Brainscape's Knowledge GenomeTM

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


See full index

Person Renal > Renal Pathology, Diuretics and Anesthesia PP#5 Number 2 > Flashcards

Renal Pathology, Diuretics and Anesthesia PP#5 Number 2 Flashcards

1
Q

Describe how dialysis works

A
  • Blood passes across a membrane
  • On the other side of the membrane is dialyzing fluid
  • Undesired substance pass via diffusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 3 things determine rate of solute movement in dialysis?

A
  • Concentration gradient
  • permeability of membrane
  • Amount of time blood in contact w/ membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much blood is in the dialysis machine at 1 time?

A

500cc

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

What is given to prevent coagulation during dialysis?

A

Heparin

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

What are the common causes of ESRD?

A
  • Diabetes 41%
  • HTN 28%
  • Other 18%
  • Glomerulonephritis 11%
  • Polycyctic kidney disease 3%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are indications for dialysis?

A
  • Fluid overload
  • Hyperkalemia
  • Acidosis
  • Metabolic encephalopathy
  • Pericarditis
  • Coagulopathy
  • Refractory GI symptoms
  • Drug toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a normal BUN?

A

10-20

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

how much urea is reabsorbed in the nephron?

A

40-50%

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

What causes an increase in urea reabsorption?

A

hypovolemia

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

What 4 things can increase BUN?

A
  • ↓ GFR
  • ↑ protein breakdown
  • Sepsis
  • blood degradation in GI tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a normal creatinine value?

A

Men 0.8-1.3

Women 0.6-1.0

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

Creatinine is a byproduct of what?

A

Muscle meatbolism

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

Creatinine is directly related to what?

A

Muscle mass

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

Creatinine is inversely related to what?

A

GFR

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

Creatinine clearance is a way to measure what?

A

GFR

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

GFR decreases how much?

A

5% decline per decade after age 20

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

Why does creatinine levels remain stable with age?

A

Muscle mass declines with age

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

Low tubular flow rates _______ urea reabsorbtion

A

enhance

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

Name 3 conditions in which BUN Creatinine ratios are > 10:1

A
  • Volume depletion
  • Decreased tubular flow
  • Obstructive uropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Urinary pH > 7 with acidosis is suggestive of what?

A

renal tubular acidosis

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

Specific gravity is related to what?

A

urinary osmolality

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

A specific gravity of _______ after an overnight fast, indicates ________ urinary concentrating.

A

> 1.018

adequate

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

Low specific gravity + plasma hyperosmolality =

A

Diabetes

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

Why are renal patients more susceptible to barbiturates and Benzos?

A

Decreased protein binding (more free drug)

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

Benzos are metabolized by the _______?

A

Liver

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

Active metabolites can happen with what meds?

A
  • Diazepam
  • Morphine
  • Demerol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

In anticholinergics (Atropine, Glyco) what can accumulate with repeated dosing?

A

metabolites

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

metoclopramide can be used safely with a _________ dose

A

Single

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

What volatile agents may accumulate fluoride?

A
  • Enflurane

- Sevo

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

Succs is safe in patients with what?

A

K<5.0

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

Succs will transiently increase K by how much?

A

0.5

32
Q

What muscle relaxer is the drug of choice and why?

A

Cis/Atracurium

Hoffman elimination

33
Q

What muscle relaxants do you need to avoid due to renal elimination?

A
  • Pipecuronium
  • Alc
  • Dox
  • Panc
34
Q

Where is Vec and Roc are primarily eliminated?

A

Liver

35
Q

Where are reversal agents excreted?

A

By kidney, but prolonged half time

36
Q

Renal disease preop eval questions.

A
  • Last dialysis
  • Most recent K
  • EKG
  • Dialysis access site
37
Q

When would you consider blood for renal patients?

A

Hgb <6-7

38
Q

What is the reason that ventilation is preferred w/ renal patients?

A

decrease risk of respiratory acidosis

39
Q

What is the key factor in periop renal failure?

A

Hypovolemia

40
Q

Post op renal failure has a mortality rate of?

A

50%

41
Q

Prophylaxis with ______ may help with kidney preservation.

A

Mannitol (.5g/kg)

42
Q

It is easier to treat ________ than to treat _________.

A

Fluid overload

Renal failure

43
Q

Periop risk factors for renal failure.

A
  • Sepsis
  • Hypovolemia
  • Jaundice
  • Aminoglycside ABX
  • Nsaids
  • Ace inhibitors
  • Dye injections
44
Q

What 6 things would you do for intraop oliguria?

A
  • Kinked foley?
  • Administer fluids
  • Check CVP
  • Increase BP if low
  • Lasix
  • Mannitol
45
Q

Where do kidney stones generally obstruct?

A

-Ureter

46
Q

What are the main symptoms of kidney stones?

A

Pain

Hematuria

47
Q

Kidney occurrence rates

A

10-15% of population
10% recurrence
Men 4x more than women

48
Q

What is the most common type of stone?

A

Calcium Oxalate

49
Q

What are struvite stones associated with?

A

Infection

50
Q

How are struvite stone made?

A

Urea splitting bacteria that forms ammonia

51
Q

When are uric stones seen?

A

Gout

Cell lysis

52
Q

When are calcium phosphate stones seen?

A

Hyperparathyroid

renal tubular acidosis

53
Q

When are cysteine stone seen?

A

Cysteinuria

54
Q

What causes cysteinuria?

A

inadequate cysteine reabsorption

55
Q

What size stones pass spontaneously?

A

<4mm

56
Q

How do alpha blockers help stones?

A

Decrease ureter tone

57
Q

When is surgery used for stones?

A
  • > 30 days

- Renal compromise

58
Q

4 surgical procedures for stones.

A
  • EWSL
  • Ureteroscopic fragmentation
  • Percutaneous nephrolithotomy
  • Double J Stents
59
Q

What does double J stents do?

A

Urine drains around obstruction

60
Q

ESWL is used for stones located where?

A

Kidney or ureter

- above illiac crest

61
Q

What are contraindications to ESWL..

A
  • Inability to position patient
  • Pregnancy
  • Infection
  • Obstruction below stone
  • Close to prosthetic device
  • Pacer/Defib
62
Q

3 stone prevention tips.

A
  • Drink water
  • Avoid soda
  • Limit protein, nitorgen and sodium in diet
63
Q

What causes gout?

A

Build up uric acid in joints

64
Q

Where are the majority of 1st gout attacks?

A

Big Toe

65
Q

How is gout diagnoised

A

Microscopy of aspirated fluid

66
Q

Where is uric acid excreted?

A

Kidney 2/3

Gut 1/3

67
Q

Gout risk factors.

A
  • Males
  • Age 40-50
  • Diet high in protein, fat and ETOH
68
Q

What to use for gout pain relief?

A
  • Nsaids
  • Steriod injection
  • Acetazolamide
69
Q

How does acetazolamide work?

A

Alkalizing urine and trap weak acid

70
Q

What med prevents gout?

A

Allopurinol

71
Q

What do uricocurics do?

A

Promote uric acid excterion

72
Q

How do uricocurics work?

A

Compete w/ uric acid for reabsorption at organic acid transporter

73
Q

What may help gout?

A

Caffeine

74
Q

How does CPAP help gout?

A

O2 starved cells die and release uric acid

75
Q

What are 2 examples of uricocurics?

A

Sulfinpyrazone

Probenacid

Person Renal (6 decks)

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