Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEX!!!!! > Renal Disease > Flashcards

Renal Disease Flashcards

1
Q

Most common causes of CKD

A

diabetes and HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what measures are used to determine the severity of kidney disease

A

proteinuria and GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOA of loop diuretics

A

inhibit the Na-K pump in the ascending loop of Henle -> less water reabsorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Long term use of loop diuretics effect on calcium

A

depletion of calcium (harmful to bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MOA of thiazide diuretics

A

inhibit the Na-Cl pump in the distal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

long term use of thiazide diuretics on calcium

A

increases calcium reabsorption - protective effect on bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aldosterone MOA

A

increase Na and water retention and decrease K in the distal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk factors for DIKD

A

multiple nephrotoxic medications, baseline reduction in renal blood flow, large doses or frequent use of nephrotoxic medications, and increased age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

common medications associated with DIKD

A

aminioglycosides, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, NSAIDs, radiographic contrast dye, tacrolimus, and vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is CrCl based estimations of kidney function limited

A

low or high muscle mass, obese, liver disease, pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

GFR considered normal or high in CKD

A

90+ and kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GFR considered mild decrease in CKD

A

60-89 with kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

GFR considered mild-moderate disease in CKD

A

45-59

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

GFR considered moderate-severe disease in CKD

A

30-44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GFR considered severe disease in CKD

A

15-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

GFR considered kidney failure in CKD

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

GFR category G1

A

90+ and kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

GFR category G2

A

60-89 and kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

GFR category G3a

A

45-49

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

GFR category G3b

A

30-44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

GFR category G4

A

15-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

GFR category G5

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CKD stage 1 GFR

A

90+ and kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CKD stage 2 GFR

A

60-89 and kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CKD stage 3 GFR

A

30-59

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CKD stage 4 GFR

A

15-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CKD stage 5 GFR

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Normal to mild increase in measured urine albumin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

measured urine albumin termed a moderate increase

A

30-300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

a severe increase in measured urine albumin

A

> 300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ALbumiuria category 1

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Albuminuria category 2

A

30-300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Albuminuria category 3

A

> 300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Goal BP in CKD (KDIGO)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When should ACE/ARB be stopped due to SCr increase?

A

> 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Dose reductions effect on peaks and troughs of medications

A

reduce peaks but maintain trough concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Extending dosing intervals effect on peaks and troughs of medications

A

maintain peaks but reduce trough concentrations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Antimicrobials/antivirals/antifungals requiring dosage adjustments for impaired kidney function

A

acyclovir, valacyclovir, amantadine, amphotericin, aminoglycosides, azole antifungals, anti-tuberculosis medications ethambutol, pyrazinamide, aztreonam, beta lactams, ganciclovir, valganciclovir, maraviroc, NRTIs, polymyxins, quinolones (except moxifloxacin), SMZ/TMP, vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Cardiovascular medications that require dosage adjustments for impaired kidney function

A

antiarrhythmics (digoxin, disopyramide, procainamide, sotalol), dabigatran, LMWHs, Rivaroxaban, statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Pain/gout medications that require dosage adjustments for impaired kidney function

A

allopurinol, colchicine, gabapentin, pregabalin, morphine, codeine, tramadol IR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

GI medications that require dosage adjustments for impaired kidney function

A

Famotidine, ranitidine, metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Drugs contraindicated in CrCl

A

chlorpropamide, cidofovir, ribavirin, voriconazole IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Drugs contraindicated in CrCl

A

Avanafil, bisphosphonates, dabigatran, duloxetine, fondaparinux, NSAIDs, potassium sparing diuretics, ribavirin, rivaroxaban, tadalafil, tramadol ER, SGLT2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

CKD patients should be screened for what abnormalities associated with CKD-MBD

A

PTH, phosphorus, calcium, vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

treatment of secondary hyperparathyroidism in CKD

A

phosphate restricted diet, phosphate binders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Duration of use for aluminum based phosphate binders

A

4 weeks - aluminum is toxic to the nervous system and bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

which phosphate binders are used first line for hyperphosphatemia of CKD

A

calcium based phosphate binders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Aluminum hydroxide brand name

A

AlternaGEL, Amphojel,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Aluminum hydroxide dosing in hyperphosphatemia of CKD

A

300-600 mg TID with meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Aluminum hydroxide side effects

A

constipation, poor taste, nausea, aluminum intoxication, dialysis dementia, osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Aluminum hydroxide monitoring

A

Ca, PO4, serum aluminum concentrations, PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Calcium acetate brand name

A

PhosLo, Phoslyra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Calcium acetate dosing in hyperphosphatemia of CKD

A

667-1334 mg TID with meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Calcium carbonate brand name

A

Tums

55
Q

Calcium carbonate dosing in hyperphosphatemia of CKD

A

500 mg TID with meals

56
Q

calcium based phosphate binders side effects

A

constipation, nausea, hypercalcemia

57
Q

calcium base phosphate binders monitoring

A

Ca, PO4, PTH

58
Q

sucroferric oxyhydroxide brand name

A

velphoro

59
Q

sucroferric oxyhydroxide dosing for hyperphosphatemia in CKD

A

500 mg TID with meals

60
Q

ferric citrate brand name

A

auryxia

61
Q

ferric citrate dosing in hyperphosphatemia of CKD

A

2000 mg TID with meals up to 12 grams per day

62
Q

side effects of sucroferric oxyhydroxide and ferric citrate

A

diarrhea, discolored (black) feces

63
Q

monitoring for sucroferric oxyhydroxide and ferric citrate

A

PO4, iron, ferritin, TSAT (ferric citrate only)

64
Q

Lanthnum carbonate brand name

A

Fosrenol

65
Q

Lanthanum carbonate dosing for hyperphosphatemia of CKD

A

500-1000 mg TID with meals - must chew thoroughly

66
Q

Contraindications for Lanthanum carbonate

A

Bowel obstruction, fecal impaction, ileus

67
Q

Side effects of lanthanum carbonate

A

N/V/d, constipation, abdominal pain

68
Q

Monitoring for lanthanum carbonate

A

Ca, PO4, PTH

69
Q

Sevelamer carbonate brand name

A

Renvela

70
Q

Sevelamer hydrochloride brand name

A

Renagel

71
Q

Sevelamer dosing for hyperphosphatemia in CKD

A

800-1600 mg TID with meals

72
Q

Sevelamer contraindictions

A

bowel obstruction

73
Q

Sevelamer side effects

A

N/V/d (>20%), constipation, abdominal pain

74
Q

Sevelamer monitoring

A

Ca, PO4, HCO3, Cl, PTH

75
Q

treatment of elevations in PTH in CKD

A

controlling hyperphosphatemia, vitamin D

76
Q

vitamin D3 other name

A

cholecalciferol

77
Q

vitamin D2 other name

A

ergocalciferol

78
Q

active form of vitamin D

A

calcitriol

79
Q

calcitriol brand name

A

Rocaltrol, calcijex

80
Q

Advantage of newer vitamin D analogs

A

less hypercalcemia than calcitriol

81
Q

calcitriol dosing in CKD

A

0.25 mcg PO 3x/week to daily. take with food to decrease stomache upset

82
Q

calcitriol dosing in dialysis

A

0.5-1 mcg PO daily or 0.5-4 mcg IV 3x/week. take with food to decrease stomach upset

83
Q

doxercalciferol brand name

A

hectorol

84
Q

doxercalciferol dosing in CKD

A

1 mcg PO 3x/week to daily

85
Q

doxercalciferol dosing in dialysis

A

2.5-10 mcg PO 3x/week, 1-4 mcg IV 3x/week

86
Q

paricalcitol brand name

A

Zemplar

87
Q

paricalcitol dosing in CKD

A

1 mcg PO 3x/week to daily

88
Q

paricalcitol dosing in dialysis

A

2.8-7 mcg IV 3x/week, 2-4 mcg PO 3x/week

89
Q

Vitamin d analogs contraindications

A

hypercalcemia, vitamin D toxicity

90
Q

vitamin D analogs side effects

A

N/V/d, hypercalcemia, hyperphosphatemia

91
Q

vitamin D analogs monitoring

A

Ca, PO4, PTH

92
Q

cinacalcet brand name

A

sensipar

93
Q

cinacalcet MOA

A

increase sensitivity of calcium receptor on the parathyroid. decrease PTH, decrease Ca, decrease Phosphorus

94
Q

cinacalcet dosing for hyperparathyrodism

A

30-180 mg PO daily with food - Swallow whole

95
Q

contraindications to cinacalcet

A

hypocalcemia

96
Q

cinacalcet warning

A

caution in patients with a history of seizures

97
Q

cinacalcet side effects

A

hypocalcemia, N/V/d, paresthesia, fatigue, depression, anorexia, constipation, bone fractures, weakess, arthralagia, myalgia, limb pain, URTIs

98
Q

cinacalcet monitoring

A

Ca, PO4, PTH

99
Q

most common cause of hyperkalemia

A

decreased renal excretion due to kidney failure

100
Q

drugs that raise potassium levels

A

ACE/ARB, aldosterone receptor antagonists, aliskiren, NSAIDs, cyclosporine, tacrolimus, everolimus, mycophenolate, glycopyrrolate, drospirenone, SMZ/TMP, chronic heparin use, canagliflozin, pentamidine

101
Q

s/s of hyperkalemia

A

muscle weakness, bradycardia, fatal arrhythmias

102
Q

3 steps for treating severe hyperkalemia

A
  1. stabilize the heart 2. move it 3. remove it
103
Q

how to stabilize the heart during severe hyperkalemia

A

calcium gluconate IV

104
Q

how to move it during severe hyperkalemia

A
  1. insulin with dextrose or glucose 2. sodium bicarbonate (if metabolic acidosis) 3. beta-agonists (albuterol)
105
Q

hot to remove it during severe hyperkalemia

A
  1. loop diuretics 2. SPS or Veltassa (takes hours to days) 3. Fludrocortisone (Florinef) (if hypoaldosteronism) 4. Dialysis
106
Q

Sodium polsteyrene sulfate brand names

A

SPS, kayexalate, kalexate, kionex

107
Q

SPS dosing

A

PO: 15 grams 1-4x/day (DO NOT MIX with fruit juices containing K) rectal: 30-50 grams Q6H

108
Q

SPS warnings

A

electrolyte disturbances including hypokalemia, fecal impaction, do not mix oral products with sorbitol (increased risk of GI necrosis)

109
Q

SPS side effects

A

Hypernatremia, hypocalcemia, hypokalemia, hypomagnesemia, N/V/d, constipation

110
Q

SPS monitoring

A

K, Mg, Na, Ca

111
Q

Patiromer brand name

A

Veltassa

112
Q

Patiromer dosing

A

8.4 grams PO daily with food. max 25.2 grams/day

113
Q

Patiromer administration

A

Add veltassa packet to 30 ml of water and stir well. Add 60 ml of water and stir (will be cloudy). drink immediately. add water and drink if powder remains in cup

114
Q

Patiromer warnings

A

give 6 hours before or after other drugs (binds), Can worsen GI motility and cause hypomagnesemia

115
Q

patiromer side effects

A

constipation, hypomagnesemia, hypokalemia, N/d

116
Q

patiromer monitoring

A

K, Mg

117
Q

When is treatment for metabolic acidosis initiated

A

serum bicarbonate

118
Q

Sodium bicarbonate dosing for metabolic acidosis in CKD

A

1-2 tabs PO 1-3x/day

119
Q

sodium bicarbonate contraindications

A

alkalosis, hypernatremia, hypocalcemia, pulmonary edema, unknown abdominal pain

120
Q

sodium bicarbonate warnings

A

caution in HTN, cardiovascular disease, fluid retention (Na load)

121
Q

sodium bicarbonate side effects

A

N/V/d, hypernatremia

122
Q

sodium bicarbonate monitoring

A

Na, HCO3

123
Q

Sodium citrate/citric acid brand names

A

Bicitra, Cytra-2, Oracit, Shohl’s solution

124
Q

Sodium citrate/citric acid dosing

A

10-30 ml PO with water after meals and at bedtime (chilled improves taste, timing to avoid laxative effect)

125
Q

Sodium citrate/citric acid contraindications

A

Alkalosis, Na restricted diet, hypernatremia

126
Q

Sodium citrate/citric acid side effects

A

N/V/d metabolic alkalosis, tetany

127
Q

sodium citrate/citric acid monitoring

A

Na, HCO3, urinary pH

128
Q

Sodium citrate/citric acid counseling note on drug interactions

A

avoid use with aluminum containing products

129
Q

Effect of MW/size on drug removal during dialysis

A

smaller molecules are more readily removed

130
Q

Effect of Vd on drug removal during dialysis

A

large Vd are less likely to be removed

131
Q

Effect of Protein binding on drug removal during dialysis

A

highly protein bound are less likely to be removed

132
Q

Effect of the membrane on drug removal during dialysis

A

high flux and high efficiency are more likely to remove drug

133
Q

Effect of the blood flow rate on drug removal during dialysis

A

higher blood flow rates increase drug removal over a given time interval

NAPLEX!!!!! (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions