2. Renal

Question 1

kidney metabolic rate

Answer 1

> 400 kcal/kg tissue/day

HIGH

Question 2

kidneys CO

Answer 2

20-25%

Question 3

normal glomeruli will filter

Answer 3

180 L plasma/day

Question 4

kidney function

Answer 4

regulate water and sodium
volume homeostasis

Question 5

kidney nephrons

Answer 5

1 million

Question 6

kidney autoregulation

Answer 6

50-150 mmHg

Question 7

what triggers afferent arteriole to dilate or constrict

Answer 7

change in Cl-

Question 8

angiotensin 2 function

Answer 8

incr ADH
efferent constriction
incr Na+ absorption in PT
incr aldosterone

Question 9

aldoserone function

Answer 9

incr Na+ absorption from DT

Question 10

best index of kidney function

Answer 10

GFR

Question 11

normal GFR

Answer 11

> 90 mL/min/1.73 m2

Question 12

after age 20 GFR decreases

Answer 12

1% annually

Question 13

uremia symtoms appear once

Answer 13

GFR < 15

Question 14

easiest marker of kidney function

Answer 14

Cr

Question 15

Cr is byproduct

Answer 15

muscle/protein breakdown

Question 16

why is cr useful

Answer 16

not secreted or ecreted

Question 17

normal Cr (female)

Answer 17

0.6-1 mg/dL

Question 18

normal Cr (male)

Answer 18

1-1.3 mg/dL

Question 19

BUN

Answer 19

soft indicator of GFR
can be reabsorbed

Question 20

what BUN correlates with decr GFR

Answer 20

BUN > 50

Question 21

FENa

Answer 21

ratio of Na+ in plasma and urine to ratio of Cr in plasma and urine

Question 22

FENa < 1%

Answer 22

tubule reabsorbing Na appropriately

Question 23

FENa > 2%

Answer 23

tubule failing to recapture Na
tubule dysfunction

Question 24

FENa > 3%

Answer 24

acute tubular necrosis

Question 25

normal Urine specific gravity

Answer 25

> 1.018

Question 26

what 2 things can affect ability for tubules to concentrate urine

Answer 26

diuretics hyperglycemia

Question 27

prerenal AKI

Answer 27

decr perfusion or blood flow

Question 28

renal AKI

Answer 28

directly affects kidney or nephron

Question 29

postrenal AKI

Answer 29

something blocking urine outflow

Question 30

prerenal causes

Answer 30

hemorrhage gi losses burns cardiogenic shock surgery sepsis

Question 31

renal causes

Answer 31

acute tubular necrosis dehydration contrast dye NSAIDs antifreeze acute golmerulonephritis vasculitis interstitial nephritis

Question 32

postrenal causes

Answer 32

nephrolithiasis BPH bladder malignancy cystic bleeding/clots ureter ligation

Question 33

AKI diagnosis

Answer 33

Cr incr 0.3 in 48 hrs or 50+% incr over 7 days

Question 34

severe AKI inidcation

Answer 34

oliguria < 100 mL/day

Question 35

nephrotic syndrome

Answer 35

severe proteinuria > 3.5 g daily low albumin

Question 36

CKD stage 2

Answer 36

GFR 60-90 mild

Question 37

CKD stage 3a

Answer 37

GFR 45-60 mild mod

Question 38

CKD stage 3b

Answer 38

GFR 30-45 mod sev

Question 39

CKD stage 4

Answer 39

GFR 15-30 sev

Question 40

CKD stage 5

Answer 40

GFR < 15 kidney failure

Question 41

which stage CKD may need dialysis

Answer 41

stage 4

Question 42

which stage CKD will need dialysis

Answer 42

stage 5

Question 43

uremic syndrome

Answer 43

constellation of symptoms that manifest once CKD progresses to 10% normal kidney function affects all other organ systems

Question 44

midodrine effect

Answer 44

incr BP during dialysis days

Question 45

uremic syndrome S+S

Answer 45

HTN LVH diastolic dysfunction pericarditis pulm edema hyponatremai hyperkalemia hypomag hyperphos hypercal metabolic acidosis anemia hyperparathyroid

Question 46

does ESRD affect propofol

Answer 46

no

Question 47

does ESRD affect etomidate

Answer 47

no

Question 48

which induction drugs are affected by ESRD

Answer 48

thiopental benzos ** decr protein binding** **decr dose**

Question 49

opioid dosing in ESRD

Answer 49

lower doses longer intervals

Question 50

opioid not recommended in ESRD

Answer 50

meperidine can cause seizures

Question 51

best opioid for ESRD

Answer 51

fentanyl (dilaudid decent)

Question 52

which muscle relaxants are predicatable and not prolonged in ESRD

Answer 52

atracurium cisatracurium

Question 53

which muscle relaxants will have peaked T waves in ESRD

Answer 53

sux

Question 54

laudanosine can cause

Answer 54

neuroexcitiation seizures

Question 55

definitive managment of ESRD

Answer 55

dialysis

Question 56

peritoneal dialysis advantages

Answer 56

at home no fluid shifts

Question 57

peritoneal dialysis disadvantages

Answer 57

cannot change volume status infection risk

Question 58

how many hemodialysis sessions

Answer 58

3 sessions per week 3 hours long

Question 59

types of vascular access for hemodialysis

Answer 59

temporaty catheter tunnele catheter AV fistula AV graft

Question 60

hemodialysis catheter symptoms

Answer 60

infection

Question 61

AV fistula/graft SE

Answer 61

thrombosis stenosis aneurysms steal syndrome

Question 62

what to ask day of surgery

Answer 62

Cr level dialysis (last dialysis) K+ BP control diabetes/glu level anemia GERD urine output

Question 63

most common anesthetic

Answer 63

MAC

Question 64

BPH

Answer 64

enlarged prostate inhibits urine flow weak stream frequent urgency

Question 65

BPH treatment

Answer 65

TURP

Question 66

TURP syndrome

Answer 66

prostate is vascular and cysto fluids can be forced/absorbed into pts vasculature

Question 67

TURP syndrom pressures

Answer 67

< 15 cmH2O

Question 68

how much fluid can be absorbed through prostate

Answer 68

200 mL/min

Question 69

TURP syndrome issues

Answer 69

fluid overload hyponatremia hyperosmolarity hyperglycinemia

Question 70

TURP irrigation fluid

Answer 70

glycine

Question 71

glycine SE

Answer 71

transient blindness

Question 72

TURP syndrom triad

Answer 72

confusion bradycardia HTN

Question 73

TURP syndrome treatment

Answer 73

remove cause supportive care