Quiz5.Renal(3,4,5),ADME(7,8),HPLC,GC,glaucoma,applicOfChromToBioFluids

Question 1

What are the stages of chronic kidney disease ?

Answer 1

Stage 1- 90GFR normal
Stage 2 - 89-60 slight decrease
Stage 3a - 59-45 moderate
Stage 3b - 44-30 decrease
Stage 4 - 29-15 severe decrease
Stage 5 - less than 15 established renalfailure

Question 2

What biochemical changes are associated with advanced CKD?

Answer 2

Blood tests show:
increased
Urea, creatinine, phosphate
decreased
Haemoglobin, calcium

Question 3

What are complications of peritoneal dialysis?

Answer 3

1. Catheter dysfunction
2. Dehydration
3. Hyperglycaemia
4. Peritonitis

Question 4

What is a complication of haemodialysis?

Answer 4

Infection related to vascular access

Question 5

What are symptoms of glomerular disease and what can they also indicate?

Answer 5

• decreased GFR
• haematuria (urine bloody)
• proteinuria (protein in urine)
• oedema
• low blood protein
  Can indicate kidney disease

Question 6

4 facts about acute pyelonephritis

Answer 6

1. Infection ascends from urinary tract to kidney
2. Women more affected
3. Onset is rapid
4. Relapse and reinfection are common

Question 7

Symptoms of acute pyelonephritis?

Answer 7

-fever and chills
-urinary frequency up
-flank pain

Question 8

3 facts about prodrugs? Give eg

Answer 8

1. They are pharmacologically inactive
2. They are used to increase the bioavailability of the parent drug
3. They are used to mask ionisable functionality in parent drug

Aspirin is a pro drug for salicylic acid
Dabigatran etexilate is a prodrug for dabigatran

Question 9

What are required features of internal standards in quantitative HPLC?

Answer 9

1. Must be chemically and physically similar to the analyte.
2. Must not co-elute with analyte
3. Must not react with the analyte or matrix.
4. Must be chemically pure

Question 10

What is Tafluprost?

Answer 10

-Glaucoma treatment
-Should be stored in the fridge
-Is a prostaglandin analogue
-Increases drainage/outflow of the aqueous humour
-Preservative free
-Does not need to be administered at night

Question 11

Four characteristics of glaucoma

Answer 11

1. Characterised by increase of intraocular pressure of more than 21mmHg
2. Caused by insufficient drainage of the aqueous humour.
3. Characterised by visual field changes.
4. Risk of permanent damage to optic nerve or blindness if left untreated.

Question 12

PACG 2 characteristics and symptoms

Answer 12

1. PACG is a medical emergency and blindness may ensue if not treated for 1-2days
2. Permanent care is laser surgery in which a laser forms a hole in the iris to increase the floor of the aqueous humour
   symptoms
   Nausea, severe pain, redness, blurred vision

Question 13

Risk factors of chronic kidney disease?

Answer 13

-male sex and inc age
-diabetes mellitus
-HPT

Question 14

How is CKD commonly managed?

Answer 14

1. Lifestyle
2. Optimise BP control
3. Reduce CV risk
4. Review existing meds (avoiding nephrotoxic meds, ACEi/ARBS) and make dose changes if necessary

Question 15

How is AKI commonly managed?

Answer 15

After initial management
1. Stop nephrotoxic meds and adjust dose of existing meds
2. Assess fluid status and correct if necessary
3. Monitor serum creatinine, sodium, potassium, phosphate and glucose

Question 16

What should a patient do during a ‘sick day’?

Answer 16

1. Maintain fluid intake and avoid alcohol to reduced dehydration and strain on kidneys
2. Stop meds to reduce potential AKI risk (ACEi/ARBS, NSAIDs, diuretics, metformin)