pt14 Flashcards
(50 cards)
What are the general and specific treatments for nephrotic syndrome?
General: bed rest, salt restriction, thiazide diuretics; Specific: corticosteroids (e.g., prednisolone) and immunosuppressants (e.g., cyclophosphamide)
How is renal failure defined?
Failure of renal excretory function due to depressed glomerular filtration rate (GFR)
Which endocrine functions are lost in renal failure?
↓ Erythropoietin (causing anaemia) and ↓ 1,25-(OH)₂-D₃ activation (renal osteodystrophy)
What are the three categories of acute renal failure (ARF)?
Prerenal (~70%: shock, hypovolaemia), intrinsic renal (~25%: acute tubular necrosis), postrenal (~5%: urinary obstruction)
Give examples of causes for each ARF category.
Prerenal: hypovolaemic shock; Intrinsic: nephrotoxins causing ATN; Postrenal: bilateral ureteric obstruction
What are the clinical features of ARF once severe?
Oliguria, oedema, rising creatinine (~100 µmol/L per day), hyperkalaemia, metabolic acidosis, and uraemic syndrome (anorexia, nausea, vomiting, seizures, coma)
What are key dialysis indications in ARF?
Hyperkalaemia (>6.5 mmol/L), severe metabolic acidosis (pH < 7.2), pulmonary oedema, uraemic complications (encephalopathy, pericarditis, seizures)
What defines chronic renal failure (CRF)?
Long-standing, usually progressive and irreversible impairment of renal function
What are the major causes of CRF?
Diabetes, hypertension, glomerulonephritis, pyelonephritis, polycystic kidney disease, and nephrotoxins (e.g., NSAIDs, heavy metals)
What clinical features appear in advanced CRF?
Insidious onset; GFR <15 mL/min; uraemic syndrome (malaise, anorexia, itching), nocturia/polyuria, oedema once urea >40 mmol/L
What haematological and metabolic complications arise in CRF?
Normocytic, normochromic anaemia (EPO deficiency), renal osteodystrophy (↓ vitamin D activation), electrolyte imbalances, and metabolic acidosis
What two broad categories comprise brain disorders?
Neurological conditions (structural, biochemical or electrical CNS/PNS dysfunction) and mental health conditions (significant distress or impairment of thoughts, emotions, behaviour)
How are neurological disorders defined?
Conditions of the central or peripheral nervous system affecting functioning via structural, biochemical or electrical abnormalities
What are the four main categories of neurological disorders?
Sudden onset; intermittent and unpredictable; progressive; stable with changing needs
Give examples of sudden onset neurological conditions.
Stroke, traumatic brain injury, spinal injury, meningitis
Give examples of intermittent and unpredictable neurological conditions.
Epilepsy and migraine
Give examples of progressive neurological conditions.
Parkinson’s disease, dementia, motor neurone disease
Give examples of stable neurological conditions with changing needs.
Tourette’s syndrome, narcolepsy, cerebral palsy
Approximately how many people in the UK are affected by neurological conditions?
About 14.7 million (≈1 in 6)
How is a mental health condition defined?
A disorder causing significant distress or impairment of personal functioning, characterized by abnormal thoughts, emotions, mood, behaviour, or relationships
What is the annual and weekly prevalence of mental health problems in England?
1 in 4 people each year; 1 in 6 each week report common problems (anxiety/depression)
What are direct medical, direct non-medical, and indirect costs?
- Direct medical: treatment, care & rehab resources (medications, consumables, staff)
- Direct non-medical: transport, caregiver time, equipment maintenance, insurance, utilities
- Indirect: economic losses from disability or premature mortality
How did England’s 2022 mental ill-health costs break down?
£300 bn total: £110 bn economic, £130 bn human (QoL loss/premature death), £60 bn health & care
How many neurons inhabit the brain and spinal cord?
~85 billion in the brain; ~100 million in the spinal cord
