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Nick's MD2 > Renal > Flashcards

Renal Flashcards

1
Q

What are the 5 complications for renal failure?

A 
Potassium
Fluid state
Anaemia
Bone density
Uraemia
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2
Q

when are you classed with stage 5 CKD

A

when GFR less than 15 ml/min

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3
Q

How should you monitor CKD?

A

eGFR

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4
Q

main medication to help CKD

A

ACEi

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5
Q

if a patient talks about a sore throat and then getting kidney failure straight away.. what does this point to

A

IgA nephropathy

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6
Q

if a patient talks about a sore throat and then getting kidney failure 2 weeks later… what does this point to

A

Post-strep nephropathy

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7
Q

Which GNs are mostly nephrotic?

A

Minimal change

Focal sclerosing

Membranous

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8
Q

Which GNs are mostly nephritic?

A

crescent associated GN

IgA nephropathy

Post strep (diffuse proliferative)

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9
Q

Treatment of CKD with ACEi is contraindicated in

A

Bilateral renal artery stenosis

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10
Q

in severe CKD where fluid overload can be a problem - which drug should you use to treat them and why

A

high dose frusemide - because it needs to enter a functional renal tubule to exert its effect

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11
Q

how do you define chronic kidney disease

A

GFR less than 60ml/min for more than 3 months (microalbuminaemia, proteinuria, glomerular haematuria, pathological abnormality, anatomical abnormality)

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12
Q

2 main causes of CKD in Australia

A

Diabetic nephropathy

Glomerulonephritis

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13
Q

What percentage of body water is intracellular?

A

67%

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14
Q

What percentage of body water is interstitial?

A

22%

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15
Q

What percentage of body water is intravascular?

A

11%

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16
Q

If you give 3L of saline, where will it distribute to?

A

Extracellular space: 2L to interstitial and 1L intravascular

17
Q

If you give 3L of 5% dextrose, where will it distribute to?

A

Equally between all spaces: 2L intracellular and 1L extracellular (666ml interstitial and 333ml intravascular)

18
Q

If you lose 3L of fluid through diarrhoea, which compartments will lose the fluid?

A

Diarrhoea is sodium rich, thus all loses will be extracellular (2L interstitial and 1L intravascular)

19
Q

If you lose 3L of fluid through fasting, which compartments will lose the fluid?

A

Equally between all spaces: 2L intracellular and 1L extracellular (666ml interstitial and 333ml intravascular)

20
Q

eGFR is only accurate when…

A

Creatinine is in a steady state (if rising - overestimates, falling - underestimates)

21
Q

How can you tell by a clinical test if AKI is glomerular in origin?

A

Haematuria with abnormal RBC morphology

22
Q

If the urine is normal or pretty bland - what does it suggest as a cause of AKI?

A

pre-renal or acute tubular necrosis

23
Q

how can you tell the difference between pre renal AKI and ATN?

A

pre renal AKI - concentrating ability still intact

24
Q

Clues pointing to CKD over AKI

A
  • pre existing illness
  • DM, HTN, age, vascular disease
  • small, echogenic kidneys by ultrasound
  • endocrine abnormalities
25
Q

how do you decide whether a patient with AKI requires dialysis?

A

AEIOU

Acidosis
Electrolyte
imbalance - hyperkalaemia Intoxication
Oedema
Uraemia
26
Q

AKI staging is based on what 2 criteria

A

creatinine and urine output

27
Q

3 key assessments in someone with AKI

A

volume status
urine studies
renal ultrasound

28
Q

Define AKI

A

1.5 x increase in creatinine from most recent baseline
OR
6 hours of oliguria

29
Q

management of hyponatraemia

A

if dehydrated- replace fluid with normal saline
normal volume - fluid restrict or increase free water clearance
volume overloaded - fluid and Na restriction, diuretics

30
Q

what is the difference is pathology between macro and micro haematuria

A

micro = need to consider glomerular causes

macro = NOT going to be glomerulonephritis

31
Q

Painless, macroscopic haematuria. What is the Dx?

A

Cancer until proven otherwise

32
Q

What percentage of creatinine is reabsorbed in the kidney?

A

None

33
Q

Which substance is responsible for constriction of the efferent arteriole in the kidney?

A

Angiotensin II

34
Q

Define oliguria

A

Less than 500ml of urine per day

35
Q

Define anuria

A

Less than 100ml of urine per day

36
Q

Staging for CKD

A 
Normal eGFR over 90
Mild 60-90
Moderate 30-59
Severe 15-29
Kidney failure less than 15

Nick's MD2 (21 decks)

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