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CMS > Renal > Flashcards

Renal Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what endocrine work do the kidneys do?

A

produce erythropoietin
activates vitamin D
controls blood pressure via RAAS

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2
Q

what are some renal investigations that can be done by looking at the urine?

A

dipsticks - glucose/blood/protein/WBC’s
microscopy
microbiology

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3
Q

what are some renal investigations that can be done by looking at the blood?

A

electrolytes
glomerular filtrate rate
specific tests

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4
Q

what imaging tests can be done for renal?

A 
plain xrays
intravenous urogram
ultrasound
MRI
CT
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5
Q

what investigations can be done via looking at the tissue?

A

renal biopsy

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6
Q

what are some consequences of renal failure?

A 
oedema
high potassium - cardiac arrest
accumulation of waste products - ureamia 
drug metabolism
acidosis
lack of erythropoietin
lack of vit d 
high bp
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7
Q

what are some causes of renal failure?

A 
diabetes
high bp
artherosclerosis
autoimmune - glomerulonephritis
cancer - myeloma
hypovolaemia
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8
Q

what drugs can cause renal failure by exacerbating pre existing disease?

A 
NSAIDS
ACE inhibitors
diuretics
tetracyclines
idiosyncratic reactions - penicillin/NSAIDS
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9
Q

what infections can cause renal failure

A

recurrent ascending UTI’s

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10
Q

what kind of obstructions can cause renal failure?

A

prostate
stones
abdominal/pelvic stones
polycystic kidney disease

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11
Q

what are the 2 forms of renal disease?

A

acute

chronic

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12
Q

what is acute renal failure?

A
  • acute loss of renal function - normal/low absent urine -output
  • life threatning - hyperkaleamia/uraemia, fluid retention, hypertension
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13
Q

is acute renal failure reversible?

A

often, yes

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14
Q

does acute failure happen in healthy kidneys?

A

usually pre existing disease

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15
Q

how to manage acute failure?

A

manage underlying cause
treat effects - potassium/fluid removal or replacement
dialysis?

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16
Q

what is chronic renal failure?

A

gradual progression of renal impairment
end stage renal disease where GFR is 5% of norm
progression depends on underlying cause and modifying factors

17
Q

what are the most common causes of chronic renal failure?

A 
diabetic retinopathy
glomerulonephritis
chronic renal infection
polscytic renal disease
atherosclerosis
high bp
18
Q

what are the effects of chronic renal disease?

A

uraemia - reduced immunity/platelet function/malaise/nausea/itch
fluid retention - hypertension/odeama
lack of erythropoietin - anaemmia
renal osteodystrophy - secondary hyperparathyroidism

19
Q

how to treat chronic renal failure?

A

avoid further damage - control hypertension/diabetes, immunosuppresion, avoid/reduce drugs, treat any obstructions

  • correct anaemia - erythropoietin injections
  • correct vit d deficiency
20
Q

types of dialysis?

A

haemodyalasis

peritoneal dialysis

21
Q

what are some problems that may rise from transplant?

A

rejection - acute/chronic
immunosuppresion - increased infection/malignancy risk
high cardiovascular mortality

22
Q

what is a UTI?

A

cystitis
increased risk if impaired bladder emptying or low urinary flow rates
e.coli gram negative bacilli

23
Q

symptoms of UTI and management?

A

dysurua
pain
antibiotics/increased fluid intake

24
Q

what may cause a urinary tract obstruction?

A

prostate
renal calculi
external compression - abdonminal/pelvic malignancies

25
Q

what oral problems may renal osteodyrstrophy cause?

A

loss of lamina dura
radiolucencies
problems with bone healing post extraction

26
Q

why may renal patients have greater bleeding tendencies?

A

abnormal platelet production, diminished factor 3 and von wilebrands factor

27
Q

when should you treat a dialysis patient in the dentist and why?

A

day after dialysis once heparin worn off

28
Q

what patients may require pep before an invasive procedure?

A 
polycystic kidneys
peritoneal dialysis
some on haemodialysis
renal transplant
discuss with renal team
29
Q

what orofacial manifestations may be seen in renal patients?

A

osseus lesions - loss of LD, osteoporosis, osteolytic areas, secondary hyperparathyroidism = giant cell lesion, abnormal bone repair

30
Q

what oral signs may a chronic renal failure patient experience?

A

dry mouth, halitosis, metallic taste
insidious oral bleeding/purpura, salivary gland swelling
calculus accumulations, oral ulceration and changes b/c anaemia

31
Q

chronic renal failure in children may cause what orally?

A 
jaw growth retarded
tooth eruption delayed
malocclusion
brownish tooth discolouration
prev tetracycline staining
low caries rate/less perio disease

CMS (42 decks)

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