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BioScience II > Renal patho-Josh > Flashcards

Renal patho-Josh Flashcards

1
Q

GFR and erythyopoetin are what?

A

linear as GFR decreases you get anemic

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2
Q

Normal GFR

A

125-140 mL/min

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3
Q

GFR decereases ___% per decade after the age of 20

A

1%

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4
Q

what is considered the best measurment of renal funtion

A

GFR

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5
Q

Clinical manifestation of uremia generally appear when GFR is less than what

A

15mL/min

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6
Q

Serum Creatinine:

what is the normal values

A
  1. 6-1.0 men
  2. 8-1.3 men
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7
Q

Serum Creatinine:

what is it

A

waste product of muscle metabolism

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8
Q

Serum Creatinine:

is is reabsorbed by the kidneys?

A

Nope

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9
Q

Serum Creatinine:

T/F

it can be low in the presence of decreased GFR?

A

yeppers

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10
Q

BUN:

normal values?

A

5-20 mg/dL

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11
Q

BUN:

BUn can be potentially misleading due to confounding factors b/c urea is the end product of protein digestion. so what can cause false levels?

A
  • high protein diet
  • Upper Gi bleed
  • Dehydration
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12
Q

Specific Gravity:

what is teh normal Specific gravity

A

1.005-1.030

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13
Q

Urine protein:

what is the normal Value

A

0-8 mg/dL

or

< 150mg/24hrs

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14
Q

Cystine C:

what is teh normal values

A

0.52-0.98 mg/dL

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15
Q

Cystine C:

what is a con of this test vs creatine?

A

it cost 2-3 dollars vs 2-15 cents for Creatinine

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16
Q

Cystine C:

Cystine C is produced by all ______ _____ in the human body- not influenced by muscle mass, gender or age

A

nucleated cells

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17
Q

what is a blanket term that can be applied to almost any acute renal disease

A

Acute Kidney disease

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18
Q

what is a term that covers diseases that involve inflammation of the nephrons

A

Nephritic

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19
Q

AKI:

may be oliguric which is UOP < _____ml/day, or non-oliguric which is a UOP > _____mL/day

A

400

400

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20
Q

AKI:

is divided into what 3 etiological categories?

A
  • prerenal
  • Intrarenal
  • Postrenal
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21
Q

AKI: Prerenal Azotemia

what is it?

A

the root of the problem lies somwwhere upstream or proximal the kidneys

the kidneys themselfs are ok

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22
Q

AKI: Prerenal Azotemia

If left untreated it is the most common factor that predispposes the pt to what?

A

ischemic-induced Acute Tubular Necrosis

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23
Q

AKI: Prerenal Azotemia

what are some causes?

A
  • hemorrhage
  • GI fluid loss
  • trauma
  • sx
  • Burns
  • Cardiogenoic shock
  • SepsisHepatic failure
  • Aortic or Renal artery clamping
  • Thromboembolism
24
Q

AKI: Intrarenal Azotemia

what is it?

A

as the name implies it lies within the parenchyma of the kidney itself

25
Q

AKI: Intrarenal Azotemia

Intrinsic (intrarenal) kidney disease that results in AKI are categorized according to the site of injury! what are the 4 categories?

A
  1. Glomerulus
  2. Renal tubules
  3. interstitium
  4. Renal Vasculature
26
Q

AKI: Intrarenal Azotemia

injury to the tubules is most often due to what?

A

Ischemia (prerenal) or the administration of nephrotoxins)

27
Q

AKI: Intrarenal Azotemia

AKI resulting from acute INTERSTITIAL NEPHRITIS is most often caused by what?

A

allergic reactions to drugs

28
Q

AKI: Intrarenal Azotemia

what are other causes (besides allergic reations) to drugs

A

Glomerulonephritis

Pyelonephritis

Renal artery emboli

Renal vein thrombosis

vasculitis

ATN

Heavy metals

Radiographic dyes

Myoglobinuria

ischemia

Solvents

29
Q

AKI: Postrenal Azotemia

what is it

A

AKI that happens when outflow tracts are obstructed

30
Q

AKI:

what are S/S

A
  • general malaise
  • Evidence of Fluid Overload (SOB, edema, HTN)
  • Lethargy
  • nausea
  • HyperKalemia
  • Encephalopathy
  • Hypotension
  • Jaundice
  • hematuria
  • urinary retention
31
Q

AKI:

How is Oliguria defined?

A

less than 0.5 mL/kg/hr or less than 400 mL/day

32
Q

AKI:

Anuria is defined as what?

A

less than 100mL/day

33
Q

AKI:

AKI manifest complications in various systems. what are the systems it causes s/s to?

A

CNS

CV

Hematological

GI

34
Q

AKI:

what are it’s effects on the CNS

A
  • Confusion
  • Asterixis (tremor of the hand)
  • Somnolemce
  • Seizures
  • polyneuropathy
35
Q

AKI:

S/S on CV system

A
  • Systemic HTN
  • CHF
  • Pulm Edema
  • Uremic pericarditis
  • Peaked T-waves
  • Dysrhythmias
36
Q

AKI:

complications on hematological

A
  • Anemia
  • Coagulopathy
37
Q

AKI:

Complications on the GI system?

A
  • Anorexia
  • Nausea
  • Vomiting
  • Paralytic ileus
  • GI bleed (1/3 of pts)
  • Gastroporesis
38
Q

AKI:

how can all of the complications listed be ameliorated?

A

Dialysis

39
Q

AKI:

treatment for AKI

A
  • no specific treatments
  • management aimed at emlimiting further renal injury, and correcting cpmplications (ex electrolytes, acid-base balance)
  • Underlying cause should be corrected
  • Keep MAP of 65
  • Fluid resuscitation
  • Vasopressors
    *
40
Q

AKI:

why is NS prefered?

A

it lacks K+

41
Q

AKI:

Although NS is preferred, what is the down side of too much?

A

hyperchloremic metabolic acidosis (which will cause hyperkalemia)

42
Q

AKI:

what does the evidence say about the use of colloids over crytalloids for AKI?

A

no evidence and Voluven has been shown to exacerbate renal injury

43
Q

AKI: Treatment:

Vasopressors cause concern why?

A

vasoconstriction may exacerbate tubular injury

44
Q

AKI: Treatment:

What are the benefits of Levophed?

A

reduces renal blood flow in healthy volunteers, BUT sytemic pressures cause LESS SYMPATHETIC TONE IN THE KIDNEYS AND BY EXTENSION MORE RENAL VASODILATION

45
Q

AKI: Treatment:

why is vasopressin good?

A

tends to selectivly constrict renal efferent arterioles

may preserve GFR and UOP better than Alpha agonist

46
Q

AKI: Treatment:

why/whynot?should you give diuretic?

A

Nope

  • increase mortality
  • Increase risk of permanent injury
47
Q

What is the progressive, irreversible deterioration of renal function that may result from a variety of diseases?

A

Chronic Kidney Disease

(CKD)

48
Q

CKD:

symptoms are typically independent of the origional insult abd reflect the inability of the kidneys to excrete _____ ___, regulate ____, and ____ _____, and ______ ______

A
  • Nitrogenous waste
  • fluid
  • electrolyte balance
  • secrete hormones
49
Q

CKD:

in most pt’s regardless of the cause a decrease in the GFR to less than ____ mL/min eventually requires dialysis or renal transplantation

A

25

50
Q

what is an autoimmune d/o caused by the manufacture of antibodies to vasular collagen or can be caused by cross reactivity of deposited antigen-antibody complexes in teh glomeruli- can occur after essentially any infection, but most commonly after strep pyogenes

A

Acute Glomerulonephritis

51
Q

Acute glomerulounephritis:

what are the clinical manifestations?

A
  • hematuria
  • Proteinuria
  • HTN
  • Edema
  • Increased creatine concentration
  • Presence of urinary RBC
  • proteinuria
52
Q

Acute Glomerulonephritis:

what are the 2 patterns that exist?

A
  • NephRITIC
  • NephROTIC
53
Q

Acute Glomerulonephritis:

which pattern is characterized by- inflammation and an active urine sediment containing red and white blood cells, and a varible amount of proteinuria

A

NephRITIC

54
Q

Acute Glomerulonephritis:

which pattern is characterized by marked Protenuria and a relatively inactive urine sediment?

A

NephROTIC

55
Q

what is a parachymal disease caused by infection by organisms usually found un the digestive tract? (AKA E.coli)

A

Pyelonephritis

56
Q

done next on to anesthesia complications?

A

yeah

BioScience II (39 decks)

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