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biological and medical sciences 2 > renal medicine > Flashcards

renal medicine Flashcards

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USMLE® Step 1 flashcards
1
Q

give some functions of the kidneys

A 
filter blood
control bodys fluid balance 
control electrolyte levels
maintain acid base balance
endocrine function
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2
Q

low pressure of blood entering the glomerulus via the afferent BV indicates _, this actives _ system?

A

indicates low BP, activating the renin-angiotensin system

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3
Q

which 2 substances should the urine not contain, presence of these indicate renal dysfunction?

A

protein or cells

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4
Q

do those with renal failure pee less or more?

A

less - kidney not functioning well

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5
Q

do those with diabetes insidious pee more or less?

A

more

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6
Q

what term is used to describe peeing too much?

A

polyuria

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7
Q

which term is used to describe pain when peeing?

A

dysuria

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8
Q

which term is used to describe blood in urine?

A

haematuria

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9
Q

which term is used to describe proteins in urine?

A

proteinuria

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10
Q

which term is used to describe the present of waste products which should have been excreted in the blood?

A

uraemia

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11
Q

which 2 tests are used to measure renal function?

A

serum urea and serum creatine

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12
Q

during renal failure the kidney is not able to function, this results in loss of which functions?

A
  • loss of renal excretory function
  • loss of water and electrolyte balance
  • loss of acid base balance
  • loss of renal endocrine function
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13
Q

describe the kidneys endocrine function

A
  • produces erythropoietin to allow RBC production
  • Ca metabolism - produces vit D dependant factor for Ca metabolism
  • renin secretion
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14
Q

how does renal failure result in no RBC production?

A

kidney doesn’t produce any erythropoetin and so no new RBCs are produced

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15
Q

rapid loss of renal function is known as?

A

acute renal failure

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16
Q

gradual loss of renal function is known as ?

A

chronic renal failure

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17
Q

acute renal failure is usually due to?

A

infection or trauma

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18
Q

how may muscle injury cause acute renal failure?

A

muscle injury causes proteins to be taken to the kidney for filtration, this then swamps the glomerulus meaning kidney can no longer filtrate plasma

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19
Q

which term is used to describe the process by which muscle injure causes renal failure.

A

rhabdomyolysis

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20
Q

name some causes of pre-renal failure

A

hypoperfusion of kidney
shock (BP drop)
renal artery or aortic disease (aneurysm)

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21
Q

name some causes of renal failure due to the kidney

A 
chronic disease
drug damage
trauma 
rhabdomyolysis
renal diabetic disease
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22
Q

what is the most common cause of kidney failure in adults?

A

renal diabetic disease

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23
Q

name some causes of post renal failure?

A

renal outflow obstrcution
can’t pee
kidney stone
bladder tumour

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24
Q

give some signs/symptoms of acute renal failure?

A 
ankle oedema if ambulatory (walking)
sacral (back) oedema if bed bound
pulmonary oedema and breathlessness
increased jugular venous pressure
increased weight
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25
Q

those with acute renal failure can develop hyperkalaemia (high potassium) this may cause ?

A

cardiac arrest

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26
Q

acute renal failure is usually due to what, pre-renal, renal or post-renal cause?

A

pre-renal

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27
Q

chronic renal failure can be primary or secondary, which is more common?

A

secondary

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28
Q

give 2 examples of primary chronic renal failure

A

glomerulonepritis

polycystic kidney disease

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29
Q

name some causes of secondary chronic renal failure?

A 
diabetes
hypertension
drug therapy
vasculitis
renal artery disease
30
Q

inflammation of the glomeruli resulting in not producing renin or angiotensin effectively is known as?

A

glomerulonephritis

31
Q

a complication of glomerulonephritis, by which you pass too much urine is called?

A

nephrotic syndrome

32
Q

which type of drug should you avoid in those with kidney disease?

A

NSAIDs

33
Q

the general name given to a variety of complications that affect arteries and veins of the kidney is?

A

renal vascular disease

34
Q

which test is used to estimate stage of renal failure?

A

GFR (glomerular filtration rate)

35
Q

name some signs and symptoms of chronic kidney failure

A 
anameia
hypertension
renal bone disease
polyuria
nocturia
nausea
36
Q

waking up to pee is known as?

A

nocturia

37
Q

name the 2 types of kidney dialysis?

A

haemodialysis

peritoneal dialysis

38
Q

is renal dialysis an active or passive process?

A

passive

39
Q

what is the name of dialysis that occurs outside the body?

A

haemodialysis

40
Q

what is the name of dialysis that takes place in the body?

A

peritoneal dialysis

41
Q

peritoneal dialysis uses what structure to filter the blood?

A

lining of abdomen (peritoneum)

42
Q

which type of dialysis allows more patient freedom?

A

peritoneal dialysis

43
Q

how is erythropoietin replaced in those with renal failure?

A

EPO injections

44
Q

how is bone mass maintained in those with renal failure?

A

Vit D supplements

45
Q

what is the optimal treatment for end stage renal disease?

A

transplantation

46
Q

is a renal transplant a permanent cure?

A

no - lasts 10-15 years

47
Q

who has priority for renal transplants ?

A

younger - as you age u lose priority

48
Q

what issues are there with renal transplant?

A

rejection - acute or chronic
immunosuppression - increased infection risk
high CV risk - effect of transplantation
osteoporosis risk

49
Q

what issues must u consider when treating a patient on dialysis

A 
appointment after haemodialysis session
lease with physician when prescribing 
do not use dialysis shunt
medicines given must be able to come out via dialysis
immune suppression
drug interactions
50
Q

what may obstruct the urinary tract?

A

renal stones
tumours
prostatic hypertrophy

51
Q

are UTIs most common in males or females?

A

females

52
Q

which microorganism is usually responsible for UTIs?

A

E coli

53
Q

what term describes bladder inflammation?

A

cystitis

54
Q

urine should be sterile, therefore detecting any bacteria indicates what ?

A

UTI

55
Q

what may indicate a UTI?

A

bacteria in urine
white cells in urine
blood in urine

56
Q

what must you ensure to do when testing urine for a UTI to avoid contamination?

A

collect a midstream sample (MSSU)

57
Q

UTIs may lead to what 3 things?

A

cystitis
renal infection
prostate infection

58
Q

how may a UTI lead to renal infection?

A

urine reflux - urine pushed back up towards kidneys

59
Q

name some symptoms of a UTI?

A 
dysuria
urine frequency
cloudy urine (cells and proteins)
offensive smelling urine
supra-pubic pain
60
Q

how are UTIs treated?

A

increased fluid intake
frequent urination
occasional antibiotic

61
Q

how is a UTI diagnosed?

A

MSSU

microscopy, culture

62
Q

what is inflammation of the prostate known as?

A

prostatitis

63
Q

hyperplasia of the prostate is known as?

A

benign prostatic hypertrophy

64
Q

what is the main cause of prostate disease?

A

benign prostatic hypertrophy

65
Q

what treatment is available for benign prostatic hypertrophy?

A

drugs - a blocking drugs to shrink prostate

surgery - prostatectomy

66
Q

name the 2 types of prostatectomy

A

TURP - cut off

open transectomy

67
Q

which common cancer are men tested for after the age of 45?

A

prostatic malignancy

68
Q

what treatment is available for prostate cancer?

A

surgery - prostatectomy
radiotherapy’
hormone treatment

69
Q

what are the 2 types of renal calculi and which is radiopaque?

A

calcium and oxalate (radiopaque)

uric acid

70
Q

how are renal stones treated ?

A

lithotripsy

biological and medical sciences 2 (11 decks)

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