Trigger CKD part 1

Question 1

proteinuric CKD increases risk for what

Answer 1

CV mortality

Question 2

anemia, fatigue, and anorexia begin appearing in what stages of CKD

Answer 2

3-4

Question 3

when do electrolyte abnormalities become present in CKD

Answer 3

stages 3-4

Question 4

marked deceased in ADLs is seen in what CKD stage

Answer 4

5

Question 5

what medication is used to reduce glomerular HTN

Answer 5

ACE/ARB

Question 6

prior to starting this medication, evaluate potassium and serum cr levels

Answer 6

ACE/ARB

Question 7

when in CKD are thiazides most effective

Answer 7

early CKD

Question 8

when in CKD are loops most effective

Answer 8

late CKD

Question 9

what does cholesterol look like in CKD

Answer 9

NORMAL

Question 10

what does HDL and lipoprotein A look like in CKD

Answer 10

HDL is deceased
lipoprotein A is increased

Question 11

when do you use ezetimibe in CKD

Answer 11

2nd line for treatment of CAD

“statins - 1st line (said in class)
PSK9 inhibitors and ezetimibe (2nd line in adjunct to statin)
fibrates (paired with statins)”

Question 12

Cardiovascular complication associated with uremia

Answer 12

pericarditis

Question 13

what is pericarditis associated with?

Answer 13

uremic CKD

Question 14

s/s: friction rub

Answer 14

pericarditis

Question 15

s/s: cardiac tamponade and uremic pericardial efffusion

Answer 15

pericarditis

Question 16

s/s: retrosternal Chest pain

Answer 16

pericarditis

Question 17

what is always an indication of hospitalization and immediate initiation of hemodialysis in CKD patients

Answer 17

pericarditis

Question 18

s/s: proximal muscle weakness

Answer 18

osteitis fibrosa cystica

Question 19

caused by hypovitaminosis D and use of bisphosphonates

Answer 19

osteomalacia

Question 20

brown tumors on Xray

Answer 20

osteitis fibrosa cystica

Question 21

what physiologic changes occur in the heart with CKD

Answer 21

left ventricular hypertrophy and diastollic dysfunction

Question 22

SE includes inceased vascular calcification or hypercalcemia

Answer 22

calcium carbonate and calcium acetate (calcium phosphate binders for treating hyperphosphatemia)

Question 23

SE of osteomalacia and neurologic complications

Answer 23

aluminum hydroxide

Question 24

what phosphate binder is used for short durations (<3 weeks)

Answer 24

aluminum hydroxide

Question 25

what phosphate binder is used if phosphate levels are severe (>7)

Answer 25

aluminum hydroxide

Question 26

what meds are used to manage PTH in CKD

Answer 26

Vit D3 - calcitriol cincalet (sensipar)

Question 27

SE is inceased serum calcium and phosphorus

Answer 27

calcitriol (vit d3)

Question 28

SE of hypocalcemia

Answer 28

cincalet

Question 29

deceased renal clearance of hepcidin in CKD leads to what complication

Answer 29

iron deficiency anemia

Question 30

when is treatment of iron deficiency anemia contraindicated

Answer 30

if ferritin levels are >500-800 even if iron saturation is <20%

Question 31

when is ferric citrate used

Answer 31

treatment of iron deficiency anemia in CKD can also use: ferrous sulfate ferrous gluconate ferrous fumerate but ferric citrate was bolded in powerpoint

Question 32

what complication in CKD is caused by platelet dysfunction

Answer 32

hypocoagulability

Question 33

treated with desmopressin

Answer 33

hypocoagulability

Question 34

s/s: difficulty concentrating

Answer 34

ealry uremic encephalopathy

Question 35

s/s: lethargy, confusion, seizure coma

Answer 35

later uremic encephalopathy

Question 36

PE: asterixis, weakness, AMS

Answer 36

uremic encephalopathy

Question 37

TCAs or anticonvulsants are given for pain in this complication

Answer 37

uremic neuropathy

Question 38

when do you start hemodialysis or peritoneal dialysis

Answer 38

GFR of 5-10

Question 39

what 4 signs are indications of need for dialysis in CKD patients

Answer 39

* GFR<10 * Uremic symptoms (pericarditis, encephalopathy, neuropathy) * metabolic disturbances (hyperkalemia, hyponatremia, met acidosis, ect) * fluid overload unresponsive to diuretics (i just cant get this into my brain)

Question 40

at what point in CKD should you STOP metformin use?

Answer 40

serum Cr>1.5 or GFR <30 remember if a CKD pt is struggling with hypoglycemia in CK we can start them on

Question 41

petechiae and purpura are s/s of what complication in CKD

Answer 41

hypocoagulability

Question 42

can be caused by NSAIDS and BB

Answer 42

hyperkalemia

Question 43

Triamterine SE is...

Answer 43

hyperkalemia

Question 44

what vascular access option for hemodialysis requires 6-8 weeks of preparation

Answer 44

arteriovenous fistula

Question 45

what vascular access option for hemodialysis requires 2 weeks for preparation and has a higher risk of infection

Answer 45

prosthetic graft

Question 46

what vascular access option for hemodialysis is temporary and has the highest risk of infection

Answer 46

indwelling vascular catheter

Question 47

what are examples of phosphorus containing drugs to avoid in CKD

Answer 47

cathartic laxatives

Question 48

what are examples of magnesium containing drugs to avoid in CKD

Answer 48

laxatives/antacids

Question 49

what are examples of nephrotoxic drugs to avoid in CKD

Answer 49

NSAIDS, IV contrast

Question 50

what are examples of renally excreted drugs to adjust in CKD

Answer 50

insulin, BB, ABX

Question 51

what opioid should be stopped in CKD

Answer 51

morphine

Question 52

cloudy dialysate indicates what

Answer 52

peritonitis