Renal disease

Question 1

The 3 main components of the renal tract are?

Answer 1

• kidneys
• ureter
• bladder

Question 2

what are the 3 main functions of the renal system?

Answer 2

1. excretory function
2. acid base balance
3. endocrine function

Question 3

what is the function of erythropoietin?

Answer 3

to stimulate red blood cell production

Question 4

what are the 3 endocrine functions of the renal system?

Answer 4

• produce erythropoietin
• activate vit D
• control blood pressure

Question 5

what is polyuria?

Answer 5

abnormally large production of urine

Question 6

what is oliguria?

Answer 6

abnormally small amount of urine produced

Question 7

what is anuria?

Answer 7

the failure of the kidneys to produce urine

Question 8

when blood is present in urine, this is called?

Answer 8

haematuria

Question 9

proteinuria is when…

Answer 9

there is abnormally high protein levels detected in the urine

Question 10

what is dysuria?

Answer 10

painful or difficult urination

Question 11

A high urea content in urine is called..?

Answer 11

uraemia

Question 12

hyperkalaemia is..?

Answer 12

high potassium content

Question 13

dialysis is defined as…

Answer 13

renal replacement therapy

Question 14

name the 4 ways to investigate the renal system.

Answer 14

1. urine
2. blood
3. imaging
4. tissue

Question 15

what are the 3 tests that can be done to investigate the urine?

Answer 15

1. dipstick
2. microscopy
3. microbiology

Question 16

what will show up in the microscopy?

Answer 16

abnormal cells of crystals

Question 17

what are the 4 things tested for in a dipstick test

Answer 17

• white blood cells
• blood
• protein
• glucose

Question 18

name 3 electrolytes

Answer 18

1. potassium
2. urea
3. ceratinine

Question 19

what does GFR stand for?

Answer 19

glomerular filtration rate

Question 20

what are 3 categories used to grade renal failure

Answer 20

• mild
• moderate
• severe

Question 21

what are the GFR ranges of each of these categories?

Answer 21

mild = 20-50ml/min
moderate = 10-20 ml/min
severe =

Question 22

4 ways to image the renal tract?

Answer 22

• plain radiograph
• intravenous urogram
• ultrasound
• MRI

Question 23

what can hyperkalaemia cause?

Answer 23

cardiac arrest

Question 24

if there is an excretion failure and uraemia occurs what are 6 possible consequences/signs? §

Answer 24

• malaise
• anorexia
• reduced immunity
• reduced platelet function
• itch
• eventually coma/death

Question 25

what is it called when you have a life threatening acid-base balance possibly caused by renal disease?

Answer 25

acidosis

Question 26

explain how a patient may get renal osteodystrophy?

Answer 26

renal failure = lack of vitamin D activation = bone disease in chronic situations

Question 27

give 5 basic causes of renal failure.

Answer 27

1. systemic disease 2. hypovolaemia 3. drugs 4. infections 5. obstruction

Question 28

what are 5 systemic diseases that can commonly lead to renal failure?

Answer 28

- cancer - diabetes - hypertension - atherosclerosis - auto-immune (glomerulonephritis)

Question 29

define hypovolaemia?

Answer 29

decreased volume of circulatory blood

Question 30

what are 3 causes of hypovolaemia?

Answer 30

1. massive haemorrhage 2. sepsis 3. O+V

Question 31

name 4 drugs that can exacerbate pre-existing renal disease.

Answer 31

- NSAIDs - tetracycline - diuretics - ACE inhibitors/angiotensin 2 blockers

Question 32

name 4 possible obstructions that can cause renal failure?

Answer 32

- prostate - stones - abdominal or pelvic masses - polycystic kidney disease

Question 33

true or false - polycystic kidney disease is genetic.

Answer 33

True

Question 34

what are the two forms of renal failure?

Answer 34

- acute | - chronic

Question 35

what is acute renal failure defined as...

Answer 35

the RAPID LOSS of renal FUNCTION

Question 36

what can the urine output be like in acute renal failure?

Answer 36

- normal - low - absent

Question 37

what are the 4 things that make acute renal failure life threatening?

Answer 37

- hyperkalaemia - uraemia - fluid retention - hypertension

Question 38

is acute renal failure reversible?

Answer 38

yes often

Question 39

how is ACUTE renal failure commonly brought about?

Answer 39

pre-exisiting diseased kidneys encounter an acute insult such as NSAIDs

Question 40

3 stages of management of acute renal failure.

Answer 40

1. identify and manage cause 2. treat effects (K, fluid removal, replacement) 3. dialysis - sometimes

Question 41

what is chronic renal failure defined as?

Answer 41

gradual progression of renal impairment

Question 42

what does ESRD stand for?

Answer 42

end stage renal disease

Question 43

what is the GFR for ESRD?

Answer 43

5% of normal

Question 44

what are 2 factors that influence the progression rate of CRF?

Answer 44

- underlying cause | - modifying factors

Question 45

what are the 6 main causes of renal disease?

Answer 45

- diabetes - hypertension - atherosclerosis - chronic renal infection - polycystic kidney disease - glomerulonephritis

Question 46

what are the 4 effects of CRF?

Answer 46

- uraemia - fluid retention - lack of erythropoietin - renal osteodystrophy

Question 47

give 5 consequences of uraemia (high urea levels in blood)

Answer 47

- reduced immunity - reduced platelet function - malaise - nausea - itch

Question 48

what are the two types of dialysis?

Answer 48

1. haemodialysis (blood) | 2. peritoneal dialysis

Question 49

3 reasons why transplant is the optimal treatment for renal disease?

Answer 49

- normal renal function - no dietary restrictions - normal energy and fertility

Question 50

3 issues with renal transplant are...

Answer 50

- rejection (acute or chronic) - immunosuppresants required - high cardiovascular mortality

Question 51

what are two main disadvantages of immunosuppresants?

Answer 51

- increased infection risk | - increased risk of malignancy

Question 52

what are 3 urinary tract diseases?

Answer 52

- urinary tract infections - urinary tract obstruction - urinary tract malignancy

Question 53

which type of bacteria usually causes cystitis?

Answer 53

gram -ve bacilli ie E.coli

Question 54

what are 4 main symptoms of UTI?

Answer 54

- dysuria - frequency - cloudy/offensive smelling urine - suprapubic pain

Question 55

2 forms of treatment for UTIs? -

Answer 55

- increased fluid intake | - antibiotics

Question 56

what are the tests to detect a UTI?

Answer 56

- dipstick indicator | - microscopy, culture and sensitivity

Question 57

what are 3 possible obstructions of the urinary tract?

Answer 57

- prostate - renal calculi (stones) - external compression (abdominal or pelvic malignancy)

Question 58

what % of the population will experience renal calculi?

Answer 58

5%

Question 59

what are the symptoms and treatment options for renal calculi?

Answer 59

Extremely painful! - give them time to pass - surgery - lithotripsy (ultrasound shock waves)

Question 60

what are the main dental aspects of renal disease?

Answer 60

- take care with prescribing NSAIDs - growth/tooth eruption delayed in children = secondary to anaemia - prone to post op infection/bleeding - oral opportunistic infections/stomatitis - renal osteodystrophy - avoid regional blocks if severe bleeding tendency - CRF = halitosis, dry mouth, metallic taste - calculus accumulation - oral ulceration due to anaemia - secondary parathyroidism = giant cell lesion - osseus lesions may occur - salivary gland swelling