nephrology Flashcards
(25 cards)
What patients have a compelling indication for starting an ACE-I or ARB (unless contraindications)? (Select all that apply)
A. All diabetic patients
B. All hypertension patients
C. CKD stage 3 and above (unless hyperkalemia)
D. Non-diabetic patients stage 1 or 2 with >300mg/day albuminuria
A, C, D
Which of the following medications that should be avoided in patients with CKD? ( Select that all appy)
NSAIDS
Radiocontrast dye
C. ACE-1
D. Aminoglycoside antibiotics
E. Vancomycin
F. Cyclosporine
G. Amphotericin B
A, B, D-G
Which of the following are the potential complications of CKD stage III? (Select all that apply)
A. Volume Overload
B. Hyperkalemia
C. Metabolic acidosis
D. Respiratory acidosis
E. Renal Osteodystrophy
F. Anemia
A,B,C, E,F
Signs of waste production accumulation - (Select all that apply)
A. nausea and vomiting,
B. lethargy
C. faigure
D. impaired thought processes and headache may occur
all of the above
Patients with CKD experience an increase incidence of cardiovascular disease related to (Select all that apply)
a. hypertension
b. vascular calcifications
c. a genetic predisposition
d. hyperinsulinemia causing dyslipidemia
e. increased high-density lipoprotein levels
A, B, D
The patient with CKD is brought to the ED with Kussmaul respirations. What does you should know about CKD that could cause this patient’s Kussmaul respirations?
A. uremic pleuritis is occurring
B. decreased pulmonary macrophage activity
C. respiratory compensation for metabolic acidosis
D. pulmonary edema from HF and fluid overload is occurring
C
A patient with a 25-year history of type 1 diabetes mellitus is reporting fatigue, edema, and an irregular heartbeat. On assessment, you find newly developed hypertension and uncontrolled blood sugars. Which diagnostic study is most indicative of chronic kidney disease (CKD)?
a. Serum creatinine
b. Serum potassium
c. Microalbuminuria
d. Calculated glomerular filtration rate (GFR)
D
Which patient information will you plan to obtain in order to determine the effectiveness of the prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)?
A. Blood pressure
B. Phosphate level
C. Neurologic status
D. Creatinine clearance
B
When you are taking a history for a patient who is a possible candidate for a kidney transplant, which information about the patient indicates that the patient is not an appropriate candidate for transplantation?
A. The patient has metastatic lung cancer.
B. The patient has poorly controlled type 1 diabetes.
C. The patient has a history of chronic hepatitis C infection.
D. The patient is infected with the human
immunodeficiency virus.
A
You’re assessing morning lab values on a female patient who is recovering from a myocardial infraction. As a residence, which lab value below requires you to notify the physician?
A. Potassium level 4.2 mEq/L
B. Creatinine clearance 35 mL/min
C. BUN 20 mg/dL
D. Blood pH 7.40
B
Select all the patients below that are at risk for acute intra-renal injury?
A. A 45 year old male with a renal calculus.
B. A 65 year old male with benign prostatic hyperplasia.
C. A 25 year old female receiving chemotherapy.
D. A 36 year old female with renal artery stenosis.
E. A 6 year old male with acute glomerulonephritis.
F. An 87 year old male who is taking an aminoglycoside
medication for an infection.
C, E, F
A patient with acute kidney injury has the following labs: GFR 92 mL/min, BUN 17 mg/dL, potassium 4.9 mEq/L, and creatinine 1 mg/dL. The patient’s 24 hour urinary output is 1.75 Liters. Based on these findings, what stage of AKI is this patient in?
A. Initiation
B. Diuresis
C. Oliguric
D. Recovery
D
A 36-year-old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply:
A. Water intoxication
B. Hypotension
C. Low urine specific gravity
D. Hypokalemia
E. Normal GFR
B, C, D
Which patient below with acute kidney injury is in the oliguric stage of AKI:
A. A 56 year old male who has metabolic acidosis, decreased GFR, increased BUN/Creatinine, hyperkalemia, edema, and urinary output 350 mL/day.
B. A 45 year old female with metabolic alkalosis, hypokalemia, normal GFR, increased BUN/creatinine, edema, and urinary output 600 mL/day.
C. A 39 year old male with metabolic acidosis, hyperkalemia, improving GFR, resolving edema, and urinary output 4 L/day.
D. A 78 year old female with respiratory acidosis, increased GFR, decreased BUN/creatinine, hypokalemia, and urinary output 550 mL/day.
A
You’re developing a care plan for a patient in the diuresis stage of AKI. What diagnosis would you include in the care plan?
A. Excess fluid volume
B. Risk for electrolyte imbalance
C. Urinary retention
D. Acute pain
B
Which of the following statements about stones in the urinary tract is NOT correct?
A. Urinary tract stones are always painful.
B. Sometimes changing the diet can prevent stones.
C. Small stones can pass on their own.
D. Urinalysis can help diagnose stones.
A
People who excrete too much calcium in their urine (hypercalciuria) should follow which of these dietary measures?
A. Try to eliminate calcium in the diet.
B. Consume a low-sodium, high-potassium diet.
C. Consume a low-calcium, high-sodium diet.
D. Decrease water consumption to conserve calcium.
B
A patient with a kidney stone explains that the pain he is experiencing is intense, sharp, and wavelike that radiates to the scrotum. In addition, he explains it feels like he has to void but a small amount of urine is passed. Based on the patient’s signs and symptoms, where may the kidney stone be located?
A. Renal Calyx
B. Renal Papilla
C. Ureter
D. Urethra
C
Urine samples should be examined within 1 hour of voiding because:
A. RBC’s, leukocytes and casts agglutinate on standing for several hours at room temp
B. urobilinogen increases and bilirubin decreases after prolonged exposure to light
C. bacterial contamination will cause alkalization of the urine
D. ketones will increase due to bacterial and cellular metabolism
C
Microalbumin can be measured by a random urine collection. An increased microalbumin is predictive of:
A. diabetes mellitus
B. nephropathy
C. hypertension
D. nephrotic syndrom
B
Urine specific gravity is an index of the ability of the kidneys to:
A. filter the plasma
B. concentrate the urine
C. alter the hydrogen ion concentration
D. reabsorb sodium ions
B
A 17 y/o girl decided to go on a starvation diet. After 1 week of starving herself, what substance would most likely be found in her urine?
A. protein
B. ketones
C. glucose
D. blood
B
A reagent strip test for blood has been reported pos. Microscopic examination fails to yield RBC’s. The patient’s condition can be called:
A. hematuria
B. hemoglobinuria
C. oliguria
D. hemosiderinuria
B
Idenitify the formed element in the photomicrograph:
A. RBC
B. WBC
C. epithelial cell
D. yeast
A
