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Anesthesiology > Renal phys > Flashcards

Renal phys Flashcards

1
Q

What are nerve plexus deliver SNS to the kidneys?

A

Renal and celiac

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2
Q

Does the kidney have PNS innervation?

A

NO

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3
Q

Where is ammonia produced in the kidney?

A

PCT and collecting tubule

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4
Q

Which part of the kidney is responsible for maintaining hypertonic medullary interstitium?

A

Loop of Henle

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5
Q

Which part of the kidney secretes H, K and Ca?

A

DCT and collecting tubule

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6
Q

What is GFR directly related to?

A

MAP and efferent arteriole tone

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7
Q

What is GFR inversely related to?

A

The afferent arteriole tone

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8
Q

What is the equation for GFR?

A

GFR = 140 - age X body weight in kg/serum creatinine X 72

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9
Q

What is a normal GFR for a man?

A

120 +/- 25 ml/min

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10
Q

What is a normal GFR for a woman?

A

95 +/- 20 ml/min

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11
Q

Between what blood pressures in RBF autoregulated?

A

Between 80-800

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12
Q

What is the Hendersen-Hasselbach equation?

A

ph = 6.1 + log (HCO3/).03 X PaCO2)

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13
Q

What are the buffers in the body?

A 
Bicarb
Ammonia
Phosphate
Intracellular proteins
Hemoglobin
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14
Q

What is a normal anion gap?

A

7-14 mEq/l

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15
Q

What is the equation for calculating an anion gap?

A

Na - (Cl + HCO3)

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16
Q

What is a normal PaCO2?

A

36-44

17
Q

What is the golden rule for changes in ph based on change in PaCO2?

A

For every 10 torr change in PaCO2, the ph will change 0.08 unit in the opposite direction

18
Q

What are the predictors of postop renal failure?

A 
Jaundice
LVF
Diabetes
Advanced age
Increased BUN/Cr
Cardiac or aortic surgery
19
Q

What is acute renal failure defined as?

A

A significant decrease in GFR over 2 weeks or less or inadequate urine output of less than 0.5ml/kg/hr

20
Q

What is a late sign of renal failure?

A

Elevated serum creatinine

21
Q

Does good urine output rule out ARF?

A

no

22
Q

How much can GFR be reduced before the labs show it?

A

50%

23
Q

What does a FeNa of less than 1 tell us?

A

The problem is prerenal

24
Q

What does a FeNa of greater than 3 tell us?

A

ATN

25
Q

What is the doubling of creatinine associated with?

A

A reduction in GFR of 50%

26
Q

What is the most sensitive test for renal failure?

A

Creatinine clearance

27
Q

What are the do the volatile anesthetics do to renal function?

A

Depress it, decrease urine output, GFR, RBF and electrolyte excretion

28
Q

Which volatile anesthetic can cause renal failure with low gas flows?

A

Sevoflurane - makes compound A

29
Q

Which NMBs can be used in patients with renal failure?

A

Atracurium, cisatracurium because they undergo Hoffman elimination

30
Q

What are the indications for dialysis?

A 
Uremic platelet dysfunction
uremic symptoms
uremic percarditis/tamponade
bleeding
hypervolemia
CHF
Severe acidosis
Hyperkalemia

Anesthesiology (19 decks)

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