Renal

Question 1

GFR

Answer 1

Volume of plasma filtered thru glom Capps into Bowman’s capsule

Inverse relationship to Creatinine

125ml/min

Question 2

BUN

Answer 2

Amount of nitrogen in blood from waste product of urea

10-23

Question 3

Creatinine

Answer 3

Non protein waste

Better indicator of renal fn than BUN

0.6-1.4

Question 4

Specific Gravity urine

Answer 4

1.01-1.02

Question 5

Urine sodium

Answer 5

20mEQ/L

Question 6

Prerenal fail

Answer 6

Poor kidney perfusion

BUN:20-40:1
Urine NA: <20
Urine conc 
Urine osm ⬆️ (>500)
Spec grav ⬆️(>1.02)
Urine sed normal

Question 7

Intrarental

Answer 7

From cortical issues(infection/inflammation) or ATN (drugs, rhabdo, surg, poor perfusion)

Tx with diuretics, fluid volume mgmt, dialysis, address anemia

Question 8

Candidate for dialysis

Answer 8

A-acidemia
E-electrolyte disorders 
I-intoxication(ASA, lithium, theophylline)
O-overload (HF)
U-uremia(⬆️BUN and AMS)

Question 9

Intrarenal labs

Answer 9

BUN/creat 10-15:1
Urine NA >20
Urine diluted
Urine osm ⬇️ (<300)
Spec grav ⬇️(<1.01)
Urine sed abnormal

Question 10

Postrenal

Answer 10

Obstruction from collection duct ie stones, neurogenic bladder, tumor

Tx-fix obstruction

Question 11

Calcium

Answer 11

8.5-1.5

Question 12

⬆️Ca++

Answer 12

From renal issue, ⬇️K, tumors, bed rest

Lethargic, AMS, DTR reduced, abd pain, constipation, stones

Tx fluids and diuretics, steroids, calcitonin

Question 13

⬇️Ca++

Answer 13

From acute panc, ⬆️K, vit d deficient, alkalosis, infection

Sx, Chvostek sign, trousseau sign, torsades, twitching, anxiety

Iv fluid, calcium supp

Question 14

Chvostek sign

Answer 14

Spasm of cheek on side of poke from hypocalcemia

Question 15

Trusseau sign

Answer 15

Flex arm with BP cuff, carpopedal spams, hypocalcemia

Question 16

Potassium

Answer 16

3.5-5

Question 17

K⬆️

Answer 17

From renal fail, burns, crush injuries, met acid, adrenal insuff

Muscle weakness, NV, cramp, ekg change peak t wave, wide QRS, loss of p wave, Brady, PEA

calcium supp, bicarbonate, insulin gluc, albuterol, Kaye a late, dialysis

Question 18

K⬇️

Answer 18

From diuresis, met alk with ⬇️Cl, uncontrolled DM, cirrhosis, alchoholism

Muscle weak, NV, and distention, ⬇️LOC, ekg change: VT, Vfib

Question 19

⬆️Na

Answer 19

From dehydration, diuresis, DKA, HHS, DI

restless, hypovolemia, change LOC

check urine Na, correct slowly, vasopressin for DI

Question 20

⬇️Na

Answer 20

From fluid excess, HF, cirrhosis, SIADH

Edema, fatigue, cramps, diarrhea, sx, coma

restrict water, loop diuretic, 0.9, 3% saline

Question 21

⬆️Mg

Answer 21

From renal fail, laxative and antacid abuse

⬇️DTR, ⬇️RR, bradyardhythmia, ⬇️BP, lethargic, flushing

Calcium supp, then lsixc to correct ⬆️Ca, dialysis

Question 22

⬇️Mg

Answer 22

From alcoholism, VD, NGT, DKA,CABG, malnutrition

Hyperreflexia(chvostek and trusseau),psVT,insulin resistance, ⬇️K,⬇️Ca,⬇️phosphate, agitation

Mag supp max of 1g/min

Question 23

⬇️phosphate

Answer 23

From alcohol, increase reuptake from TPN or glucose

Lethargic, AMS, weak, constipation, ⬇️RR

Phosphate supp

Question 24

⬆️phosphate

Answer 24

From poor renal excretion

Anxiety, irritable, twitching at mouth, sx, laryngospam

Give phosphate binders, calcium carb