Htn Kidney

Question 1

Single best summary of kidney fcn

Answer 1

GFR

Question 2

Poor kidney function what effect on blood pressure?

Answer 2

high blood pressure

Question 3

GFR vs age?

Answer 3

lower with age

Question 4

Normal GFR = ?

Answer 4

120-130 mL/min/1.73 m^2

Question 5

Biochemical abnormalities when GFR = ?

Question 6

Inability to keep up with metabolism when GFR = ?

Question 7

high blood creatinine means?

Answer 7

low filtration

Question 8

Cr affected by?

Answer 8

muscle mass, age, sex

Question 9

Clinical kidney disease criteria

Answer 9

Chronicity plus:

eGFR

Question 10

Dietary restrictions designed to avoid?

Answer 10

salt/water retention
hyperkalemia
severe bone disease from hyperphosphatemia

Question 11

Options when disease is advanced?

Answer 11

transplant or dialysis

Question 12

best transplant scenario?

Answer 12

pre-emptive living donor

Question 13

Absoulte indications to start dialysis?

Answer 13

encephalopathy
pericarditis/pleuritis
uremic bleeding
intractable hyperkalemia, metabolic acidosis, volume overload

Question 14

Abx prophylaxis needed with dialysis?

Answer 14

Not unless high-grade bacteremia anticipated

new fistula, graft, catheters

Question 15

Meperedine/demerol safe?

Answer 15

NOOOO

Question 16

which is safe pain med?

Answer 16

hydromorphone/diluadid

Question 17

Why are NSAIDS bad?

Answer 17

cause loss of reamining kidney function in CKD

Question 18

Dental work and hemodialysis bleeding

Answer 18

better on non-HD days b/c will be on heparin, warfarin, aspirin

Question 19

Dose adjustments for abx?

Answer 19

single dose: no adjustment
Clindamycin, Azirthromycin not adjusted (the two you take)
Amoxicillin, cephalexin: interval adjustment (the x’s)
Clarithromycin: dose reduction

Question 20

Increase of BP vs CVDisease?

Answer 20

Each increase of 20/10 mmHg doubles risk of CVD starting with 115/75 mmHg

Question 21

Htn classification
Normal
Prehypertension
Stage 1
Stage 2

Answer 21

Normal 120/80
Prehypertension 160/100

(increase by 20/10)

Question 22

Treatment cutoffs?

Answer 22

140/90 adults or 130/80 for proteinuria

Question 23

Htn followup?

Answer 23

180/110 now

Question 24

If cuff is too small, what will happen to reading?

Answer 24

too high

Question 25

oral contraceptives and BP

Answer 25

may increase

Question 26

Elderly BP epidemiology? | Control?

Answer 26

2/3 are hypertensive above 65 yo lowest rates of BP control Need lower initial drug doses/combinations

Question 27

BP emergency defined as?

Answer 27

marked elevation or >180/120

Question 28

Highest impact on BP from lifestyle? lowest?

Answer 28

Weight reductoin/DASH eating Lowest is moderation EtOH

Question 29

DASH diet low in?

Answer 29

sat fat, cholesterol, total fat