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Gen Med and Surg - C.U > Renal > Flashcards

Renal Flashcards

1
Q

Renal failure definition

A

Creatinine >50% above the baseline

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2
Q

Symptoms due to ureamia in renal failure

A 
Lethargy 
Confusion 
Convulsions 
Nausea and Vom 
Itching
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3
Q

Life threatening conditions caused by ureamia

A

Pericarditis and encephalopathy

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4
Q

Poor regulation of salt and water in renal failure leads to

A

oedema, hypertension and breathlessness

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5
Q

Cardiac symptoms of renal failure

A

Pericarditis, fluid overload, arrhythmias

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6
Q

GI symptoms of renal failure

A

nausea, vomiting, anorexia

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7
Q

CNS symptoms of renal failure

A

fatigue, weakness, confusion, seziures, coma

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8
Q

Investigations in renal failure

A 
FBC 
Urine 
ECG 
Imaging  - USS 
Biopsy
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9
Q

How to distinguish prerenal and renal causes

A

Pre-renal reduced perfusion - urine concentrated

Renal - salt and water loss due to problems with kidney

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10
Q

Pre renal causes of acute renal failure

A 
Cardiogenic shock 
Septic shock 
Fluid loss - haemorrhage / dehydration 
Renal artery stenosis 
Nephrotoxic drugs
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11
Q

Renal causes of acute renal failure

A 
Glomerular disease 
Acute tubular necrosis 
Ischaemia 
Vascuilitis 
Pyelonephritis
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12
Q

Postrenal causes of acute renal failure

A

Urinary tract obstruction

Rena vein thrombosis

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13
Q

ABG result in acute renal failure

A

Metabolic acidosis (with / without resp compensations)

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14
Q

ECG changes in acute renal failure

A

Peaked T waves, wide QRS, reduced P waves

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15
Q

CXR result in acute renal failure

A

overload in pulmonary oedema

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16
Q

Acute treatment of acute renal failure

A 
ABC - TREAT SEPSIS 
Treat PO and hyperkalaemia 
Monitor - BP, pulse, CVP and urinary output 
Monitor fluids 
U&Es 
Stop nephrotoxic drugs 
Nutrition
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17
Q

C ommonest extra-renal manifestation of ADPKD are?

A

Liver cysts are the commonest extra-renal manifestation of ADPKD

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18
Q

Blood tests in glomerulonephritis

A

FBC
UandEs
Blood film
ABG

19
Q

Non blood investigations on glomerulonephritis

A

Urine - dip, protein and creatinine levels
Renal US
Renal biopsy

20
Q

Treatment of glomerulonephritis

A

Treat the cause - immunosuppression
Blood pressure monitoring
Fluid control
consider renal transplan

21
Q

Triad of nephrotic syndrome

A

Oedema
Hypoalbuminaemia
Proteinuria

22
Q

Causes of acute nephritic syndrome

A

Post strep
IgA
SLE
Haemolytic uraemic syndrome

23
Q

Causes of nephrotic syndrome

A

SLE
Myeloma
DM
Glomerulonephritis

24
Q

Blood test in nephrotic syndrome

A 
Renal profile 
Albumin 
Clotting 
Cholestrol 
Glucose
25
Q

Urine tests in nephrotic syndrome

A

Protein and creatinine

Benz-Jones

26
Q

None bedside tests in nephrotic syndrome

A

Renal US

Biopsy

27
Q

Complications of nephrotic syndrome

A

Hypercoagulability
Hypercholesterolaemia
Infection

28
Q

Triad of HUS

A

Haemolysis
Thrombocytopenia
Acute renal failure

29
Q

Common cause of HUS

A

Post infection - renal failure

30
Q

Symptoms of chronic renal failure

A 
NandV 
Puritis 
Oedema 
Fatige 
SOB 
Bone pain
31
Q

Blood results in chronic renal failure

FBC
Ca2+ and Phosphate 
ABG
K+
Haematemics
A 
Chronic normocytic anaemia 
Low, high 
metabolic acidosis 
high 
low ferritin
32
Q

Treatment of chronic renal failure

A 
Low protein diet 
Fluid control 
Symptom control
Treat anaemia 
Correct calcium

Dialysis CrCl <20mL/min

33
Q

Commonest cause of glomerulonephritis

A

IgA nephropathy

34
Q

Why does nephrotic syndrome lead to a hypercoagulable state?

A

Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys

35
Q

Cause of chronic kidney disease

H
I
D
D
E
N
A 
HTN 
(recurrent) Infections 
Diabetes 
Drugs 
Exotica - SLE / vasculitis 
Nephritis
36
Q

Indications for dialysis

A

Low creatinine clearance <20 / 15 depending on guidelines

Symptomatic uraemia despite treatment

Fluid overload

Bone disease

Hyperkalaemia

37
Q

what causes the thrill you can feel in an AV fistula

A

Arterial blood from the radial artery

38
Q

which artery and vein are usually used in an AV fistula

A

radial artery and cephalic vein

39
Q

Complications of AV fistula?

A

Thrombosis
Infection
Stenosis
Bleeding

40
Q

Cycle of pathology in CKD

A

Irreversible loss of nephrons (HTN/ DM etc)
Blood flow shifts to the healthy nephrons
Hyperfiltration
Eventual sclerosis
Loss of nephron…

Leads to clinical manifesations

  • low eGFR
  • low urine production
  • waste retention
41
Q

Why is calcium low in CKD

A

Unable to produce calcitriol

so Ca2+ no reabs

42
Q

What does this low calcium in CKD lead to?

A

secondary hyperparathyroidism

43
Q

Metabolic results of CKD

A 
Water and Na2+ retention 
K+ retention 
Metabolic acidosis - can't secrete H+ and reabs HCO3- 
Hypocalcaemia 
Uraemia

Gen Med and Surg - C.U (16 decks)

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