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PCM II Final > Renal > Flashcards

Renal Flashcards

1
Q

Definition of CKD

A

GFR<60 OR Kidney damage (protein in urine, abn urinary sediment, abn biopsy, abn imaging, electrolyte anomalies, hx of transplant) for 3 months

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2
Q

Definition of AKI

A

GFR<60 OR Kidney damage (protein in urine, abn urinary sediment, abn biopsy, abn imaging, electrolyte anomalies, hx of transplant) for LESS THAN 3 months

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3
Q

Stage I CKD

A

GFR >90

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4
Q

Stage 2 CKD

A

GFR 60-90

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5
Q

Stage 3a CKD

A

GFR 45-59

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6
Q

Stage 3b CKD

A

GFR 30-44

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7
Q

Stage 4 CKD

A

GFR 15-29

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8
Q

Stage 5 CKD

A

<15

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9
Q

How many adults are affected by CKD in the US

A

15%, 1/7, about 37 million

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10
Q

Major CKD risk factors

A

DM, HTN, CVD, AKI

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11
Q

Most common etiology of CKD

A

DM or HTN

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12
Q

Clinical presentation of CKD

A

Edema, HTN, decreased urine output, proteinuria(foamy), hematuria, uremia, pericardial friction rub, uremic frost

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13
Q

Most important diagnostic tests for CKD pts

A

eGFR, urine albumin-to-creatinine ratio, urinalysis

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14
Q

limitations of eGFR

A

not reliable when >60, in AKI, if pt <18

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15
Q

renal U/S findings for CKD

A

atrophic or small kidneys, cortical thinning, increased echogenicity, elevated resistive indices

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16
Q

Change in kidney function with age

A

GFR declines by 1ml/min/yr after 30-40

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17
Q

Common complications of CKD

A

CVD, mineral and bone disease (hypocalcemia-> secondary hyperparathyroidism), anemia, electrolyte abnormalities, HTN, uremia

18
Q

Indications for dialysis

A 
A: severe Acidosis
E: Electrolyte disturbance
I: Ingestion
O: volume Overload
U: Uremia
19
Q

Definition of azotemia

A

elevated BUN without sxs

20
Q

Definition of uremia

A

elevated BUN with sxs (N/V, confusion, pruritus, metallic taste in mouth, fatigue, anorexia)

21
Q

AKI diagnosis is based on

A

serum creatinine and urine output

22
Q

State 1 AKI

A

1.5-1.9x baseline creatinine, urine output <0.5L for 6-12 hours

23
Q

Stage 2 AKI

A

2-2.9x baseline creatinine, UO < 0.5ml for >12 hours

24
Q

Stage 3 AKI

A

3x baseline Cr, UO < 0.3 for >24 hours

25
Q

Major risk factors for AKI

A

old age, proteinuria, CKD, HTN, DM, CVD, exposures to nephrotoxins, cardiac surgery, fluid overload, sepsis

26
Q

Etiology of AKI

A

drugs (NSAIDs, abx, PPIs), infections, autoimmune disorders

27
Q

Complications of AKI

A

Development of CKD, progression of CKD, ESRD, CVD

28
Q

Clinical presentations of AKI

A

pericardial friction rub, uremia, foamy urine, decreased UO, HTN, edema

29
Q

Common diagnostic test for AKI

A

UA with microscopy, Urine albumin/Cr ratio, renal U/S

30
Q

Renal tubular epithelial cells, transitional epithelial cells are indicative of

A

acute tubular necrosis

31
Q

WBC, WBC cast or urine eosinophil are indicative of

A

acute interstitial nephritis

32
Q

dysmorphic RBCs, RBC casts are indicative of

A

vasculitis, glomerulonephritis

33
Q

proteinuria, hematuria, dysmorphic RBC and RBC casts are indicative of

A

nephritic syndrome

34
Q

heavy proteinuria, lipiduria, minimal hematuria are indicative of

A

nephrotic syndrome

35
Q

hyaline cast indicative of

A

prerenal azotemia

36
Q

WBC, RBC, bacteria indicative of

A

UTI

37
Q

Definition of anuria

A

<50 to 100 ml/day

38
Q

Definition of oliguria

A

< 400 to 500 ml/day

39
Q

Definition of polyuria

A

> 3000 ml/day

40
Q

What is the purpose of ordering a FeNa or FeUrea

A

differentiate between prerenal azotemia from intrinsic renal injury

41
Q

FeNa or FeUrea is valid in what patients?

A

Oliguric patients

42
Q

Treatment of AKI

A

dependent on etiology (prerenal needs IV, ATN needs supportive care, glomerulonephritic needs immunosupression), mostly supportive

PCM II Final (7 decks)

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