WSCredit 2 Renal Flashcards
All of the following would cause edema except:
- Hypertension
- Liver disease
- Incompetent venous valves
- Hypoproteinemia
Hypertension
What are the clinical signs of hypovolemia?
- Oliguria and cold extremities
- Bradycardia and dyspnea
- Hypertension and vertigo
- Polyuria and alkalosis
Oliguria and cold extremities
High anion gap is due to:
- Accumulation of lactate
- Renal failure
- Diarrhoea
- Benzodiazepine intoxication
Accumulation of lactate
Auditory problems have often patients suffering from:
- Gouty nephritis
- Alport disease
- Diabetic nephropathy
- AD polycystic kidney disease
- Alport disease
In peritoneal dialysis the inflow fluid is rendered hyperosmolar by the addition of
- ATP
- polyethylene glycol
- Sodium
- Glucose or icodextrin
Glucose or icodextrin
Increased risk of intracranial bleeding is associated with:
- Oxalate stones
- AD polycystic kidney disease
- Renal tubular acidosis
- Agenesis of one kidney
AD polycystic kidney disease
To compensate for metabolic acidosis … will:
- Decrease respiratory rate
- Increase respiratory rate
- Excrete more monohydrogen phosphate
- Excrete more bicarbonate ions
Increase respiratory rate
Life threatening complication of the correction of chronic hyponatremia might be:
- Hypotension
- Pontine myelinolysis
- Seizures
- Hypokalemia
Pontine myelinolysis
The falling blood pH and rising partial pressure of CO2 due to pneumonia or emphysema indicates:
- Metabolic alkalosis
- Respiratory alkalosis
- Metabolic acidosis
- Respiratory acidosis
- Respiratory acidosis
Typical blood elements found in patients with microangiopathic haemolytic anemia of patients with TTP / HUS are:
- Spherocytes
- Microspherocytes
- Schistiocytes
- Acanthocytes
Schistiocytes
Glomerular filtration rate in healthy women during 2nd and 3rd trimester of pregnancy is
- Increased
- Unchanged
- First increases, then suddenly decreases
- Decreases
Increased
Which condition would cause a drop in … (pCO2?? Or pH ?? don’t know)
- Hyperventilation
- Shock
- Vomiting
- Hypernatremia
Shock
Which EKG results would you expect to find in hyperkalemia ?
Peaked t wave
Hyperkalemia is caused by:
Potassium excess
Reduced excretion: acute and chronic kidney disease
hypocortisolism, hypoaldosteronism
potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs, and trimethoprim-sulfamethoxazole
Type IV renal tubular acidosis
myolysis, tumor lysis, hemolysis
Increased intake (high potassium diet, K+ containing IV fluids)
Extracellular shift
Acidosis → ↑ extracellular H+ → inhibition of the Na+/H+ antiporter → ↓ intracellular Na+ → ↓ sodium gradient inhibits the Na+/K+-ATPase → ↑ extracellular K+ concentration
Hyperkalemia → ↑ extracellular K+ concentration → ↑ potassium gradient stimulates the Na+/K+-ATPase → ↑ extracellular Na+ → ↑ sodium gradient stimulates the Na+/H+ antiporter → ↑ extracellular H+ → acidosis
Exceptions: In renal tubular acidosis and acetazolamide toxicity, findings include hypokalemia and metabolic acidosis.
Hyperosmolality
Insulin deficiency (manifests with hyperglycemia)
rhabdomyolysis, tumor lysis syndrome, hemolysis
Drugs
Beta-blockers
Succinylcholine: (esp. when given with preexisting burns and/or muscle trauma)
Digoxin: inhibits the Na+/K+-ATPase → ↑ extracellular K+ concentration
Diabetic ketoacidosis is an example of which imbalance?
- Respiratory acidosis
- Metabolic alkalosis
- Respiratory alkalosis
- Metabolic acidosis
Metabolic acidosis
Suggestive clinical findings for renovascular hypertension are not:
- Acute rate of onset
- Severe and refractory hypertension
- Onset of resistant hypertension before the age of 30 years
- Mild hypertension and onset in elderly
Mild hypertension and onset in elderly
A renal bruit is associated with which of the following disorders:
- Renal artery stenosis
- Polyarteritis nodosa
- Hypertensive nephropathy
- Wegeners granulomatosis
Renal artery stenosis
Immunosuppressive drugs used after (renal?) transplantation are all of the following (except?)
— Cyclosporine A
— Cyclophosphamide (or other source→“triple therapy”)
— Prednisone
— Mycophenolate mofetil
Cyclophosphamide (or other source→“triple therapy”)
the effect of NSAIDs on (on the kidneys?) circulation:
Renal function impairment: Prostaglandins normally maintain renal blood flow by inducing vasodilation of the afferent arterioles. NSAIDS inhibit prostaglandin production, which leads to harmful hypoperfusion of the kidneys and reduced GFR.
Analgesic nephropathy: prolonged NSAID use results in tubulointerstitial nephritis and papillary necrosis
Which of the values are in the normal renge for potassium:
- 4.3
- 3.3
- 6.5
- 2.8
- 4.3
Drug induced hyperkalemia is caused by:
- Heparin (uncommon side effect only)
- Digoxin
- Beta agonists
- ACE inhibitors
ACE inhibitors
Hematuria in IgA nephropathy usually appears:
- With a latency of 2-3 weeks after throat infections
- With a latency of 2-3 weeks after infection of any origin
- During an infection
- With a latency of 2-3 weeks after a UTI
During an infection
Optimal and most often used vascular access for chronic haemodialysis is:
- CVC
- Peritoneal catheter
- AV fistula in forearm
- PVC, usually in EJV
AV fistula in forearm
An important means of regulating Na+ and H2O balance in the body is through secretion of aldosterone
—true
—false
True
Ideal Kidney donor is:
Non-heart-beating donor
Transgenic pig
Living donor
Deceased donor
Living
Hypovolemia can be caused by all of the following, except:
- Aldosterone hypersecretion
- Diarrhoea
- Polyuria
- Bleeding
Aldosterone hypersecretion
Lab analysis in nephrotic syndrome does not reveal:
- Proteinuria
- Hypalbuminemia
- Hypercholesterolemia
- polyglobulia
polyglobulia
Hyperventilation causes the pH to elevate:
- True
- False
True
Which of the following EKG results would you expect in hyperkalemia
- St depression
- Tall t
- T wave flattening
- Short qrs
Tall t
Urinary protein losses exceeding 0.150 g/24 h
- Cannot be ignored and must be further evaluated
- This trace of urine does not need further evaluation
- Must be further evaluated only in patients with simultaneous dysuria and another pathology
in urinary sediment
- Must be further evaluated only in patients with simultaneous dysuria and nycturia
Cannot be ignored and must be further evaluated
A 62 year old man with COPD, baseline PCO2 8kPa and HCO3- 30mmol/l is administered to the hospital with somnolence and confusion following a flu-like syndrome.
Lab test showed pH 7.22, PCO2 10kPa, HCO3- 32 mmol/l, Na+ 141 mEq/l, K+ 4mEq/l. What is the underlying acid-base disorder?
- Respiratory acidosis plus metabolic acidosis
- Chronic respiratory acidosis
- Respiratory acidosis plus metabolic alkalosis
- Chronic respiratory acidosis plus acute respiratory acidosis
Chronic respiratory acidosis plus acute respiratory acidosis
In peritoneal dialysis metabolic waste products diffuse from peritoneal capillaries into the dialysis fluid down concentration gradient
- True
- False
T
A blood pH < 7.35 indicates acidosis but it does NOT tell you the cause
- True
- False
T
Which condition would cause a drop in pH?
- Shock
- Hypervolemia
- Vomiting
- Hypernatremia
Shock
What is the effect of NSAIDS on renal circulation?
- NSAIDs cause dilation of afferent arteriole and increase renal perfusion pressure
- NSAIDs cause constriction of afferent arteriole and decrease renal perfusion pressure
- NSAIDs lead to vasoconstriction of vas efferens and increase glomerular perfusion
- NSAIDs normalize glomerular perfusion in the case of severe diarrhoea
NSAIDs cause constriction of afferent arteriole and decrease renal perfusion pressure
Which method of glomerular filtration rate assessment do we use to determine the stage of chronic kidney disease?
- Serum cystatin C measurement
- Calculation using MDRD formula
- Acidification test
- Mean urea and creatinine clearance
Calculation using MDRD formula
Basic principle of hemodialysis is/are
— selective elimination of uremic toxins in bioreactor
— adsorption of immune complexes and uremic toxins
— separation of plasma by filtration
— diffusion of solutes across a semipermeable membrane and ultrafiltration
diffusion of solutes across a semipermeable membrane and ultrafiltration
What electrolyte imbalance can be treated by administration of glucose and insulin
— hyperkalemia
—hypokalemia
— hyponstremia
— hypercalcemia
Hyperkalemia
Increased risk of urinary tract cancer is not associated with —smoking —oxalate stones —Heavy metals —asbestos
Oxalate Stones
Antineutrophil cytoplasmic antibodies are typically detected in
— any urinary tract infection
— wegener´s granulomatosis
— bacterial pyelonephritis
— renal vein thrombosis
wegener´s granulomatosis
Abnormally high levels of CO2 in the blood would result in respiratory alkalosis
—True
—False
False —> acidosis
