Renal phys

Question 1

What are nerve plexus deliver SNS to the kidneys?

Answer 1

Renal and celiac

Question 2

Does the kidney have PNS innervation?

Answer 2

NO

Question 3

Where is ammonia produced in the kidney?

Answer 3

PCT and collecting tubule

Question 4

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

Answer 4

Loop of Henle

Question 5

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

Answer 5

DCT and collecting tubule

Question 6

What is GFR directly related to?

Answer 6

MAP and efferent arteriole tone

Question 7

What is GFR inversely related to?

Answer 7

The afferent arteriole tone

Question 8

What is the equation for GFR?

Answer 8

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

Question 9

What is a normal GFR for a man?

Answer 9

120 +/- 25 ml/min

Question 10

What is a normal GFR for a woman?

Answer 10

95 +/- 20 ml/min

Question 11

Between what blood pressures in RBF autoregulated?

Answer 11

Between 80-800

Question 12

What is the Hendersen-Hasselbach equation?

Answer 12

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

Question 13

What are the buffers in the body?

Answer 13

Bicarb
Ammonia
Phosphate
Intracellular proteins
Hemoglobin

Question 14

What is a normal anion gap?

Answer 14

7-14 mEq/l

Question 15

What is the equation for calculating an anion gap?

Answer 15

Na - (Cl + HCO3)

Question 16

What is a normal PaCO2?

Answer 16

36-44

Question 17

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

Answer 17

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

Question 18

What are the predictors of postop renal failure?

Answer 18

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

Question 19

What is acute renal failure defined as?

Answer 19

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

Question 20

What is a late sign of renal failure?

Answer 20

Elevated serum creatinine

Question 21

Does good urine output rule out ARF?

Answer 21

no

Question 22

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

Answer 22

50%

Question 23

What does a FeNa of less than 1 tell us?

Answer 23

The problem is prerenal

Question 24

What does a FeNa of greater than 3 tell us?

Answer 24

ATN

Question 25

What is the doubling of creatinine associated with?

Answer 25

A reduction in GFR of 50%

Question 26

What is the most sensitive test for renal failure?

Answer 26

Creatinine clearance

Question 27

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

Answer 27

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

Question 28

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

Answer 28

Sevoflurane - makes compound A

Question 29

Which NMBs can be used in patients with renal failure?

Answer 29

Atracurium, cisatracurium because they undergo Hoffman elimination

Question 30

What are the indications for dialysis?

Answer 30

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