Renal Disease & Urologic Surgery Flashcards Preview

AP: Cumulative > Renal Disease & Urologic Surgery > Flashcards

Flashcards in Renal Disease & Urologic Surgery Deck (43):
1

What percent of cardiac output goes to the kidneys?

15-25%

2

Anesthesia Increases or decreases renal bloodflow?

Decreases by decreasing cardiac output

3

Blood urea nitrogen is not elevated until GFR is decreased to almost __% of normal

75

4

Serum creatinine measurements reflect what?

Glomerular function

5

What are the normal creatinine levels for men and women?

Men: 0.8-1.3 mg/dL
Women: 0.6-1 mg/dL

6

What is the most accurate measure of glomerular filtration rate?

Creatinine clearance

7

What is a normal GFR for men and women?

Men: 95-140 mL/min
Women: 85-125 mL/min

8

Decreasing flow does what to the BUN/Cr ratio?

Increases it

9

What is the normal pH range for urine?

4.5-8.0

10

Anemia may be present in patients with renal disease because of abnormalities in the production of what?

Erythropoietin

11

Most patients with chronic renal disease have increased body water as well as ____ Na/K balance

Increased

12

Which groups are at highest risk for developing acute renal failure?

Elderly
Diabetic
Baseline renal insufficiency

13

Deterioration of function over hours to days leading to the inability of the kidneys to excrete waste products and maintain fluid and electrolyte homeostasis

Acute renal failure

14

What are the three types of acute renal failure?

Prerenal (decreased renal flow)
Renal (intrinsic)
Post renal (obstructive)

15

What are the primary risk factors for acute renal failure?

Advanced age
Congestive heart failure
Sepsis
Nephrotoxic drugs
Multiple blood transfusions
Hemolysis
Hypotension
Perirenal surgery

16

What are some causes of prerenal ARF?

Hypotension
Hypovolemia
Congestive heart failure
Prerenal aortic crossclamping

17

What are some renal causes of ARF?

Intrinsic renal disease
Renal ischemia
Nephrotoxic drugs

18

What are some causes of post renal ARF?

Caused by an obstruction of urinary outflow

19

The in-hospital mortality rate among patients with ARF ranges from _____ to ____%

20-50%

20

What is hepatorenal syndrome?

Functional renal failure that occurs in severe cirrhosis

Characterized by tight constriction of renal arteries resulting in oliguria and sodium retention

21

What are the five primary diseases of the kidney?

Glomerulonephritis
Polycystic renal disease
Renal artery stenosis
Renal hypertension
Diabetic nephropathy

22

What is glomerulonephritis?

Deposits of antigen-antibody complexes in the glomeruli causes hematuria, proteinuria, hypertension and increased creatinine

23

What is polycystic renal disease?

Progressive genetic disease characterized by hypertension and proteinuria with eventful renal failure

24

What is renal artery stenosis?

Athlerosclerosis of renal arteries accounts for most cases
may be unilateral or bilateral

25

What Is the most common cause of end-stage renal disease?

Diabetic nephropathy

26

What is chronic renal failure?

Progressive irreversible deterioration of renal function that occurs over months or years

27

What are some causes of chronic renal failure?

Glomerulopathy
Tubular interstitial disease
Hereditary disease
Vascular disease

28

What are some of the clinical symptoms of CRF?

General: fatigue, weakness & malaise
GI: anorexia, N/V
Neurological: Irritability, subtle memory defects, difficulty concentrating

29

What type of catheter is large and stiff and associated with dialysis

Perverts! it's a vas cath

30

What type of catheter has central access to multiple ports?

Central line

31

What type of catheters are under the skin and commonly in the subclavian.
usually stay in longer

Portacaths

32

What are the two types of dialysis?

Hemodialysis
Peritoneal dialysis

33

What type of dialysis can be done at home?

Peritoneal dialysis

34

What type of dialysis is done three days a week?

Hemodialysis

35

What type of muscle relaxants can be used on induction for renal patients?

Choose NMBs with clearance independent of renal function

36

What are three important considerations to remember in the maintenance of anesthesia for renal patients?

Fluid management
Muscle relaxation
Hyperkalemia

37

Why should you avoid or use caution when administering morphine and meperidine to CRF patients?

Morphine is a very potent sedative and can accumulate 10 to 15 times normal
Normeperidine is the active metabolite in accumulates within the patient causing seizures

38

What is BPH?

Benign prostatic hypertrophy
-Nonmalignant enlargement of the prostate

39

What is the definitive treatment for BPH?

Transurethral resection of the prostate (TURP)

40

What is TURP syndrome?

When too much fluid is absorbed and intravascular volume expansion and hypo-osmolality occur

41

What is lithotripsy?

Using repetitive shocks to break up stones

42

What is the definitive surgical treatment for patients with end-stage renal disease who are on chronic dialysis?

Renal transplantation

43

How long can a donor kidney survive?

Up to 48 hours