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Pathophysiology > Renal 2 (Week 13) > Flashcards

Renal 2 (Week 13) Flashcards

1
Q

What causes prerenal AKI

A

reduced blood perfusion of kidney

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2
Q

what causes reduced blood perfusion to kidneys

A

arterial hypotension
dehydration
sepsis
arterial occlusion (plaques, air bubbles, fat globules)
administration of ACE inhibitors or ARB meds

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3
Q

what do NSAIDs do

A

inhibit production of all types of prostaglandins

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4
Q

intrinsic AKI

A

damage to structures within the kidney

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5
Q

most common cause of intrinsic AKI

A

acute tubular necrosis

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6
Q

what causes acute tubular necrosis

A

renal ischemia

shock syndrome

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7
Q

causes of intrinsic AKI

A 
acute tubular necrosis
exposure to toxins such as
-myoglobin
-contrast dyes
-aminoglycosides
-infections (TSS)
- auroimmunity
-other pharmaceuticals
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8
Q

postrenal AKI due to

A

obstruction of flow in urinary system

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9
Q

causes of postrenal AKI

A

prosttatic hypertrophy or cancer
infection
improperly placed urinary catheter
nephrolithiasis (kidney stone)

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10
Q

primary means to determine presence of AKI

A

serum creatinine

urine output

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11
Q

other tests used to detect AKI

A 
urine sedimentation
urine osmolality and electrolytes
serum electrolytes
urinary specific gravity
microscopic eval of urine
blood urea nitrogen
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12
Q

what would you look for in microscopic eval of urine

A

bacteria
pieces of dead cells
-indicates infection or breakdown of cells (usually renal tubular cells)

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13
Q

blood urea nitrogen more useful for

A

monitoring chronic kidney disease

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14
Q

what happens as BUN levels increase above normal?

A

GFR decreases below normal

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15
Q

albuminuria

A

albumin (protein) in urine

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16
Q

how is chronic kidney disease defined (CKD)

A

abnormalities in kidney structure or function present for 3 months or longer

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17
Q

structural abnormalities seen in chronic kidney disease

A

albumuria
hemaaturia
presence of red cell casts
electrolyte abnormalities

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18
Q

what indicates a functional abnormality in CKD

A

drop in GFR

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19
Q

Biggest risk factor for CKD

A

diabetes

20
Q

other risk factors for CKD

A

hypertension

60 y/o or greater

21
Q

prognosis of CKD determined by

A
  • cause of kidney disease
  • GFR at diagnosis
  • degree of albuminuria
  • presence of other pathologies
22
Q

what cause of kidney disease would yield a poor prognosis

A

autoimmune process

23
Q

(increased/decreased) GFR at diagnosis yields a poor prognosis in CKD

A

decreased

24
Q

(increased/decreased) albuminuria yields a poor prognosis in CKD

A

increased

25
Q

what comorbid pathologies would yield a poor prognosis in CKD

A

diabetes
high BP
pulmonary disease
autoimmune disorders

26
Q

what does KDOQI stand for

A

Kidney Disease Outcome Quality Initiative

27
Q

what does the KDOQI categorize

A

categorizes CKD into categories based on GFR

28
Q

(higher/lower) KDOQI level indicates worse prognosis

A

higher

29
Q

how is hypertension related to CKD

A
  • can cause or be a result of CKD
  • retaining water and sodium
  • derangements of angiotensin system
30
Q

what does proteinuria have a direct proportion to?

A

risk of cardiovascular disease

31
Q

nicotine causes vaso(constriction/dilation)

A

vasoconstriction

32
Q

what does smoking do in relation to CKD

A

reduces GFR
increases BP
increases urinary albumin excretion

33
Q

what does cigarette pack years help predict

A

how fast CKD will progress

34
Q

hos is pack years calculated

A

packs per day x # years smoker

35
Q

what is the relationship between smoking and CKD

A

obesity increases risk of G5 CKD

36
Q

what does CKD progress into after several years

A

end stage renal disease

37
Q

what type of tx are patients typically undergoing at ESRD

A

dialysis (or being considered)

38
Q

what causes CKD to progress into ESRD

A
  • ongoing loss of nephron mass
  • glomerular capillary hypertension
  • proteinuria
39
Q

what happens with glomerular capillary hypertension

A

hypertrophy of remaining glomeruli; pores get larger; more protein goes through pores leading to proteinuria

40
Q

what does erythropoietin do

A

secreted by kidney; acts on marrow to produce RBC

41
Q

how is CKD related to anemia

A

decreased production and secretion of erythropoietin occurs due to damage and loss within kidney

42
Q

what stage of CKD is anemia typically present

A

C3a and beyond

43
Q

how is CKD related to osteoporosis

A

decreased elimination of phosphorus which leads to hyperphosphatemia and a decrease in calcium levels.
decreased conversion of vitamin D into its active form so less calcium absorption in gut

44
Q

what happens in CKD in relation to acid base balance

A

CKD interferes with acid-base balance; CKD patients are acidotic

45
Q

medical treatment for CKD

A

control acid/base balance
control electrolyte imbalances
antihypertensive medications (ACE inhibitors, ARBs)

46
Q

how are electrolyte imbalances controlled in CKD

A

dietary restriction

-limit potassium, sodium, or water intake

47
Q

Therapeutic treatment of CKD

A

diet- protein restriction, sodium restriction (elevated sodium increases BP and proteinuria)
exercise- achieve and maintain healthy BMI
smoking cessation- slows progression of CKD
pharmaceuticals- diuretics; treat sx/problems

Pathophysiology (19 decks)

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