Brainscape's Knowledge GenomeTM

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


See full index

HD 3 > Renal - to final > Flashcards

Renal - to final Flashcards

0
Q

Hemodialysis

A

filtration process via semipermeable membrane, used to eliminate toxins from the blood stream
* need to perform surgery to make fistula (for access to blood)

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

Causes of End-stage kidney disease

A
  1. Diabetes
  2. HTN *usually not biopsied.
  3. Glomerulonephritis (esp. IgA)
  4. Interstitial Nephritis (esp. from meds)
  5. PCKD/Alport’s
  6. ATN (acute tubular necrosis, rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is risk for end stage renal disease greater in African Americans?

A

*1. genetic: G1 or G2 variants of Apo-L1 gene
(increase risk 40% if 1 copy, 60% if 2 copies)
2. higher risk for other diseases (DM, HTN)
3. inadequate medical care (poor)

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

Why are fistulas preferred to catheters for dialysis port?

A

catheters have higher need for anticoagulation, and higher risk of infection.
(vs. much less in arm fistula)

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

What is removed or not by dialysis?

A

Removed: small ions (Na+, K+, Ca2+, Mg2+), Lithium
* water: removed proportionately to permeability (# pores) of dialysis membrane
NOT removed: blood, protein, high MW proteins

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

4 Renal Heroes:

A
  1. Bud Rose
  2. Peter Agre
  3. Willem Kolff (invented first dialysis machine)
  4. Steve Jobs (made organ donation an opt OUT process in California)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications of dialysis

A
  1. hypotension
  2. bleeding
  3. dialysis disequilibrium (bc electrolytes off, not so much now)
  4. bacteremia/sepsis
  5. AV fistula thrombosis/intravascular clots from catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal GFR for healthy person (avg)

A

normal GFR = 100 ml/min

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

Problems assoc. w/ dialysis & mortality

A

1. MI/cardiovascular disease

  - hypertension BEFORE dialysis procedure
  - lipids (low HDL, high TGs) 2. infection 3. amputations 4. anemia (bc low EPO)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Transplant vs. Dialysis

A

transplants recipients have lower relative risk of death
* harder/takes longer to get transplant (have to wait on list)

BUT do have similar associated medical problems as dialysis

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

Medical problems improved with kidney transplantation

A

Will stabilize: Ca deposition, renal osteodystrophy

Will improve: malnutrition, depression, anemia, myopathy, LV dysf(x), energy level

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

Medical problems that continue/are associated with kidney transplants

A

Ongoing: HTN, atherosclerosis
New: Malignancy (esp. skin cancer), DM (new onset/worse control), opportunistic infections

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

Chronic Kidney Disease

A

Kidney damage, w/ GFR < 60 for at least 3 months. 5 stages – 1 = normal GFR, 5 = dialysis.
(“kidney damage” can be IDed w/ blood/urine tests or imaging)

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

Causes of Chronic Kidney Disease (not necessarily end-stage)

A
  1. Diabetes (50%)
  2. HTN
  3. Glomerulonephritis
  4. Polycystic Kidney Disease
  5. Failed transplants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Association btwn retinopathy and nephropathy in diabetics

A

DM1: almost ALL pts w/ nephropathy have retinopathy also.
(but more DM1 have retinopathy than nephropathy)
DM2: 75% w/ nephrop. also have retinopathy
==> if DM2 & retinopathy, VERY VERY likely to have nephropathy.

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

Mechanism of chronic kidney disease from diabetes

A
  1. loss of some/many nephrons
  2. remaining nephrons compensate –> intraglomerular pressure rises
  3. more renal damage bc high P
17
Q

effect of blood pressure on renal function

A

maintainting systolic BP < 140 –> postpone prorgession to dialysis by 16 years! AND reduce risk CV/other complications too!
*even better than controlling glycemic levels!

18
Q

role of diabetes control in preventing kidney disease

A

NO evidence that glycemic control alone slows CKD directly, but does decrease proteinuria.
CAN get protection and Regression (!) of diabetic kidney lesions after pancreatic transplant!

19
Q

Treatments most helpful in preventing kidney disease progression

A
  1. anti-hypertensives
  2. ACE Is or ARBs (but NOT both)
  3. control glycemia in diabetics
  4. HCO3 supplementation (slows progression by 50%!)
20
Q

Lifestyle changes to help prevent renal disease progression

A
  1. lowering lipids
  2. smoking cessation
    * Conflicting evidence on protein and salt intake
21
Q

Symptoms of anemia

A

LV dysfunction, sleep impairment, poor exercise tolerance, sexual dysfunction
* can treat w/ EPO but has heart risks

22
Q

Fetuins

A

powerful inhibitors of hydroxyapaptite formation,
often low w/ renal failure ==> exess arterial/valve calcifications & weak bones
* Tx: phosphate control, calcitrol (VitD) supplementation, calcimimetics (–> suppress PTH)

23
Q

5 causes of acidosis WITH abnormal anion gap

A
  1. Lactic acid
  2. Ketoacids
  3. Organic acids (accumulate in renal failure)
  4. Toxins (methanol, ethylene glycol, salycilate)
  5. Rhabdomyolysis
24
Q

2 causes of non-anion gap acidosis

A
  1. Diarrhea

2. Renal Tubular Acidosis

25
Q

3 types of renal tubular acidosis (RTA)

A

type I: Distal, decreased H+ excretion –> pH >5.3 (Sjogrens, amphotericin)
type II: Proximal, decreased HCO3- reabsorption –> LOW K, pH HIGH K

26
Q

3 steps in nephrolithiasis

A
  1. form nidus (oversaturation or supersaturation)
  2. retain nidus *higher risk if have “randall plaques”
  3. nidus GROWTH
27
Q

Risk factors for Calcium stones

A

1. hypercalciuria (hyperPTH, type 1 RTA, sarcoidosis, GI malabsorption)

  1. hypocitraturia *bc citrate –l stones
  2. hyperuricosuria (uric acid in urine)
  3. hyperoxaluria
  4. low urine volume
28
Q

risk factors for Uric acid stones

A

1. acidic urine!! (pH = 5, constant)

  1. uricosuria (gout, chronic diarrhea, myeloproliferative disorders, DM2)
  2. low urine volume
29
Q

risk factors for cystine stones

A
  1. high cystine excretion (*kids often have low renal cystine transport)
  2. acidic urine
  3. low urine volume
30
Q

Risk factors for infectious stones

A
  1. urease-producing bacteria
  2. alkaline urine
  3. urine NH3
31
Q

Causes of acute kidney injury

A
  1. prerenal (low renal blood flow)
  2. renal –> ATN, AIN, acute GN, cholesterol emboli
  3. post-renal (obstruction)

ATN: tubular necrosis, AIN: interstitial nephritis, GN: glomerulonephritis

HD 3 (8 decks)

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