Questions and Answers
What is a possible cause of accelerated atherosclerosis in chronic renal failure?
Hyperlipidemia
Which type of breathing pattern is seen in chronic renal failure?
Kussmaul's breathing
What is a common gastrointestinal manifestation of chronic renal failure?
Constipation
Which of the following is a complication of chronic renal failure?
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What is a possible neurological manifestation of chronic renal failure?
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What is a common respiratory manifestation of chronic renal failure?
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Which of the following is a possible genital manifestation of chronic renal failure in males?
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What is a possible skin manifestation of chronic renal failure?
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What is the primary cause of anemia in patients with chronic renal failure?
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What is the primary cause of muscle cramps in patients with chronic renal failure?
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What is the name of the condition characterized by deposits of urea crystals on the skin?
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What is the primary cause of bleeding tendency in patients with chronic renal failure?
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What is the name of the condition characterized by pigmentation of the skin in patients with chronic renal failure?
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What is the primary cause of osteomalacia in patients with chronic renal failure?
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What is the name of the condition characterized by confusion and coma in patients with chronic renal failure?
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What is the primary cause of osteitis fibrosa cystica in patients with chronic renal failure?
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What is the normal glomerular filtration rate (GFR) in milliliters per minute?
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What is the definition of chronic renal failure?
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What is the most common cause of chronic renal failure?
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What is the stage of acute renal failure characterized by features of acute uremia and hyperkalemia?
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What is the estimated daily urine volume in acute renal failure?
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What is the pathology of acute renal failure?
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What is the feature of electrolyte imbalance in acute renal failure?
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What is the clinical feature of uraemic syndrome in acute renal failure?
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Study Notes
Hyperdynamic Circulation
- Salt and water retention
- Increased renin secretion leading to hypertension
- Uremic pericarditis and cardiomyopathy
- Coronary heart disease and cardiac arrhythmia
Clinical Picture of Chronic Renal Failure
- Respiratory manifestations:
- Rapid deep breathing (Kussmaul's breathing)
- Pulmonary edema due to hypervolemia
- Pleurisy and pleural effusion
- Ulcers in respiratory tract
- GIT manifestations:
- Stomatitis and dry mouth
- Unpleasant taste and uremic odor
- Anorexia, nausea, and vomiting
- Constipation and bleeding
- Urinary manifestations:
- Water disorders
- Genital manifestations:
- Male: Impotence and infertility
- Female: Amenorrhea and infertility
- Skin manifestations:
- Pallor and earthy color (muddy or uremic skin)
- Pigmentation
- Pruritis
- Uraemic frost
- Neurological manifestations:
- Apathy and psychiatric symptoms
- Asterixis (flappy tremors)
- Peripheral neuropathy and proximal myopathy
- Convulsions and coma
- Musculoskeletal manifestations:
- Renal osteodystrophy
- Bone pain and pathological fractures
- Myopathy (proximal)
- Hematological manifestations:
- Anemia
- Bleeding tendency
- Increased liability to infections
Acute Renal Failure
- Clinical features:
- Oliguric stage (1-6 weeks)
- Features of acute uremia
- Features of hyperkalemia
- ECG changes
- Features of overhydration and acidosis
- Stages:
- Oliguric stage
- Diuretic stage
- Recovery stage
Chronic Renal Failure
- Definition:
- Gradually progressive and irreversible deterioration of renal function over months or years
- Reduction of glomerular function rate (GFR) below 10ml/min
- Manifestation and complication often occur when GFR below 15 ml/min
- Normal GFR: 120ml/min, measured by creatinine clearance
- Renal reserve: 50-120 ml/min
- Renal impairment: 10-50 ml/min
- Acute renal failure: sudden but irreversible decrease of GFR
Etiology of Chronic Renal Failure
- Most common causes: Chronic pyelonephritis and DM
- Commonest cause: GN (14%)
- Other causes:
- Infections: Chronic pyelonephritis, Bilateral renal TB
- Immune: GN (35%)
- Metabolic: Diabetic nephropathy, Gouty nephropathy, Nephrocalcinosis, Amyloidosis
- Malignancy: Multiple myeloma
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