Renal High Yield HO Flashcards Preview

PCM 3 Midterm > Renal High Yield HO > Flashcards

Flashcards in Renal High Yield HO Deck (26)
Loading flashcards...
1

most accurate place to check for skin tenting

forehead

2

increase in acute phase reactants accompanies what processes in the body

inflammation and tissue injury both acute and chronic

3

what is the definition of acute phase proteins

proteins whose serum concentraitons increase or decrease by at least 25% during inflammatory states
positive: ESR, CRP, ferritin, WBC, haptoglobin, ceruloplasmin
negative: albumin, transferrin

4

thrombocytosis in the absence of a chronic myeloproliferative or myelodysplastic disorder
in patients who have a medical or surgical condition likely to be associate with increased plaetlet count
normalizes at the resolution of this surgery/infection/trauma

reactive thrombocytosis

5

causes of aki pre/intra/post

pre - dehydration/hypotension BUN/Cr 20:1
intra - anatomic abnormality (and resulting hypertrophy of normal kidny_, toxins - environmental/medications
post- obstruciton

6

KDIGO for cr and urine output criteria

increase in Cr >0.3 mg/dL w/in 48 hours or >50% within 7 days
OR
urine output of <0.5 mL/Kg/hr for >6 hours **** test question **** pay attention****

7

clinical features of hyperkalemia

occur when k is >7
muscle weakness
arrhythmias
peaked t waves
shrinking and loss of p waves
widened QRS

occurs by increased k release from cells or reduced k excretion in urine

8

management of hyperkalemia

exclude pseudohyperkalemia
obtain ECG and perform continuous cardiac monitoring
give calcium gluconate over 2-3 minutes
give insulin and glucose
remove potassium by hemodialysis/diuretics/gi cation exchanger in patients with seve renal impairment

9

things included on a UA

luekocytes
nitrite
urobilinogen
protein
ph
blood
specific gravity
ketone
bilirubin
glucose

10

appropriate use of urinary catheters

only for appropriate indications and only leave in palce as long as needed
minimize urinary cath use - avoid in patients in nursing home residents for management of incontinence

11

appropriate indictaions for indwelling urethral catheter use

acute urinary retention or bladder outlet obstruction
need for accurate measurements of urinary output in critically ill patients
periopoerative use for selected surgical procedures (urologic surgery - anticipated prologned duration of surgery - pt anticipated to recieve large volume infusions or duiretics during surgery - need for intraoperative monitoring of urinary output
to assist in healing of open sacral or peirineal wounds in incontinent patients
patient requires prolonged immobilization
to improve comfort for en d of life care

12

examples of innappropriate use of indwelling catheters

substitute for nursing care in patients or residents with incontinence
as a means of obtaining urine or culture when patient can voluntarily void
for prolonged postop duration without appropriate indications

13

ddx of a renal mass

RCC
oncocytoma
angiolypoma
metanephric adenoma
metastitic disease
xanthogranulomatous pyelonephritis

14

in utero cuases of renal hypoplasia/atrophic kidney

vascular event
urinary tract abnormalities
posterio rurethral valve
vesicouretrul reflux
upj obstruction
ACEI use
genetic abnormality
hyperglycemia/DM of mother
maternal vit a deficiency
intrauterine growth retardation

15

first year of life causes of atrophic kidney/ renal hypoplasia

persistent anorexia and vomiting
failure to thrive

16

after first year of life causes of atrophic kidney/renal hypoplasia

frequent pyelonephritis
other disorders that lead to renal scarring and ESRD

17

indications for dialysis therapy

fluid overload that is refractory to diuretics
hyperkalemia (serium k >6.5 meq/L) or rapidly rising k levels
metabolic acidosis in patients in whom the admin of bicarb is not indicated
signs of uremia such as pericarditis, neuropathy, or an otherwise unexplained decline in mental status

18

manifestatinos of SIRS

2 or more of the following
temperature >38 or <36
hr over 90
respiration rate over 20 or paco <32 mm Hg
WBC > 12000, < 4000 or >10% immature

19

definition of sepsis

systemic responses to an infection defined by 2 or more SIRS criteria as a result of an infection

20

what should you always get in septic patients before administering antibiotics

draw blood for blood cultures

21

most common cause of UTI and pyelonephritis

e coli
staph sprophyticius is primary cause of honeymoon cystitis
if previous urine culture are available look at those - pt will usually become infected with same organism

22

how to calculate anion gap

na - (cl + hco3)

23

viscerosomatic reflex of the kidneys

t10-11

24

what should be on your ddx of all women of childbearing age

pregnancy

25

number of times a woman has been pregnant

gravidity

26

number of pregnancies that led to brith at or beyond 20 weeks or an infant weighing more than 500g

parity