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Paces > Station 1 - the renal patient > Flashcards

Station 1 - the renal patient Flashcards

1
Q

what clinical signs in the arms may be found in the renal patient?

A

-AV fistula: currently working (thrill), needled (dressings), failed

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2
Q

what clinical signs in the neck may be found in the renal patient?

A

Tunelled dialysis line, previous lines, scars in root of necks and over chest wall

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3
Q

What scars may be found in the renal patient?

A

Flank scar: nephrectomy (ADPKD/malignancy)
Peritoneal dialysis: catheter, scar from previous catheter,
Iliac fossa scar

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4
Q

what clinical signs in the legs may be found in the renal patient?

A

Leg oedema

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5
Q

Underlying reason for renal failure:

-polycystic kidneys

A

ADPKD

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6
Q

Underlying reason for renal failure:

  • Visual impairment
  • fingerprick marks
  • injection sites
A

Diabetes

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7
Q

Underlying reason for renal failure:

  • sclerodactyly
  • taut skin
A

Systemic sclerosis

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8
Q

Underlying reason for renal failure:

-Rheumatoid hands/nodules

A

RA

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9
Q

Underlying reason for renal failure:

Hepatosplenomegaly

A

Amyloid

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10
Q

Underlying reason for renal failure:

-Other organ transplantation

A

Calcineurin inhibitor nephrotoxicity

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11
Q

Underlying reason for renal failure:

  • ungual fibromata
  • adenoma sebaceum
  • Polycystic kidneys
A

tuberous sclerosis

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12
Q

What signs will give evidence of current treatment modality in the renal patient?

A

Haemodialysis: working fistula, tunnelled neck lines, AV grafts
Peritoneal dialysis: abdominal catheter
Functioning transplant: nil evidence of other current dialysis access

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13
Q

What signs will give evidence of complications of past/current treatment?

A
  • Side effects of steroid use in glomerulonephritis: cushingoid appearance
  • Side effects of immunosuppression: fine tremor (tacrolimus), gum hypertrophy (ciclosporin), HTN (ciclosporin, tacrolimus), skin damage and malignancy (esp. ciclosporin and azathioprine)
  • Scars from prev. dialysis access/failed transplants
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14
Q

When to consider a patient may have had a kidney pancreas transplantation?

A
  • Low-midline abdominal incision with palpable kidney in iliac fossa
  • evidence prev. diabetes
  • Young patient
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15
Q

What are the top 3 causes for kidney transplant?

A
  • Glomerulonephritis
  • diabetic nephropathy
  • PKD
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16
Q

What are the 6 problems patients can suffer post renal transplant?

A
  • Rejection - acute / chronic
  • Infection secondary to immunosuppression: PCP pneumonia, CMV
  • Increased risk of other pathology: skin malignancy, post-transplant lymphoproliferative disease, HTN/Hyperlipidaemia causing CVD
  • Immunosuppressant drug effects/toxicity: ciclosporin nephrotoxicity
  • Recurrence of original disease
  • Chronic graft dysfunction
17
Q

What is the success rate for renal transplantation?

A

90% 1 year graft survival

50% 10 year graft survival

Paces (11 decks)

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