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Nephrology > CKD > Flashcards

CKD Flashcards

1
Q

CKD

A

a slow and progressive loss of
renal function

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2
Q

Loss of function in CKD is reversible (T/F)

A

false. irreversible

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3
Q

CKD injury site

A

On glomeruli.

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4
Q

Does glomeruli regenerate

A

Nopesy

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5
Q

Histological features on CKD

A

o Shrunken kidneys
o Sclerotic glomeruli
o Fibrotic changes

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6
Q

Kidneys may be normal or enlarged in CKD patients with

A

DM
PCKD
Amyloidosis
SLE
Infections
NSAIDs
Obstructive uropathies

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7
Q

Casuses of CKD

A

DM
HTN
GN
SLE
PCKD
Amyloidosis
CKDu (CINAC)
Obstructive uropathies
Drugs
Snake bites

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8
Q

Sx of CKD

A

 Anaemia, pallor
 Nausea, vomiting
 Pruritus
 Pigmentation
 Pleural effusion
 Pericardial effusion
 Peripheral neuropathy
 Fluid overload and it features

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9
Q

Earliest Sx of CKD

A

Nocturia

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10
Q

GFR value when Sx starts appear in CKD

A

GFR<20

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11
Q

Type of breathing in severe metabolic acidosis

A

Kussamaul’s breathing

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12
Q

Dx of CKD

A

 Suspect based on
o underlying disease
o time frame for disease manifestation
 Confirm using biochemistry/radiology
o high serum creatinine
o abnormal phosphate and calcium levels
o anaemia
o small kidneys on ultrasound

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13
Q

Stages of CKD

A

 1 (GFR 90-120)
 2 (GFR 60-90)
 3 (GFR 30-60)
 4 (GFR 15-30)
 5 (GFR < 15) (ESRD)

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14
Q

Even stages 3, 4 or 5 of CKD can be Asx (T/F)

A

True

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15
Q

Treatment protocol in stage 1-5 in CKD

A

o Measures to retard disease progression

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16
Q

Treatment protocol in stage 3-5 in CKD

A

o Measures to reduce symptoms

17
Q

Final Mx step for CKD stage 5

A

RRT

18
Q

Measures to retard progression in CKD

A

 Reduce Intra renal BP
 Reduce Systemic BP
 Reduce RAS pathway activation
 Block AT/aldosterone/PGE2….TGF beta
 Reduce Proteinuria
 Reduce Cytokine release

19
Q

A multiple risk modification is required for CKD (T/F)

A

True

20
Q

Measures for symptomatic management for CKD

A

 Furosemide
 Nifedipine
 Domperidone
 1 alpha calcidol
 Erythropoietin
 Emollient ointment
 Calcium carbonate
 Sodium bicarbonate powder
 Polystyrene resins

21
Q

Benefit of giving anti- hypertensives for CKD

A

Reduces fluid overload

22
Q

Benefit of giving 1- alpha calcidol in CKD

A

To correct hypocalcemia

23
Q

EPO is a IM injection (T/F)

A

False. SC

24
Q

Benefit of giving emollients of CKD

A

Pruritis

25
Q

When will the Cr levels start to increase in CKD

A

GFR is around 60

26
Q

Histological finding in Kidneys in CKD

A

Loss of cortico- medullary demarcation

27
Q

Reason for hypocalcemia in CKD

A

Vitamin D undergoes 1- alpha hydroxylation in the kidney (Become 1,25 (OH)2 vit D)
The hydroxylation is affected so Ca2+ levels will be reduced. (Vitamin D increases Ca2+ levels)

28
Q

Why is there increased Phosphate levels in CKD

A

Coz they are not excreted by the kidneys

29
Q

Why is there a secondary hyperparathyroidism in CKD

A

hypocalcemia stimulates the parathyroid gland causing increased PTH

30
Q

Result of secondary hyperparathyroidism in CKD

A

PTH will reduce phosphate levels and increase calcium levels

31
Q

Tertiary hyperparathyroidism in CKD

A

In CKD because the parathyroid gland is constantly stimulated, at some point the gland will autonomously stimulate

32
Q

Calcium and phosphate levels in CKD

A

Increased Calcium and Phosphate levels

33
Q

Why is Reducing RAS pathway activation necessary in CKD

A

the remaining active glomeruli will try to increase the GFR by activating RAAS and vasoconstricting the efferent arterioles. In the long run this is detrimental

34
Q

Why is there a cytokine release in CKD

A

proteinuria causes inflammation at the glomeruli causing a cytokine release

35
Q

Why is EPO given to CKD patients

A

CKD patients have normochromic normocytic anemia.
o Loss of appetite
o Blood loss from GIT
o Erythropoietin deficiency
o Bone marrow toxins are retained
o Haemolysis during dialysis

36
Q

methods of EPO administration

A

IV or SC

37
Q

Mx of Anemia of renal disease

A

o Look at blood picture
o Assess iron stores/folate/B 12
o Erythropoietin replacement ± Fe/
Folate/ B12

38
Q

Measures of RRT

A

 Dialysis
o Haemo-dialysis
o Peritoneal-dialysis
 Transplant
o Cadaveric
o Live
 Related
 Non-related

Nephrology (4 decks)

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