Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal Exam 2 > CKD > Flashcards

CKD Flashcards

(51 cards)

Start Studying
1
Q

Define CKD

A

A spectrum of different pathophysiologic process/diseases associated with abnormal kidney function and a progressive decline in GFR

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

Define Chronic Renal Failure

A

Irreversible reduction in nephron number, corresponds to CKD stages 3-5

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

Define ESRD

A

Accumulation of toxins, fluid and electrolytes normally excreted by the kidney results in the uremic syndrome

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

Stage 0

A

GFR >90 with RF for CKD

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

Stage 1

A

GFR > 90 with kidney damage/malfunction (persistent proteinuria, abnormal urine sediment, abnormal blood/urine chemistry, abnormal imaging studies

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

Stage 2

A

GFR 60-89

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

Stage 3

A

GFR 30-59

Symptoms are present

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

Stage 4

A

GFR 15-29

Symptoms are present

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

Stage 5

A

GFR less than 15

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

CKD Pathophysiology

A

1) Mechanisms specific to the etiology (glomerulonephritis, tubulointerstitial disease, kidney development)
2) Progressive reduction of renal mass (hyperfiltration and hypertrophy of remaining nephrons)

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

Decreased number of nephrons leads to

A

Hypertrophy and hyperfiltration –> increased pressure and flow –> distortion of glomerular architecture/sclerosis and drop out of remaining nephrons –> destruction of parenchyma

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

What can cause hypertrophy and hyperfiltrations

A

Vasoactive hormones
Cytokines
Growth factors
RAS

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

What can cause distortion of glomerular architecture/sclerosis and drop out of remaining nephrons?

A

RAS and TGF-beta

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

What are the consequences of hyperfiltration

A

Fibrosis and compression of the endothelial cells –> can’t function –> more nephrons are removed –> irreversible process of damage begins

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

Common risk factors for CKD

A 
HTN and DM
Lupus
Age
Previous AKI
Genes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

GFR normal

A

120 mL/min per 1.73 m^2

Lower in women than in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mild elevation in SCr

A

Signifies substantial reduction in GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mild elevation in SCr

A

Signifies substantial reduction in GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Microalbuminuria refers to

A

the excretion of amounts of albumin too small to detect by regular urinary distick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Monitoring nephron injury

A

GFR
Albuminuria (24 hr collection)
Protein-to-creatinine ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Stage 1 and 2 Symptoms

Study These Flashcards
A

None related to decreased GFR but may be some related to the renal disease (edema, HTN)

22
Q

Stage 3 and 4 symptoms

Study These Flashcards
A

Anemia
Fatigability
Decreasing appetite with progressive malnutrition
Calcium, phosphorus, sodium, potassium, water, acid-base homeostatis and mineral regulating hormone abnormalities

23
Q

Stage 5 Symptoms

Study These Flashcards
A

Toxins accumulate –> disturbance in their daily living, well being, nutrional status, water/electrlyte homeostatis

24
Q

Stage 5 leads to

Study These Flashcards
A

Uremic syndrome

25
Leading etiologies of CKD
DM II Glomerulonephritis Hypertensive nephropathy Polycystic kidney disease
26
Pathophysiology of uremia
Accumulation of toxins that undergo renal excretion Loss of other renal functions (fluid homeostatis and hormone regulation) Systemic inflammation and its vascular and nutritional complications (elevated protein C)
27
Surrogate markers of real toxins are:
Urea and creatinine
28
Uremia leads to
disturbances in the function of virtually every organ system
29
Severy complications and consequences of CKD
Cardiovascular Hematologic (no erythropoietin) Ca, PO4 and bone (replacement with fibrosis)
30
Define metabolic acidosis
Abnormally high level of acid and low bicarbonate in blood and other tissues resulting from inability to excrete protons and reabsorb bicarb
31
Hypervolemia
Na & H2O retention Extracellular fluid expansion --> HTN and edema HTN leads to nephron injury acceleration (no RAAS activation so retention)
32
Hypovolemia
Na and H2O leads to extrarenal fluid loss + | Impaired renal conservation leads to acute-on-chronic renal failure
33
Acute on chronic
Inability to concentrate the urine leads to increased water loss and decreased CO
34
Things that lead to hyperkalemia
``` Protein catabolism GI hemorrhage ACEi ARBs Transfusion Hemolysis Diuretics ```
35
HyperK is seen in
DM | Obstructive and sickle cell nephropathy
36
Ischemic cardiovascular disease types
Occlusive coronary disease Cerebrovascular disease Peripheral vascular disease
37
Normocytic, normochromic anemia
``` Insufficient erythropoietin Iron deficiency Impaired iron utilization Severe hyperparathyroidism (bone marrow fibrosis) Shortened RBC survival ```
38
Abnormal hemostatis =
Prolong bleeding time | Thromboembolism (nephrotic syndrome - loss of anticoagulants)
39
Bone manifestations of CKD
High bone turnover with increased PTH levels | Low bone turnover with low or normal PTH
40
Bone manifestations of CKD
High bone turnover with increased PTH levels | Low bone turnover with low or normal PTH
41
High bone turnover with increased PTH levels =
Osteitis fibrosa cystica
42
Low bone turnover with low or normal PTH =
Adynamic bone disease (PTH suppression) | Osteomalacia
43
Decreased calcium leads to
Bone :Increased bone absorption and Ca efflux Kidney and intestine: Increased Ca reabs and decreased PO4 reabs Bone and Kidney due to increased PTH Intestine due to increased dihyroxycholecalciferol
44
Too much calcium =
Thyroid gland releases calcitonin which stimulates Ca salt deposit in bone
45
Too little calcium =
Thyroid gland releases PTH which tells osteoclast to degrade bone matrix to release Ca into blood
46
Renal osteodystrophy
Increased osteoclastic bone resorption (osteitis fibrosa cystica like disease) Osteomalacia (decreased matrix mineralization) Adynamic bone (reduced volume and mineralization
47
Secondary hyperparathyroidism Patho
Declining GFR leads to reduced PO4 excretion PO4 stimulates increased PTH and growth of parathyroid gland Decreased Ca leads to PTH production Low calcitriol has a direct effect on PTH transcription Metabolic Acidosis stimulates bone resorption - GFR
48
FGR-23 (phosphatonin)
RF for left ventricular hypertrophy and mortality in dialysis pts Tries to keep normal phosphorus levels Increases early in CKD and promotes PO4 excretion
49
CKD has
Hypocalcemia and hyper PO4
50
CKD has
Hypocalcemia and hyper PO4
51
Consequences of CKD
``` Bone pain and fragility Brown tumor Compression syndromes Erythropoietin resistance PTH related muscle weakness and fibrosis of cardiac muscles ```

Renal Exam 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions