Brainscape's Knowledge GenomeTM

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


See full index

year three exam 2 > CKD > Flashcards

CKD Flashcards

1
Q

what is CKD

A

worsening, progressive and irreversible loss of kidney function

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

what are the causes of CKD

A

AKI with irreversible intrinsic damage
hypertension - vessel thickening reduces blood flow
diabetes - nephropathy
glomerulopathies
vasculitis
polycystic kidney disease

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

what are the 6 complications associated with CKD

A

water, electrolyte and acid/base balance
hypertension
muscle dysfunction
renal bone disease
uraemia
renal anaemia

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

what is electrolyte/water and acid/base balance in CKD and how is it caused

A

in early stages it is caused by the inability to dilate urine
in late stages, it causes fluid build up - hyperkalaemia and acidosis

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

what is acidosis

A

inability of kidneys to remove H+ ions from the urine

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

how is electrolyte/water balance in CKD treated

A

turn off tap - fluid and sodium restriction
pull the plug - loop diuretics then metolazone
- stop at dialysis

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

how is acid/base balance in CKD treated

A

potassium - 4-6mmol/L target - calcium resonium
acidosis - sodium bicarbonate 500mg TDS

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

what does calcium resonium do

A

binds to potassium in the GIT and releases calcium ions - constipation

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

what causes hypertension in CKD

A

circulatory volume increase due to sodium and water retention - can cause artery stenosis, renin release and kidney decline and proteinuria

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

how is hypertension in CKD treated

A

lifestyle and meds
- if ACR <30 - as per NICE
- if ACR >30 - ACEi/ARB, other anti-hypertensives can be added as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

monitoring requirements in ACEi/ARB in CKD

A

potassium prior and 1-2 weeks post
creatinine
C/I IN RENAL ARTERY STENOSIS

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

how is muscle dysfunction caused in CKD

A

nutritional deficiencies and electrolyte disturbances

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

how is muscle dysfunction in CKD treated

A

lifestyle - iron, caffeine, alcohol, diet
medicines - efficacy is debated - quinine and ropinerole

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

which stages of CKD are renal bone disease the most prevalent

A

4 and 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what causes renal bone disease in CKD

A

hyperphosphatemia
low vit D
hypocalcaemia
increased PTH release from parathyroid

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

what causes hyperphosphatemia in CKD

A

high phosphate as it is not being excreted by kidneys - can cause pruritis

17
Q

what is low vitamin D caused by in CKD

A

less vit d activation as it is not happening in the kidney - causes bone softening

18
Q

what causes hypocalcaemia in CKD

A

less vit d = less absorption of calcium from GI tract, increase of phosphate also leads to more sequestering of calcium in bones

19
Q

what causes increased PTH release in CKD

A

low calcium, PTH is released to release calcium from bones

20
Q

what is the effect of high PTH in CKD

A

weakened bone structure
osteopenia and osteoporosis
increased fracture risk
bone hardening
- can lead to secondary hyperparathyroidism

21
Q

how is hyperphosphatemia treated in CKD

A

diet
phosphate binders - calcium acetate or sevlamer

22
Q

how is hypocalcaemia and low vit d treated in CKD

A

vit d3 analogue that is activated in the liver - alfacalcidol

23
Q

how is hyperparathyroidism treated in CKD

A

effective management of causes of renal bone disease
cinacalet - lowers PTH by increasing sensitivity of calcium receptors
paricalcitol - iv vit d

24
Q

what are the symptoms of uraemia

A

anorexia
N&V
constipation
foul taste
pruritis
skin discolouration

25
Q

how is uraemia treated in CKD

A
  1. dialysis
    - off label - antihistamines, SSRIs, gaba
26
Q

what causes renal anaemia in CKD

A

low levels of iron and erythropoietin - hormone synthesised in kidneys that stimulate RBC proliferation

27
Q

how is renal anaemia treated in CKD

A

recomb erythropoietin IV/SC
PO or IV ferritin

28
Q

what are the side effects of erythropoietin

A

hypertension, pre red cell aplasia

29
Q

target ferritin range

A

200-500mcg/L

30
Q

why would SGLT2 inhibitors be used in CKD

A

dapa only - renal protective effect

31
Q

what warnings are associated with dapagliflozin

A

sick day - stop
DKA can have normal BM
Fournier’s gangrene

32
Q

what vitamin replacement is used in CKD

A

renavit - all water soluble vitamins needed

33
Q

which vaccinations do all CKD patients with blood manipulation need

A

Hep B 5 yearly

year three exam 2 (38 decks)

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