8: Renal Complaint

Question 1

CrCl

Answer 1

Creatinine clearance

Question 2

ESRD

Answer 2

End stage renal disease

Question 3

Uremia

Answer 3

Elevated levels of BUN

Question 4

BUN

Answer 4

Blood urea nitrogen

Question 5

What do BUN and Cr gauge?

Answer 5

Kidney function

Question 6

Cr

Answer 6

Creatinine

Question 7

How BUN works

Answer 7

Urea nitrogen is a waste product by liver -> travels from liver to kidneys for excretion

Question 8

How does creatinine work?

Answer 8

Waste product of muscle breakdown, constantly excreted by kidneys

Question 9

Seven things tested for in BMP (basic metabolic panel)

Answer 9

Na, K, Cl, bicarb, BUN, Cr, glucose

Question 10

CMP: complete metabolic panel: BMP + which other six tests?

Answer 10

AST, ALT, AlkPhos, bilirubin, total protein, albumin

Question 11

Specific gravity

Answer 11

Tests urine concentration (usually 1.01 to 1.03)

Question 12

Nl pH of urine

Answer 12

4.5-8

Question 13

Reference range for urine protein, glucose, blood, and bilirubin

Answer 13

0

Question 14

Nitrites in urine?

Answer 14

Associated with UTI

Question 15

Leukocyte esterase in urine?

Answer 15

Enzyme produced by WBCs, suspect infection

Question 16

How to know if AKI progresses to CKD

Answer 16

If renal dysfunction is not resolved in 3 months

Question 17

What are the 5 stages of CKD defined by?

Answer 17

GFR

Question 18

What CKD stage is considered ESRD?

Answer 18

Stage 5

Question 19

Renal ROS questions for suspected CKD

Answer 19

Urine output, frequency, hesitancy, foamy urine, urine color, smell, flank pain, dysuria, Hx stones, N/V, confusion, pruritis, metallic taste in mouth, fatigue

Question 20

Asterixis

Answer 20

Cant hold hand with wrist extended

Question 21

Uremic frost

Answer 21

Sweating out urea -> creates frosty look on skin

Question 22

Three limitations to using GFR to Dx CKD

Answer 22

1. Not reliable when GFR > 60
2. Not reliable in AKI (changes too rapidly)
3. Not reliable in low muscle mass pts

Question 23

Complications in CKD

Answer 23

CVD, mineral and bone disease, Amelia, electrolyte abnormalities, metabolic acidosis, volume overload, uremia, HTN

Question 24

Three types of renal replacement therapy (RRT)

Answer 24

1. Hemodialysis
2. Peritoneal dialysis
3. Renal transplant

Question 25

Five indicators for dialysis

Answer 25

1. A: severe acidosis 2. E: electrolyte disturbance 3. I: ingestion of certain substances 4. O: volume overload 5. U: uremia (AEIOU)

Question 26

Asymptomatic bacteriuria

Answer 26

Presence of bacteria w/out sx

Question 27

Cystitis

Answer 27

Bladder infection

Question 28

Imaging of pyelonephritis

Answer 28

Mild cases -> no imaging | Severe cases -> CT abd/pelvis

Question 29

Lloyd’s punch positive test

Answer 29

Pain in costovertebral angle with deep percussion/punch -> kidney path

Question 30

Symp level of GU tract including bladder

Answer 30

T10-L2

Question 31

Sympathetic innervation levels for upper and lower ureter

Answer 31

Upper: T10-11 Lower: T12-L2

Question 32

Parasymp innervation to upper and lower ureter and bladder

Answer 32

Upper: vagus N Lower: S2-S4 Bladder: S2-S4

Question 33

Chapman’s reflex points

Answer 33

Group of palpable points occurring in predictable locations on the anterior and posterior surfaces of the body that are reflections of the visceral dysfunction or disease