Renal disease Flashcards

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1
Q

The 3 main components of the renal tract are?

A
  • kidneys
  • ureter
  • bladder
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2
Q

what are the 3 main functions of the renal system?

A
  1. excretory function
  2. acid base balance
  3. endocrine function
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3
Q

what is the function of erythropoietin?

A

to stimulate red blood cell production

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4
Q

what are the 3 endocrine functions of the renal system?

A
  • produce erythropoietin
  • activate vit D
  • control blood pressure
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5
Q

what is polyuria?

A

abnormally large production of urine

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6
Q

what is oliguria?

A

abnormally small amount of urine produced

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7
Q

what is anuria?

A

the failure of the kidneys to produce urine

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8
Q

when blood is present in urine, this is called?

A

haematuria

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9
Q

proteinuria is when…

A

there is abnormally high protein levels detected in the urine

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10
Q

what is dysuria?

A

painful or difficult urination

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11
Q

A high urea content in urine is called..?

A

uraemia

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12
Q

hyperkalaemia is..?

A

high potassium content

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13
Q

dialysis is defined as…

A

renal replacement therapy

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14
Q

name the 4 ways to investigate the renal system.

A
  1. urine
  2. blood
  3. imaging
  4. tissue
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15
Q

what are the 3 tests that can be done to investigate the urine?

A
  1. dipstick
  2. microscopy
  3. microbiology
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16
Q

what will show up in the microscopy?

A

abnormal cells of crystals

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17
Q

what are the 4 things tested for in a dipstick test

A
  • white blood cells
  • blood
  • protein
  • glucose
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18
Q

name 3 electrolytes

A
  1. potassium
  2. urea
  3. ceratinine
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19
Q

what does GFR stand for?

A

glomerular filtration rate

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20
Q

what are 3 categories used to grade renal failure

A
  • mild
  • moderate
  • severe
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21
Q

what are the GFR ranges of each of these categories?

A

mild = 20-50ml/min
moderate = 10-20 ml/min
severe =

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22
Q

4 ways to image the renal tract?

A
  • plain radiograph
  • intravenous urogram
  • ultrasound
  • MRI
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23
Q

what can hyperkalaemia cause?

A

cardiac arrest

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24
Q

if there is an excretion failure and uraemia occurs what are 6 possible consequences/signs? §

A
  • malaise
  • anorexia
  • reduced immunity
  • reduced platelet function
  • itch
  • eventually coma/death
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25
Q

what is it called when you have a life threatening acid-base balance possibly caused by renal disease?

A

acidosis

26
Q

explain how a patient may get renal osteodystrophy?

A

renal failure = lack of vitamin D activation = bone disease in chronic situations

27
Q

give 5 basic causes of renal failure.

A
  1. systemic disease
  2. hypovolaemia
  3. drugs
  4. infections
  5. obstruction
28
Q

what are 5 systemic diseases that can commonly lead to renal failure?

A
  • cancer
  • diabetes
  • hypertension
  • atherosclerosis
  • auto-immune (glomerulonephritis)
29
Q

define hypovolaemia?

A

decreased volume of circulatory blood

30
Q

what are 3 causes of hypovolaemia?

A
  1. massive haemorrhage
  2. sepsis
  3. O+V
31
Q

name 4 drugs that can exacerbate pre-existing renal disease.

A
  • NSAIDs
  • tetracycline
  • diuretics
  • ACE inhibitors/angiotensin 2 blockers
32
Q

name 4 possible obstructions that can cause renal failure?

A
  • prostate
  • stones
  • abdominal or pelvic masses
  • polycystic kidney disease
33
Q

true or false - polycystic kidney disease is genetic.

A

True

34
Q

what are the two forms of renal failure?

A
  • acute

- chronic

35
Q

what is acute renal failure defined as…

A

the RAPID LOSS of renal FUNCTION

36
Q

what can the urine output be like in acute renal failure?

A
  • normal
  • low
  • absent
37
Q

what are the 4 things that make acute renal failure life threatening?

A
  • hyperkalaemia
  • uraemia
  • fluid retention
  • hypertension
38
Q

is acute renal failure reversible?

A

yes often

39
Q

how is ACUTE renal failure commonly brought about?

A

pre-exisiting diseased kidneys encounter an acute insult such as NSAIDs

40
Q

3 stages of management of acute renal failure.

A
  1. identify and manage cause
  2. treat effects (K, fluid removal, replacement)
  3. dialysis - sometimes
41
Q

what is chronic renal failure defined as?

A

gradual progression of renal impairment

42
Q

what does ESRD stand for?

A

end stage renal disease

43
Q

what is the GFR for ESRD?

A

5% of normal

44
Q

what are 2 factors that influence the progression rate of CRF?

A
  • underlying cause

- modifying factors

45
Q

what are the 6 main causes of renal disease?

A
  • diabetes
  • hypertension
  • atherosclerosis
  • chronic renal infection
  • polycystic kidney disease
  • glomerulonephritis
46
Q

what are the 4 effects of CRF?

A
  • uraemia
  • fluid retention
  • lack of erythropoietin
  • renal osteodystrophy
47
Q

give 5 consequences of uraemia (high urea levels in blood)

A
  • reduced immunity
  • reduced platelet function
  • malaise
  • nausea
  • itch
48
Q

what are the two types of dialysis?

A
  1. haemodialysis (blood)

2. peritoneal dialysis

49
Q

3 reasons why transplant is the optimal treatment for renal disease?

A
  • normal renal function
  • no dietary restrictions
  • normal energy and fertility
50
Q

3 issues with renal transplant are…

A
  • rejection (acute or chronic)
  • immunosuppresants required
  • high cardiovascular mortality
51
Q

what are two main disadvantages of immunosuppresants?

A
  • increased infection risk

- increased risk of malignancy

52
Q

what are 3 urinary tract diseases?

A
  • urinary tract infections
  • urinary tract obstruction
  • urinary tract malignancy
53
Q

which type of bacteria usually causes cystitis?

A

gram -ve bacilli ie E.coli

54
Q

what are 4 main symptoms of UTI?

A
  • dysuria
  • frequency
  • cloudy/offensive smelling urine
  • suprapubic pain
55
Q

2 forms of treatment for UTIs? -

A
  • increased fluid intake

- antibiotics

56
Q

what are the tests to detect a UTI?

A
  • dipstick indicator

- microscopy, culture and sensitivity

57
Q

what are 3 possible obstructions of the urinary tract?

A
  • prostate
  • renal calculi (stones)
  • external compression (abdominal or pelvic malignancy)
58
Q

what % of the population will experience renal calculi?

A

5%

59
Q

what are the symptoms and treatment options for renal calculi?

A

Extremely painful!

  • give them time to pass
  • surgery
  • lithotripsy (ultrasound shock waves)
60
Q

what are the main dental aspects of renal disease?

A
  • take care with prescribing NSAIDs
  • growth/tooth eruption delayed in children = secondary to anaemia
  • prone to post op infection/bleeding
  • oral opportunistic infections/stomatitis
  • renal osteodystrophy
  • avoid regional blocks if severe bleeding tendency
  • CRF = halitosis, dry mouth, metallic taste
  • calculus accumulation
  • oral ulceration due to anaemia
  • secondary parathyroidism = giant cell lesion
  • osseus lesions may occur
  • salivary gland swelling