Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AFN Health Assessment > Renal > Flashcards

Renal Flashcards

1
Q

What part of nephron regulates the fx of the nephron?

A

JGA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 3 things can stimulate renin release from JGA cells

A

-Beta 1 stimulation

-decreased renal perf pressure

-decreased Na in filtrate (sensed my macula densa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cheif mineralocorticoid?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aldo does what and where in the nephron?

A

Reabsorbs Na (therfore H20 follows in collecting duct) in the DCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is ADH synthesized and released?

A

Synthesized - hypothalamus

Release - post. pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The most potent diuretic in human body

A

ANP (atrial natriuretic peptide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Prostaglandins do what to the vasculature?

A

Vasodilate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thromboxane A2 does what to the vasculature?

A

Vasoconstricts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What class of drugs should you hold w/ renal dysfunction

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 Major mechanisms of kidney

A

-Filtration

-reabsorption

-tubular secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Normal RBF

A

1200mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Normal GFR

A

125mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What % of CO is RBF?

A

20-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MAP range for autoregulation to maintain RBF

A

50-180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

W/ MAP < ___ renal filtration ceases

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Does PNS affect RBF?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Decreased RBF = __________ GFR

A

Decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most important part of H&P w/ renal pts

A

Past medical history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What labs to assess GFR

A

BUN/Cr

Cr clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What labs to assess tubular fx?

A

Urine specific gravity

Urine Osmolality

Urine Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Chief product of protein metabolism

A

Urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is urea formed

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Normal BUN

A

10-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Low BUN = what hydration status?

A

Hypervolemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

High BUN = what hydration status?

A

Hypovolemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

BUN > ____ = decreased GFR (almost always)

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Is BUN a good early indicator of reduced GFR?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

BUN does not increase until GFR is reduced by ____%

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Reliable marker of GFR

A

Creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Creatinine is almost 100% removed by __________ filtration

A

Glomerular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Normal Cr

A

0.7-1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Normal BUN/Cr ratio

33
Q

Most specific test for GFR and most reliable for renal fx

A

Cr clearance

34
Q

Normal Cr clearance

A

95-150 mL/min

35
Q

Normal specific gravity

A

1.003-1.030

36
Q

Urine Na >___ indicates damage to the renal tubules; diuretics (AKA RENAL)

37
Q

Urine Na <___ indicates hypovolemia (AKA PRE-RENAL)

38
Q

FENa of <___% = pre-renal dx

39
Q

FENa of >___% = renal dx

40
Q

3 main renal protective strategies

A
  • goal-directed fluid therapy

-isotonic crystalloids

-hemodynamics within autoregulation limits

41
Q

What AKI stage?

UOP < 0.5mL/kg/hr for >6hrs

Cr increased >1.5x

GFR decreased > 25%

A

AKI stage 1

42
Q

What AKI stage?

UOP < 0.5mL/kg/hr for >12hrs

Cr increased >2x

GFR decreased > 50%

A

AKI stage 2

43
Q

What AKI stage?

UOP < 0.5mL/kg/hr for >24hrs
Anuria for >12hrs

Cr increased >3x

GFR decreased > 75%

A

AKI stage 3

44
Q

What is the leading cuase of AKI in hospital pts

45
Q

List the 10 renal protective strategies w/ evidence

A
  1. correct anemia/minimize transfusions
  2. Maintain perfusion (MAP 80-160)
  3. Avoid nephrotoxins
  4. Use balanced crystalloids (avoid NS and HES solutions)
  5. Avoid diuretics
  6. Continue statin therapy
  7. Maintain normoglycemia
  8. Consider low-dose dexmedetomidine & NaHCO3 infusions
  9. Dexamethasone (protective effect)
  10. Early initiation of CRRT
46
Q

What meds do you hold DOS?

A

ACEI

ARBs

NSAIDs

Diuretics

47
Q

Low dose ___________ is NOT supported in the literature

48
Q

What renal protective strategy provides the greatest protective benefit?

A

Maintaining perfusion within autoregulation & adminstering appropriate fluid therapy

49
Q

Should you postpone surgery w/ pt w/ active HF w/ elective surg

50
Q

GFR <___ for > 3months = CKD

51
Q

GFR <____ represents loss of at least 50% of kidney fx

52
Q

What GFR category jumps to a high risk?

A

G3b

(G3a is very moderate/low risk)

53
Q

What GFR for stage G3a?

54
Q

What GFR for stage G3b?

55
Q

Most common CV complication of CKD?

A

Systemic HTN

56
Q

Is sevoflurane ok for renal pts?

A

Yes, all inhalation agents are safe according to the literature

57
Q

GFR <15 = ?

58
Q

What are the 2 leading causes of CKD & ESRD

59
Q

What do you check w/ hyperkalemia in renal pts?

A

12 lead EKG

60
Q

What range should you keep your preop Hgb for renal pts?

A

11-12 (not over 13!)

61
Q

What is the most important way to prevent contrast induced nephropathy (CIN)

A

Ensuring pre-procedural hydration

62
Q

T/F, Pts should be dialyzed prior to elective surgery

63
Q

Maintain what UO for renal pts?

A

0.5ml/kg/hr

64
Q

Renal pts have __________ sensitivity to CNS depressants

65
Q

What could you mix in w/ propofol to mitigate expected hypotension w/ induction?

66
Q

What co-ag test is best indicator of platelet fx?

A

Bleeding time

67
Q

Renal pts may have increased bleeding risk, even with normal coags d/t what?

A

Platelet dysfunction

68
Q

What can be done post op to help restore platelet fx?

A

Dialysis (within 24 hrs)

69
Q

What should you have readily available for induction hypotension w/ renal pts?

A

Pressors (don’t give a lot of fluids)

70
Q

What 2 drugs/drug types are less protein bound and are safer to use with pts w/ hypoalbunemia

A

Ketamine & benzos

71
Q

NMB is prolonged or shortened w/ renal pts?

72
Q

Which NMB is least effected by renal dysfunction?

A

Cis-atracurium (d/t hoffman elimination)

73
Q

Caution w/ SCh in renal pts why?

A

Increased serum K

74
Q

(t/f), SCh is ok in normo-K+ patients w/ recent dialysis

75
Q

List main anesthetic pharmacology considerations

A

-decrease propofol dose by mixing w/ ketamine

-Caution w/ SCh d/t hyperkalemia

-Cis-atracurium least effected d/t hoffman elimination

-w/ rocuronium, 1/3 renal excreted, so will have to use higher dose of suggamadex

-all inhalation agents are safe

-Opioid duration is prolonged, caution with long-acting meds

76
Q

LR ok to us w/ anuric pts?

77
Q

Replace UO w/ what IV solution?

A

0.45% saline

78
Q

What is only definitive tx for hepatorenal syndrome?

A

Hepatic transplant

79
Q

List out pathophysiology steps for hepatorenal syndrome

A
  1. Portal HTN
  2. splanchnic (GI vessels) vasodilation
  3. reduced circulatory volume
  4. RAAS activiation
  5. Renal vasoconstriction
  6. Hepatorenal syndrome

AFN Health Assessment (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions