Renal Failure

Question 1

What are clinical abnormalities seen with chronic renal insufficiency?

Answer 1

Dehydration, metabolic acidosis, hypokalemia, uremia, anorexia, Ca/P imbalance, anemia, hypertension

Question 2

When is diagnosis of chronic renal insufficiency usually made?

Answer 2

Once isosthenuria and azotemia are present

Question 3

How does polyuria affect the kidneys?

Answer 3

Hypoperfusion and pre-renal azotemia

Question 4

How can you treat metabolic acidosis assoc. w/chronic renal insufficiency?

Answer 4

Tx not usually needed but can tx w/potassium citrate

Question 5

What causes uremia assoc. w/chronic renal insufficiency?

Answer 5

Inability to excrete metabolic byproducts leads to buildup in the bloodstream

Question 6

What might cause anorexia assoc. w/chronic renal insufficiency?

Answer 6

Uremic ulcers and gastritis

Question 7

What H2-blocker is frequently used to treat gastric ulcers assoc. w/chronic renal insufficiency?

Answer 7

Famotidine

Question 8

How does increased phosphate further the progression of renal dysfunction?

Answer 8

Excessive PTH secretion, renal osteodystrophy, extraskeletal mineralization

Question 9

How can Calcitriol therapy help improve therapeutic outcome of chronic renal insufficiency?

Answer 9

Reduces PTH levels

Question 10

What is a major factor of anemia assoc. w/chronic renal insufficiency?

Answer 10

Inadequate renal erythropoietin production

Question 11

How do you manage hypertension assoc. w/chronic renal insufficiency?

Answer 11

ACE-inhibitors

Question 12

How does dietary therapy influence the prognosis of a chronic renal insufficiency case?

Answer 12

Prolongs live 2-3x

Question 13

What is an appropriate diet for a chronic renal insufficiency patient?

Answer 13

Low protein, low phosphorus, high moisture

Question 14

What may be indicated to treat a chronic renal insufficiency patient with significant anemia that is compromising QoL or necessitating transfusion?

Answer 14

Recombinant human erythropoietin administration

Question 15

Does anuria occur with acute or chronic renal disease?

Answer 15

Acute

Question 16

Does anemia occur with acute or chronic renal disease?

Answer 16

Chronic

Question 17

What diet decreases formation of nitrogenous wastes?

Answer 17

Low phosphorus

Question 18

What drug can help palliate hypertension?

Answer 18

Ca channel blocker (amplodipine)

Question 19

What are sequelae of renal failure?

Answer 19

Cannot make calcitriol, gastric ulcers, 2* hyperPTH

Question 20

What does the loss of ability to make calcitriol result in clinically?

Answer 20

Chronic weight loss

Question 21

What measurement necessitates calcitriol supplementeation?

Answer 21

Phosphorous <6mg/dL

Question 22

How does renal disease cause gastric ulcers?

Answer 22

Decreases mucosal blood flow and gastric hypersecretion

Question 23

How does hyperparathyroidism result from renal failure?

Answer 23

PTH upregulated to compensate for incr. P (d/t decr. GFR)

Question 24

How is USG affected by chronic renal failure?

Answer 24

Isosthenuria (1.008-1.015)

Question 25

What is the most common form of chronic renal failure?

Answer 25

Glomerulonephritis

Question 26

What causes glomerulonephritis?

Answer 26

Deposition of immune complexes in glomerular basement membrane