WEEK 5: RENAL

Question 1

RENAL INSUFFICIENCY

Answer 1

• Partial or complete kidney function impairment
• Leads to poor excretion of waste products and water and functional disturbance for all body systems
• Acute renal failure or Chronic renal disease

Question 2

CHRONIC KIDNEY DISEASE

Answer 2

• Also known as chronic renal disease→ A progressive loss in renal function over a period of months or years
• A person can lose up to 90% of their kidney function before experiencing any symptoms
• 1 in 9 Australians over 25 have one clinical sign for CKD (reduced kidney function, proteinuria or haematuria)

Question 3

CKD AETIOLOGY

Answer 3

• Diabetic nephropathy
• Hypertension
• Glomerulonephritis
• HIV nephropathy
• Reflux nephropathy in children
• Polycystic kidney disease
• Kidney infections and obstructions

Question 4

DELIRIUM AND DSM CRITERIA

Answer 4

• Acute alteration of mental state that is related to a physical cause
  1) Disturbed attention and awareness
  2) Disturbance develops over a short period of time, is a change from baseline, tends to fluctuate in severity over the day
  3) An additional disturbance in cognition
  4) (1) and (3) are not better explained by another pre-existing, established or evolving neurocognitive disorder (e.g. dementia) nor in context of severely reduced level of consciousness, such as coma
  5) Evidence of an aetiological cause

Question 5

DELIRIUM; PREDISPOSING RISK FACTORS

Answer 5

• Age >70 years
• Severe medical illness
• Pre-existing cognitive impairment (e.g. dementia)
• Depression
• Alcoholism
• Malnutrition
• Functional impairment
• Sensory impairment

Question 6

DELIRIUM: PRECIPITATING FACTORS

Answer 6

• Psychotropic medications
• Polypharmacy
• Infection
• Dehydration
• Indwelling catheter
• Physical restraints
• Alcohol or drug withdrawal
• Hypoxic encephalopathy
• Metabolic (e.g abnormal serum sodium, low serum albumin)
• Pain