Renal medicine

Question 1

average GFR?

Answer 1

125ml/min

Question 2

how many litres of filtrate and urine a day?

Answer 2

180l filtrate

1.5l urine

Question 3

how do you measure renal function?

Answer 3

serum creatinine via blood test

Question 4

what is GFR?

Answer 4

glomerular filtration rate = sum of filtration rates of all functioning nephrons

Question 5

how is creatine filtered across glomerulus??

Answer 5

freely

Question 6

how does creatine plasma conc effect GFR?

Answer 6

increased creatine = decreased GFR

Question 7

how many stages of chronic kidney disease?

Answer 7

5

Question 8

what is GFR in stage 5 CKD?

Answer 8

<15ml/min

Question 9

how does muscle mass affect GFR?

Answer 9

muscly people make more creatine = higher GFR

Question 10

most common cause of CKD?

Answer 10

diabetes

Question 11

what stage CKD do symptoms show?

Answer 11

stage 4

Question 12

why does CKD caused hypertension?

Answer 12

solutes retained

Question 13

why does CKD cause anaemia?

Answer 13

reduced erythroprotein production

Question 14

why are phosphate binders used in CKD?

Answer 14

to reduce phosphate serum levels

Question 15

what anti-hypertensive drugs are usually taken in CKD?

Answer 15

duiretics

Question 16

why may someone with CKD bleed for longer?

Answer 16

uraemia = urea level build up, these stop platelets working

Question 17

why may CKD cause cardiac instability?

Answer 17

metabolic acidosis - hyperkalaeima + hypocalcaeimia

Question 18

how are haemodialysis patients anti coagulated?

Answer 18

with heparin

Question 19

2 types of dialysis?

Answer 19

extra-corporeal

peritoneal dialysis

Question 20

are peritoneal dialysis patients anti coagulated?

Answer 20

no

Question 21

when is the ideal time to see a dialysis patient?

Answer 21

day after dialysis - dialysis peaked but heparin worn off

Question 22

what is nephrotic syndrome? what can it lead to?

Answer 22

too much protein excreted in urine

lead to oedema

Question 23

definition of chronic kidney injury?

Answer 23

low GFR for more than 3 months

occurs after progressive kidney damage

Question 24

why do patients suffering from nephrotic syndrome have increased risk of infection?

Answer 24

probably taking long term steroid

electrolyte imbalance

Question 25

what is renal osteodystrophy?

Answer 25

wasting away of bone due to kidney disease
result from increase in plasma phosphate levels
suppression of plasma calcium
elevated PTH

Question 26

thing to be aware of when examining patient with CKD?

Answer 26

oedema
steroid faces
pulmonary/cardiac effusions
osteodystrophy - bone pain
infection increase
gingival hyperplasia - ciclosproin
beware of skin cancers

Question 27

common oral side effect of dialysis?

Answer 27

sialosis - infective swelling of salivary gland

Question 28

oral manifestations of CKD in children?

Answer 28

decreased growth, delayed tooth eruption, enamel hypoplasia

Question 29

why must CKD patients not swallow blood?

Answer 29

heavy protein load

Question 30

which drugs should be avoided in kidney disease?

Answer 30

NSAIDs
tetracyclines except doxycycline
gentamycin

Question 31

what happens in acute renal failure?

Answer 31

potassium levels rise - must be lowered by either calcium resonium paste or glucose + insulin infusions