Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrinology > The kidney in health and disease - for clinical dental trainees > Flashcards

The kidney in health and disease - for clinical dental trainees Flashcards

1
Q

Normal kidney functions

A
  1. Salt and water homeostasis
  2. Excretion of waste
  3. Humoral regulation of other organs
    - bone (Vti D)
    - RBCs (erythropoietin)
    - BVs (renin)
    - selectivity barrier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nephron

A 
Functioning unit of kidney
Tubules
-proximal (convoluted and straight)
-distal
-collecting ducts
-loop of Henle
We have between 500,000 and 2,000,000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Glomerulus

A

Folded, large surface area
Filters blood that’s passing through
-retains protein and blood cells
-25% of cardiac output goes through here

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

Creatinine and GFR calculation

A 
GFR calculated (24hr urine/plasma):
Creatinine clearance: \_\_\_\_\_\_ml/min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Formulae to estimate GFR (eGFR)

A

Modification of Diet in Renal Disease (MDRD)
(4) - Plasma creatinine, age, gender, race
Recently switched to CKD-EPI equation
- Performs better at higher eGFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Formulae to estimate GFR (eGFR)

A

Modification of Diet in Renal Disease (MDRD)
(4) - Plasma creatinine, age, gender, race
Recently switched to CKD-EPI equation
- Performs better at higher eGFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dialysis

A

2l bags each

120l of fluid processed by kidney each day

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

Where is vit D made?

A

Skin

-processed by kidney and liver

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

Creatinine and GFR relationship

A

GFR varies inversely with reciprocal of plasma creatinine (1/Pcr)

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

Kidney dysfunction

A
  1. Salt and water homeostasis
  2. Excretion of waste products
  3. Humoral disturbance
  4. Barrier failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Kidney dysfunction - salt and water homeostasis

A
  • changes in total body water
  • changes in BP
  • changes in urine volume or concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Kidney dysfunction - excretion and waste products

A
  • uraemia
  • acidosis e.g. lactic acid, ketoacids
  • others: potassium, phosphate, uric acid
  • clearance of drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Kidney dysfunction - humoral disturbance

A
  • anaemia
  • renal bone disease
  • hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Kidney dysfunction - barrier failure

A 
Haematuria
-red/ blood
Proteinuria
-frothy urine
-precipitates as it cools down
Lipiduria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

K/DOQI classification

A 
Stages 1-5
GFR decreases as stage increases
1. Kidney damage/ normal GFR >90
2. Mild renal insufficiency GFR 89-60
3. Moderate renal insufficiency GFR 59-30
4. Severe renal insufficiency GFR 29-15
5. Kidney failure GFR <15
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of chronic kidney disease - mild/ moderate

A 
Diet/ fluid balance
Supplements
-alkali
-vitamin D
-iron
Drugs
-phosphate
-hypertension
-anaemima
-specific conditions: immunosuppression
17
Q

Treatment of chronic kidney disease - severe

A

Dialysis

Transplantation

18
Q

Treatment of chronic kidney disease - very severe

A

Kidney replacement treatment

  • peritoneal
  • dialysis
19
Q

Signs of renal disease

A 
Flame shaped haemorrhages  in retina
Oedema
Haemorrhage in heart
Rough 'moth-eaten' edges of bone 
RBCs broken up - schistocytes
20
Q

Primary cause of ESRF in prevalent patients UK, top 5 causes <65 years

A
  1. Glomerulonephritis
  2. Diabetes
  3. Pyelonephritis
  4. Polycystic Kidney Disease
  5. Hypertension
21
Q

Fistula

A

Abnormal connection between artery and vein

Manmade for pts with kidney disease

22
Q

Why do we avoid using catheters

A

Inconvenience for patients
Bleeding
Infection
Air embolus

23
Q

Primary cause of ESRF in prevalent patients UK, top 5 causes >65 years

A
  1. Diabetes
  2. Glomerulonephritis
  3. Polycystic Kidney Disease
  4. Pyelonephritis
  5. Hypertension
24
Q

Dialysis

A 
3 times a week on average
-ideally every day
Peritoneal dialysis
-not as efficient
-cheaper
-probably 4x day
25
Clinical syndromes
``` Acute renal failure Chronic renal failure Nephrotic syndrome (proteinuria) Nephritic syndrome (haematuria) Malignant (accelerated phase) hypertension ```
26
Primary diagnosis in prevalent RRT patients in E&W
1. Glomerulonephritis 2. Pyelonephritis 3. Diabetes 4. Polycystic kidney disease 5. Hypertension/ renovascular
27
Splinter haemorrhage cause
Endocarditis Vasculitis (disease of small BVs) -renal??
28
Splinter haemorrhage history
Is it on one or both hands? Are you right or left handed? -can be due to gardening or strenuous activity
29
Blotchy rash on cheeks, woman
Systemic Lupus Erythematosus | -kidney failure
30
Red swollen hand Cotton wool spots (retina) Hands - flexion deformity, swollen, red and shiny
Completely blocked kidney due to excess material | Systemic sclerosis
31
ESRD complications
``` Cardiovascular disease -hypertension -K-related arrhythmias -cardiac valvular calcifications Infections Malnutrition Renal osteodystrophy Immunosuppression -infection (atypicals) -cancer (skin, post tx lymphoproliferative) -hypertension, diabetes CVD Recurrent disease ```
32
Oropharyngeal candidiasis
Common problem for immunosuppressed pts
33
Gingival overgrowth associated with which drugs
Cyclosporin -transplants/ immunosuppression Antihypertensives -calcium channel blockers (Amlodipine, Diltiazem, Nifedipine)
34
Kidney failure and the dentist
``` The kidney patient, especially patients with stage 4-5 (eGFR<30, Advanced CKD) are: -anaemic -have a bleeding tendency -->Minimise blood loss -->Transfusions (complicates future transplant) -->Maximum homeostasis Has CVD: -hypertensive -fluid overloaded -valvular sclerosis -->prophylactic antibiotics -->may have difficulty lying supine -->likely to have fluid restriction -hyperkalemic or pre-dialysis -->Be careful with GA -->Monitor serum K post-operatively (rebounds) ```
35
Chronic kidney disease and drugs
Generally be careful with appropriate dosing of medications commenced Ensure considered correct dose and frequency for eGFR Be aware of medication interactions eg Clarithromycin/erythromycin/fluconazole and Tacrolimus If in doubt, aim to plan electively or contact the renal unit to query
36
Creatinine
End product of skeletal muscle catabolism > by dietary meat intake Released into circulation at constant rate Freely filtered at glomerulus -15% of urinary creatinine secreted by tubules -used to calculate GFR

Endocrinology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions