renal injury and disease

Question 1

what is more pink Pct or DCT

Answer 1

PCT - much pinker tubular epithelium than DCT due to packed through of mitochondria from a biopsy as 90% of solutes are reabsorbed in PCT

Question 2

Formation or urine and eliminate of N2 waste
Control of water balance and serum osmolarity
Control electrolytes - sodium, potassium ,phosphate
Drug metabolism
Drug excretion
Hormone synthesis - renin and vit d EPO
Calcium and phosphate homeostasis
Acid base regulation
Blood pressure control

are all functions of what

Answer 2

kidney

Question 3

where is urien collected

Answer 3

bowmans space

Question 4

angiotensin 2 constrict which arteriole

Answer 4

efferent maintaining intraglomerular pressure - also noradrenaline and vasopressin

increase vasodilatory prostogladnisn on afferent side therefore increasing preload such as endothelial NO

Question 5

preload

Answer 5

vol of blood in ventricles at end of diastole

Question 6

after load

Answer 6

resistance left ventricle must overcome to circulate blood

Question 7

the crockroft-gault equation evaluates creatinine clearance what mistake does ti assume

Answer 7

everyone is 70kg in weight

Question 8

Renal injury definition

Answer 8

Reduced functional capacity ( principally diminished excretory function)

Question 9

CKD defintion

Answer 9

kidney damage for over 3 months defined by strictly or functional abnormalities of the kidney with or without decreased GFR either pathological abnormalities or markers of kidney damage including blood or ruin

or GFR below 60 for 3 months or more

Question 10

how many stages of kidney disease - chronic

Answer 10

5
1- 90 GRF - normal
2- 60-89 - middle reduced , blood monitor control
3- 30 - diagnosis
4-15 - several reduce mamnaegmtn of complications
5- under 15 - end stage kidney failure

Question 11

acute kidney injury

Answer 11

An acute decline of renal function with risk of clinically significant toxicity which is potentially reversible and potentially required RRT
rise in creatine increases length of stay

Question 12

the rifle criteria for acute renal dysfunction

Answer 12

increase creatine increased or GFR decreases in stages
1- Cr > 26.4
2 Cr > 200-300%
3- Cr> above 300%

Question 13

impact of AKI

Answer 13

local production of inflammatory mediators 
cytokines ( IL-1) and chemokine (IL-8) 
compelmtn activation 
palette activating factor 
metabolites of arachidonic acid 
ROS

Question 14

causes of AKI

Answer 14

Pre-renal - msot 
Intra renal 
ATN 
Glomerular 
micro/macro vascular 
Interstitial nephritis 
Post renal 
50% due to sepsis

Question 15

what is a clinical consequence of AKI

how to treat it

Answer 15

hyperkalaemia - ECG - widening ORS complex and increased T waves

anagnoise the effect of potassium on heart with calcium
shift potassium back into cells usign beta agnostic and insulin
remove potassium from the body by diet and stop potassium retaining drugs like spironolactone and ACEI
dialysis

Question 16

indications for dialysis

Answer 16

uremia
hyperkalaemia
fluid overload - resistant to diuretics especially pulmonary oedema
metabolic acidosis

Question 17

difference between AKI and CKD

Answer 17

kidney size goes small in chronic
carbamylated Hb goes high in chronic
broad casts on urinalysis present on chronic
history of kidney disease for chronic
anaemia and metboaci acids etc always present chronic
chronic is not really reversible

Question 18

lab abnorm in renal failure

Answer 18

sodium is low or high 
potassium high 
bicarbonate low 
pH low 
calcium low 
phosphate high 
Hb low