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Renal > Renal disease > Flashcards

Renal disease Flashcards

1
Q

how do most renal patients present?

A

asymptomatic- through blood tests

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2
Q

how do most renal patients present?

A

asymptomatic- through blood tests

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3
Q

what would lots of proteinuria look like in urine?

A

frothy

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4
Q

what are the functions of the kidney

A

excretes fluid, maintains acid base and electrolytes, vitamin D metabolism, excretion of urea

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5
Q

what type of breathing is associated with metallic acidosis

A

kussmals breathing

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6
Q

are renal disease patients likely to present with dyspepsia?

A

yes- can die from it

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7
Q

what drugs are renal consultants most concerned a out

A 
ACEI- prevent renal failure BUT
 dehydrating effect
Gentamicin- nephrotoxic
PPI- acute kidney injury
contrast nephropathy- after radiology with contrast (dehydrated/ renal impairment problem)
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8
Q

what sign is a medical emergency

A

pericardial rub- uraemia

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9
Q

where are palpable kidneys found

A

autosomal dominant kidney disease

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10
Q

what is an important measurement in renal disease

A

blood pressure (

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11
Q

what is accelerated hypertension

A

a medical emergency- diastolic BP >120, papilloedema, end organ decompensation (fits, heart failure, acute renal failure)

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12
Q

what nail findings are common in acute illness or hypoalbuminaemia

A

leukonychia, splinter haemorrhages (nephritits, vasculitis)

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13
Q

what do scratch lesions that do not blanche represent?

A

vasculitis, acute glomerulonephritis

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14
Q

what is a smokey urine likely to be caused by

A

acute kidney injury requiring dialysis- muscle breakdown, dehydration, injury which occurs during earthquakes

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15
Q

what does specific gravity show?

A

urine concentration

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16
Q

what does leukocyte/ nitrates tell us on urinalysisi

A

UTI

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17
Q

how do you determine urine protein quantification

A

24 hour collection (

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18
Q

when do we worry about proteinurea

A

> 0.5g per day

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19
Q

what is seen by hyperkalaemia on an ECG

A

tall tented T waves

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20
Q

what GFR is classed as renal failure

A
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21
Q

what is acute kidney injury

A

decline in GFR over hours/ days/ weeks, with/without oliguria, in a patient with normal or impaired renal function

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22
Q

what is a classic presentation in nephrotic syndrome

A

proteinuria >3g per day, hypoalbuminaemia, oedema- periorbital (which is not present in heart failure)

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23
Q

what is nephritis syndrome

A

patient has nephritis- AKI, oliguria, oedema/ fluid retention, hypertension active urinary sediment

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24
Q

what is nephritis syndrome

A

patient has nephritis- AKI, oliguria, oedema/ fluid retention, hypertension active urinary sediment

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25
Q

what would lots of proteinuria look like in urine?

A

frothy

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26
Q

what are the functions of the kidney

A

excretes fluid, maintains acid base and electrolytes, vitamin D metabolism, excretion of urea

How well did you know this?
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3
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27
Q

what type of breathing is associated with metallic acidosis

A

kussmals breathing

How well did you know this?
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28
Q

are renal disease patients likely to present with dyspepsia?

A

yes- can die from it

How well did you know this?
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3
4
5
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29
Q

what drugs are renal consultants most concerned a out

A 
ACEI- prevent renal failure BUT
 dehydrating effect
Gentamicin- nephrotoxic
PPI- acute kidney injury
contrast nephropathy- after radiology with contrast (dehydrated/ renal impairment problem)
30
Q

what sign is a medical emergency

A

pericardial rub- uraemia

31
Q

where are palpable kidneys found

A

autosomal dominant kidney disease

32
Q

what is an important measurement in renal disease

A

blood pressure (

33
Q

what is accelerated hypertension

A

a medical emergency- diastolic BP >120, papilloedema, end organ decompensation (fits, heart failure, acute renal failure)

34
Q

what nail findings are common in acute illness or hypoalbuminaemia

A

leukonychia, splinter haemorrhages (nephritits, vasculitis)

35
Q

what do scratch lesions that do not blanche represent?

A

vasculitis, acute glomerulonephritis

36
Q

what is a smokey urine likely to be caused by

A

acute kidney injury requiring dialysis- muscle breakdown, dehydration, injury which occurs during earthquakes

37
Q

what does specific gravity show?

A

urine concentration

38
Q

what does leukocyte/ nitrates tell us on urinalysisi

A

UTI

39
Q

how do you determine urine protein quantification

A

24 hour collection (

40
Q

when do we worry about proteinurea

A

> 0.5g per day

41
Q

what is seen by hyperkalaemia on an ECG

A

tall tented T waves

42
Q

what GFR is classed as renal failure

A
43
Q

what is acute kidney injury

A

decline in GFR over hours/ days/ weeks, with/without oliguria, in a patient with normal or impaired renal function

44
Q

what is a classic presentation in nephrotic syndrome

A

proteinuria >3g per day, hypoalbuminaemia, oedema- periorbital (which is not present in heart failure)

45
Q

what is nephrotic syndrome caused by

A

diabetes, glomerulonephritis- immunosuppression

46
Q

what is nephritis syndrome

A

patient has nephritis- AKI, oliguria, oedema/ fluid retention, hypertension active urinary sediment

47
Q

what is chronic kidney disease

A

reduced GFR and or evidence of kidney damage and must be seen to be chronic

48
Q

how do we assess GFR

A

measured through nuclear medicine, estimated by creatinine clearance (neither reabsorbed or secreted at glomerulus)- by 24 hour urine sample- inaccurate

Can be estimated by age, sex, race, Creatinine

49
Q

what is creatinine a measurement of

A

muscle breakdown

50
Q

what is the average eGFR for most people,

A
51
Q

what is stage 1 of CKD

A

GFR >90ml/min and evidence of kidney damage

52
Q

what is stage 2

A

GFR 60-90 with evidence of kidney damage- proteinuria, haematuria and abnormal imaging

53
Q

how are stages 3-5 defined?>

A

only by GFR

54
Q

is severe kidney disease common?

A

rare- 0.1%

55
Q

what does CKD increase the risk of

A

cardiovascular problems

56
Q

what symptom suggests that patients are more likely to progress

A

proteinuria

57
Q

what are common causes of CKD

A

Diabetes, hypertension, vascular disease, chronic glomerulonephritis, reflux nephropathy- pyelonephritis, polycystic kidneys, cause may not be known

58
Q

what symptoms do people present with CKD

A

tiredness, loss of appetite, itch, sleep disturbance, nocturia

59
Q

how do you manage CKD

A

slow decline in GFR, reduce cardiovascular risk, identify and treat complications of CKD, prepare for renal replacement therapy

60
Q

how do you slow progression of CKD

A

control BP, reduce proteinuria, ACEI reduce BP and proteinuria-> reduce glomerular pressure so may cause hyperkalaemia so have blood test after 10 days.

Control diabetes and stop smoking

61
Q

how do you reduce cardiovascular risk

A

stop smoking, statins, control BP and proteinuria

62
Q

what are complications of CKD

A

anaemia- Erythropoietin (bone marrow to producee RBC) declines in CKD. Check B12 and folate levels, may be from other cause

Bone disease- Vit D impaired in kidneys- reduced calcium absorption and causes secondary hyperparathyroidism, in advanced disease increases PTH secretion

63
Q

how do you fix anaemia

A

IV iron, EPO by subcutaneously,

64
Q

what is hyperparathyroidism

A

can lead to hypercalcaemia

65
Q

what can bone disease actually have an effect on?

A

cardiovascular- calcification of vessels and heart valves

66
Q

how do we fix bone disease

A

alfacalcidol- hydroxylated Vit D, phosphate or phosphate binders to reduce absorption including sevelamer, calcium carbonate

67
Q

what are some renal replacement therapy

A

haemodialysis, peritoneal dialysis, transplantation, conservative management

68
Q

when would a patient be on dialysis according to their GFR

A

20ml/min

69
Q

what do you need for haemodialysis

A

Arteriovenous fistula for easy access- when GFR 15ml/min

70
Q

what is needed for peritoneal dialysis

A

catheter

71
Q

when can patients go on transplant list

A

when within 6 months of dialysis

72
Q

who goes for conservative management

A

multiple co morbidities, old people

Renal (18 decks)

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