3- and low pH
a.IV fluids, vasopressors
b. stop nephrotoxic drugs, limit sodium,potassium and fluid intake
c.prednisolone and plasma exchange
d.stopping newly prescribed drug
e.remove obstruction and prevent UTIs
b. stop nephrotoxic drugs, limit sodium,potassiuma nd fluid intake
renal AKI
supportibe treatment until tubules recover
if acute glomerulonephritis c.prednisolone and plasma exchange
if acute interstitial nephritis
d.stopping newly prescribed drug
patient experiencing, nausea , confusion and breathlessness with pitting oedema
has severe pain that comes and goes in their side
which diagnosis most likely
a.pre renal AKI
b.post renal AKI
c. renal AKI
b.post renal AKI
obstruction of urinary tract in this case -> kidney stones
could be tumour/enlarged prostate in males
patient experiencing, nausea , confusion and breathlessness with pitting oedema
has severe pain that comes and goes in their side , examination shows an kidney stones
which treatment most appropriate
a.IV fluids, vasopressors
b. stop nephrotoxic drugs, limit sodium,potassiuma nd fluid intake
c.prednisolone and plasma exchange
d.stopping newly prescribed drug
e.catheterization and prevent UTIs
e.catheterization and prevent UTIs
kidney damage and reduced glomerular filtration rate lasting more than 3 months is known as
a.acute kidney injury
b.nephritic syndrome
c.nephrotic syndrome
d. interstitial glomerulonephritis
e.chronic kidney disease
e.chronic kidney disease
typically irreversible decrease in function
hypertension, polycystic kidney disease, glomerulopnephritis , tubulointerstitial disease, chronic urinary tract obstruction and diabetes are all causes of what
a.acute kidney injury
b.nephritic syndrome
c.nephrotic syndrome
d. interstitial glomerulonephritis
e.chronic kidney disease
e.chronic kidney disease
Which of these is NOT an effect of Agt2 on the kidney
a.efferent arteriole constriction
b. increased glomerular filtration pore size
c.stimulation of collagen
d.afferent arteriole constriction
d.afferent arteriole constriction
reduced GFR leading to fluid retention causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
a.heart failure
reduced GFR also causes reduced excretion so uraemia, oedema, increased serum creatinine,pro longed drug half lives
reduced tubular function causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
b.polyuria
also nocturia
hyperkalaemia
metabolic acidosis
decreased erythropoetin production causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
c.normocytic anaemia with reduced RBC count
decreased vit D activation and calcium resorption causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
d.osteomalacia
build up of nitrogenous wast compounds causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
e.itchy skin
activation of RAAS causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.itchy skin
f.hypertension
f.hypertension
abnormal metabolism and retained toxins causes which complication of CKD?
a.heart failure
b.polyuria
c.normocytic anaemia with reduced RBC count
d.osteomalacia
e.seizures and reduced reproductive function
f.hypertension
e.seizures and reduced reproductive function
what are the 2 main targets when trying to slow disease progression of CKD
maintain normal BP
reduce proteinuria
which drugs are used to reduce agt2 activity to slow ckd progression
a.ACEi
b.diuretics
c.CCBs
d.statins
e.oral bicarbonate
a.ACEi
which drugs are used to reduce BP activity to slow ckd progression
a.ACEi
b.diuretics
c.CCBs
d.statins
e.oral bicarbonate
b.diuretics
c.CCBs
what drug is given to treat hyperlipidaemia as a complication of CKD
a.ACEi
b.diuretics
c.CCBs
d.statins
e.oral bicarbonate
d.statins
what drug is given to treat metabolic acidosis as a complication of CKD
a.ACEi
b.diuretics
c.CCBs
d.statins
e.oral bicarbonate
e.oral bicarbonate
