10.27: intro Flashcards Preview

MHD V: Renal > 10.27: intro > Flashcards

Flashcards in 10.27: intro Deck (42):
1

Major functions of the kidney?

1. Filtration
2. Excretion
3. Electrolyte / acid base homeostasis
4. BP regulation

2

When are GFR calculations reliable?

- Only when ptn. is in steady state
- Calculations do not work once patient has renal impairment

3

Equation for fractional excretion of Na / urea?

= (Urine Na / Plasma Na) / (Urine Creatinine / Plasma Ca)
***Helps to determine cause of acute kidney injury

4

Components of the kidney?

1. Glomeruli
2. Tubules
3. Interstitium
4. Vasculature
5. Renal calyx

5

Components of collecting system?

1. Ureters
2. Bladder
3. Urethra

6

GFR equation?

(Urine creatinine x volume) / Plasma creatinine

7

Cockrost Gault GFR forluma?

( (140 - age) x weight (kg) x .85 (females)) / 72 x serum Cr

8

What is normal urine output?

1500 ml per day

9

What is Oliguria?

- Too little urine output

10

What is anuria?

No urine output

11

What is polyuria?

- > 3000 ml per day
- Too much urine output

12

What is azotemia?

- An elevation in renal indices
- Normally an increase in BUN

13

What is BUN?

"Blood urea nitrogen"
- Urea nitrogen is formed when protein breaks down

14

What is uremia?

- Syndrome that can accompany severe renal failure
1. Fatigue
2. Anorexia
3. Altered mental status
4. Serositis: effusion
5. Platelet dysfunction
6. Itching

15

What is AKI? ARF?

ARF: "Acute renal failure" old term
AKI: "Acute kidney injury" new term

16

What are CRI? CRF? CKD?

CRI: "Chronic renal insufficiency"
CRF: "Chronic renal failure"
CKD: "Chronic kidney disease" NEW TERM

17

What is ESRD?

- "End stage renal disease"

18

Parameters for AKI?

Abrupt drop in kidney function in 48 hours defined as:
1. Increase serum Cr
2. Oliguria

19

Characteristics of CKD?

- Progressive decrease in GFR over time
- Usually lasting at least 3 months
- With or without albuminuria

20

What is normal GFR?

> 90

21

What are the 5 stages of renal disease?

1. Kidney damage with normal GFR > 90
2. Kidney damage with GFR 60 - 89
3. GFR 30 - 59
4. GFR 15 - 29
5. Kidney failure: GFR

22

What is hematuria?

Blood in the urine

23

What is nephrolithiasis?

- AKA "Kidney Stones"
- Presents as moderate to severe renal colic
- Ca oxalate and Ca phosphate most common

24

Another name for kidney stones?

Nephrolithiasis

25

What are dysmorphic RBCs in urine characteristic of?

- Glomerular hematuria

26

What is pyuria?

WBCs or pus in the urine

27

When are epithelial casts usually seen?

Acute tubular necrosis

28

When are fatty casts seen?

Lipiduria seen in nephrotic syndrome

29

When are hyaline casts seen?

1. Dehydration
2. Exercise
3. Diuretic therapy

30

When are waxy casts seen?

Advanced kidney disease

31

What is nephrotic syndrome? Characteristics?

** > 3 - 3.5g / day of protein in urine
1. Hypoalbuminemia
2. Peripheral edema
3. Hyperlipidemia: to raise oncotic pressure
4. Thrombophilia: tendency to clot, in renal vein
5. Bland urinary sediment
6. Non inflammatory renal biopsy

32

Characteristics of nephritic syndrome?

1. Inflammatory renal biopsy
2. Active urinary sediment
3. Variable proteinuria
4. Azotemia / oliguria
5. Mild Htn.

33

What is normal total body water?

- 60% total body weight
- 2/3 intracellular, 1/3 extra
- 1/4 of extra is plasma volume
- 3/4 extra is interstitial space

34

What are IV crystalloid solutions?

- Used in volume depletion
- Disperse across ECW

35

What are IV colloid solutions?

- Given in volume depletion
- Tend to stay in plasma volume
- Packed RBCs or albumin solution

36

Where is EPO produced?

Kidneys

37

Function of Vitamin D?

- Regulates Ca absorption and maintains normal levels of Ca and phosphorus

38

Where is vitamin D activated?

- In the kidneys
- Produced in liver

39

Why is anemia seen in advanced kidney disease?

EPO is made in kidney

40

Why is there decrease in vitamin D in kidney disease?

- Vitamin D is activated in kidney

41

What are the non specific symptoms of renal disease?

1. Fever
2. Pain
3. Rash
4. Eosinophilia

42

What type of molecules can be

- Small, uncharged un protein bound molecules