Kidney Functions and Disorders Quiz
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Questions and Answers

Which of the following is a primary function of the kidneys?

  • Storing excess glucose
  • Producing digestive enzymes
  • Filtering waste products from the blood (correct)
  • Regulating body temperature

    • What is the role of erythropoietin, produced by the kidneys?

  • Regulating calcium levels
  • Aiding in vitamin D activation
  • Controlling blood pressure
  • Stimulating red blood cell production (correct)

    • Failure to activate vitamin D by the kidneys can lead to alterations in which electrolyte level?

  • Potassium
  • Magnesium
  • Sodium
  • Calcium (correct)

    • Uncontrolled hypertension can damage the kidneys, leading to a condition known as:

    <p>Nephrosclerosis (D)</p> Signup and view all the answers

    A patient with kidney disease is at risk for anemia due to a deficiency in:

    <p>Erythropoietin (B)</p> Signup and view all the answers

    Which type of infection can lead to acute post-streptococcal glomerulonephritis?

    <p>Streptococcal infection (B)</p> Signup and view all the answers

    What is the medical term for kidney stones?

    <p>Nephrolithiasis (D)</p> Signup and view all the answers

    Which patient population, due to vascular problems, is at an increased risk of renal problems?

    <p>Diabetic patients (A)</p> Signup and view all the answers

    What is the primary concern for patients with high potassium levels?

    <p>Fatal cardiac dysrhythmias (C)</p> Signup and view all the answers

    What is the first-line treatment for hyperkalemia?

    <p>Calcium gluconate (B)</p> Signup and view all the answers

    What is the purpose of giving bicarbonate to patients with hyperkalemia?

    <p>To correct metabolic acidosis (A)</p> Signup and view all the answers

    What is the mechanism of action of insulin in treating hyperkalemia?

    <p>To decrease potassium levels in the cells (D)</p> Signup and view all the answers

    What is the purpose of giving glucose along with insulin in the treatment of hyperkalemia?

    <p>To ensure adequate blood sugar levels (C)</p> Signup and view all the answers

    What is the mechanism of action of sodium polystyrene in treating hyperkalemia?

    <p>To decrease potassium levels in the blood by binding to potassium in the gut (D)</p> Signup and view all the answers

    Which of the following is a sign that sodium polystyrene is effective?

    <p>Diarrhea (B)</p> Signup and view all the answers

    During the oliguric phase of acute kidney injury, what is the primary goal of treatment?

    <p>To correct electrolyte imbalances (D)</p> Signup and view all the answers

    What is the primary treatment strategy during the diuretic phase of acute kidney injury?

    <p>Fluid replacement (B)</p> Signup and view all the answers

    Why is it important to monitor for dehydration during the diuretic phase of acute kidney injury?

    <p>Because the patient is at risk for fluid volume overload (D)</p> Signup and view all the answers

    What is the primary goal of treatment during the recovery phase of acute kidney injury?

    <p>To restore normal kidney function (A)</p> Signup and view all the answers

    What is the most common type of acid-base disorder that occurs in acute kidney injury?

    <p>Metabolic acidosis (B)</p> Signup and view all the answers

    What is the most likely cause of hyponatremia in patients with acute kidney injury?

    <p>Fluid volume overload (A)</p> Signup and view all the answers

    What is the primary treatment for edema in patients with acute kidney injury?

    <p>Diuretics (B)</p> Signup and view all the answers

    Which dietary modification is most important for patients with acute kidney injury?

    <p>Decrease sodium intake (C)</p> Signup and view all the answers

    What is the maximum recommended rate for potassium replacement?

    <p>10 milliequivalents per hour (A)</p> Signup and view all the answers

    Which of the following is a sign of a fluid volume deficit?

    <p>{ &quot;A&quot;: &quot;Hypotension&quot;, &quot;B&quot;: &quot;Crackles in the lungs&quot;, &quot;C&quot;: &quot;Hyperkalemia&quot;, &quot;D&quot;: &quot;Increased urine output&quot; } (A)</p> Signup and view all the answers

    Which condition is characterized by metabolic acidosis?

    <p>Chronic kidney disease (A)</p> Signup and view all the answers

    What would be expected in the lab results of a patient with metabolic acidosis regarding bicarbonate levels?

    <p>Decreased levels below 21 (D)</p> Signup and view all the answers

    What prevents patients with kidney disease from filtering fluid effectively?

    <p>Chronic renal damage (B)</p> Signup and view all the answers

    Which symptom is most likely in a patient experiencing fluid overload due to kidney failure?

    <p>Shortness of breath (C)</p> Signup and view all the answers

    Which type of pain is associated with kidney problems such as pyelonephritis?

    <p>Flank pain (C)</p> Signup and view all the answers

    What lab result commonly indicates the presence of kidney dysfunction?

    <p>High creatinine levels (D)</p> Signup and view all the answers

    What is the typical pH range for a patient with metabolic acidosis?

    <p>Below 7.35 (A)</p> Signup and view all the answers

    Which medication is commonly used to counteract anemia in patients with kidney issues?

    <p>Erythropoietin (D)</p> Signup and view all the answers

    What should a patient avoid for about 5 to 7 days after a renal biopsy?

    <p>Heavy lifting (D)</p> Signup and view all the answers

    What skin color change can be observed in patients with kidney disease?

    <p>Sallow pigmentation (C)</p> Signup and view all the answers

    What is recommended to help prevent kidney stones?

    <p>Increased hydration (D)</p> Signup and view all the answers

    What type of urinary output alteration might occur in patients with chronic kidney disease?

    <p>Oliguria (A)</p> Signup and view all the answers

    What should patients with uncontrolled hypertension understand about their condition?

    <p>It can damage the kidneys over time (B)</p> Signup and view all the answers

    Which of the following can lead to decreased cardiac output in kidney disease patients?

    <p>Fluid overload (C)</p> Signup and view all the answers

    What is a common complication regarding cognitive function in patients with kidney issues?

    <p>Dizziness and confusion (C)</p> Signup and view all the answers

    Which of the following is a sign that a patient might have a renal biopsy complication?

    <p>Tachycardia (D)</p> Signup and view all the answers

    What should be done if a patient shows symptoms of a UTI?

    <p>Collect blood cultures and administer antibiotics quickly (A)</p> Signup and view all the answers

    Which of the following lab tests assesses kidney function by measuring waste products in blood?

    <p>BMP (B)</p> Signup and view all the answers

    What practice can help reduce the risk of UTIs?

    <p>Drinking fluids regularly (D)</p> Signup and view all the answers

    What electrolyte imbalance is common in patients with renal failure?

    <p>Hyperkalemia (C)</p> Signup and view all the answers

    What is a common cause of chronic kidney disease related to hypertension?

    <p>Uncontrolled hypertension (D)</p> Signup and view all the answers

    Which of the following statements about lithotripsy is true?

    <p>It breaks up kidney stones for easier passage (B)</p> Signup and view all the answers

    What should patients with a UTI be taught regarding their antibiotic prescription?

    <p>Completely adhere to the prescribed course (B)</p> Signup and view all the answers

    Which demographic is at higher risk for developing urinary tract infections?

    <p>Patients with indwelling catheters (A)</p> Signup and view all the answers

    What dietary change can help in managing hypertension?

    <p>Follow a balanced diet rich in potassium (A)</p> Signup and view all the answers

    What is the primary method for diabetic patients to reduce complications related to their condition?

    <p>Compliant sugar control (A)</p> Signup and view all the answers

    What condition can result from the kidneys thinking they need to increase blood pressure due to low blood flow?

    <p>Kidney failure (A)</p> Signup and view all the answers

    What is the primary benefit of hemodialysis compared to peritoneal dialysis?

    <p>Better fluid removal (A)</p> Signup and view all the answers

    What is a key component used in continuous renal replacement therapy for anemia related to kidney disease?

    <p>Erythropoietin (EPO) (A)</p> Signup and view all the answers

    Why might a patient with metabolic acidosis be placed on sodium bicarbonate?

    <p>To neutralize acidity in the blood (D)</p> Signup and view all the answers

    Which dietary change is recommended for patients with high uric acid levels?

    <p>Limit fruits high in fructose (B)</p> Signup and view all the answers

    What should be monitored in patients after undergoing dialysis to prevent complications?

    <p>Weight changes and vital signs (D)</p> Signup and view all the answers

    What is the role of dietary phosphate binders in patients with kidney disease?

    <p>Reduce phosphate absorption (D)</p> Signup and view all the answers

    In patients undergoing peritoneal dialysis, which component acts as a filter for waste products?

    <p>Peritoneum (B)</p> Signup and view all the answers

    What is the common treatment for high potassium levels in kidney disease patients?

    <p>Dialysis (C)</p> Signup and view all the answers

    Which vitamin deficiency contributes to anemia in patients with kidney disease?

    <p>Folic acid (B)</p> Signup and view all the answers

    What type of therapy is specifically mentioned for patients experiencing fluid volume overload?

    <p>Peritoneal dialysis (B)</p> Signup and view all the answers

    What is the minimum urinary output that should be maintained?

    <p>30 mL/hour (C)</p> Signup and view all the answers

    Which of the following is a common first sign of infection in older adults?

    <p>Confusion (B)</p> Signup and view all the answers

    What type of acute kidney injury is characterized by poor blood flow to the kidneys?

    <p>Pre renal (A)</p> Signup and view all the answers

    Which of the following can be a post renal cause of acute kidney injury?

    <p>Benign prostatic hypertrophy (C)</p> Signup and view all the answers

    What happens during the oliguric phase of acute kidney injury?

    <p>Fluid retention (A)</p> Signup and view all the answers

    Which of the following patients is likely to require intermittent catheterization?

    <p>Patients with multiple sclerosis (A)</p> Signup and view all the answers

    Which symptom might indicate that a patient is experiencing urinary obstruction?

    <p>Blood in urine (C)</p> Signup and view all the answers

    Which category of acute kidney injuries is caused by issues occurring within the kidney?

    <p>Intra renal (A)</p> Signup and view all the answers

    What condition may result from untreated benign prostatic hypertrophy?

    <p>Acute kidney injury (A)</p> Signup and view all the answers

    What is a common risk factor for acute kidney injury in elderly patients?

    <p>Advanced age (B)</p> Signup and view all the answers

    Which of the following medications can be nephrotoxic?

    <p>Metformin (A)</p> Signup and view all the answers

    What is a significant complication of post renal acute kidney injury?

    <p>Fluid overload (B)</p> Signup and view all the answers

    What is one of the main differences between acute kidney injury and chronic kidney disease?

    <p>Acute kidney injury is temporary while chronic is permanent (B)</p> Signup and view all the answers

    Which factor does NOT contribute to renal problems in older adults?

    <p>Increased hydration (A)</p> Signup and view all the answers

    What is the primary concern regarding potassium levels in patients with kidney issues?

    <p>It can accumulate and lead to hyperkalemia. (B)</p> Signup and view all the answers

    Which test is the best indicator of kidney function?

    <p>Glomerular filtration rate (C)</p> Signup and view all the answers

    What does a urinalysis help to analyze?

    <p>Concentration of electrolytes and substances in urine (C)</p> Signup and view all the answers

    What is the risk associated with using contrast dye during kidney tests?

    <p>It can be toxic to the kidneys. (C)</p> Signup and view all the answers

    Which of the following is a necessary step in conducting a 24-hour urine test?

    <p>Save the first urine sample collected. (B)</p> Signup and view all the answers

    What can elevated uric acid levels in the blood lead to?

    <p>Development of kidney stones. (B)</p> Signup and view all the answers

    Patients with a shellfish allergy should be monitored for which type of testing?

    <p>Contrast-enhanced imaging (D)</p> Signup and view all the answers

    How long does a urine culture typically take to yield results?

    <p>3 days (C)</p> Signup and view all the answers

    What is one critical action required after administering contrast dye to a patient?

    <p>Encourage extra fluids to flush the kidneys. (B)</p> Signup and view all the answers

    What type of problems can a cystoscopy help diagnose?

    <p>Urethra and bladder abnormalities (B)</p> Signup and view all the answers

    What condition can result from untreated urinary tract infections that extend to the kidneys?

    <p>Pyelonephritis (B)</p> Signup and view all the answers

    What must be done if a patient's urine sample is inadvertently discarded during a 24-hour collection?

    <p>Start the entire 24-hour collection procedure over. (D)</p> Signup and view all the answers

    What is indicated by the absence of a bruit or thrill in an AV fistula or graft?

    <p>The catheter may be clotted (C)</p> Signup and view all the answers

    What does the sensitivity portion of a urine culture inform clinicians about?

    <p>Best antibiotics for treatment. (B)</p> Signup and view all the answers

    How often do new patients typically need to receive hemodialysis?

    <p>Three times a week (B)</p> Signup and view all the answers

    What additional tests may be ordered alongside a urinalysis?

    <p>Urine culture (D)</p> Signup and view all the answers

    What can happen if a patient does not undergo dialysis?

    <p>Fluid builds up in the body (B)</p> Signup and view all the answers

    Why might antihypertensives be held before a dialysis session?

    <p>Fluid shifting can drop blood pressure (C)</p> Signup and view all the answers

    What is a common consequence of excessive fluid removal during dialysis?

    <p>Low blood pressure (C)</p> Signup and view all the answers

    What electrolyte imbalance should be a top priority for patients with kidney problems?

    <p>Hyperkalemia (C)</p> Signup and view all the answers

    What should be monitored closely after a patient receives dialysis?

    <p>Blood pressure and heart rate (D)</p> Signup and view all the answers

    What is a potential complication of chronic kidney disease related to fluid overload?

    <p>Shortness of breath (B)</p> Signup and view all the answers

    What effect does chronic kidney disease have on calcium levels?

    <p>Decreases calcium levels (A)</p> Signup and view all the answers

    What might be a reason for a patient with kidney disease to experience dysrhythmias?

    <p>High potassium levels (A)</p> Signup and view all the answers

    What signs might indicate issues with erythropoietin production in patients with chronic kidney failure?

    <p>Low hemoglobin and hematocrit (D)</p> Signup and view all the answers

    Which symptom indicates a worsening metabolic state in chronic kidney disease?

    <p>Nausea and vomiting (B)</p> Signup and view all the answers

    What can occur as a result of altered carbohydrate metabolism in chronic kidney disease?

    <p>Loss of appetite (C)</p> Signup and view all the answers

    What is the typical urine output in patients with chronic kidney disease?

    <p>Low urine output or anuria (C)</p> Signup and view all the answers

    What is the primary goal of a renal diet?

    <p>To promote kidney function and slow kidney failure progression (C)</p> Signup and view all the answers

    Why should patients on a renal diet avoid salt substitutes like Mrs. Dash?

    <p>They typically contain potassium chloride. (A)</p> Signup and view all the answers

    Which of the following foods should be avoided on a renal diet?

    <p>Potatoes (A)</p> Signup and view all the answers

    What medication is typically administered for high potassium levels in renal patients?

    <p>Sodium polystyrene sulfonate (D)</p> Signup and view all the answers

    Which vital sign change is most expected in a patient experiencing sepsis?

    <p>Hypotension (C)</p> Signup and view all the answers

    An important monitoring aspect for a patient on dialysis is checking for which of the following?

    <p>Signs of infection (B)</p> Signup and view all the answers

    What is a common characteristic of patients experiencing septic shock?

    <p>Altered mental status (B)</p> Signup and view all the answers

    What is a significant risk associated with low body temperature in sepsis?

    <p>Blood coagulation problems (B)</p> Signup and view all the answers

    Which medication might be given to a renal patient who has low hemoglobin levels?

    <p>Erythropoietin (D)</p> Signup and view all the answers

    Which condition is a direct result of untreated localized infections leading to sepsis?

    <p>Septicemia (B)</p> Signup and view all the answers

    What could indicate the progression of sepsis in a patient?

    <p>Rapidly increasing heart rate (D)</p> Signup and view all the answers

    Why is it important to check a dialysis catheter for a 'bruit' or 'thrill'?

    <p>To assess for appropriate flow and function (B)</p> Signup and view all the answers

    What dietary component should be particularly restricted in renal patients?

    <p>Potassium (D)</p> Signup and view all the answers

    Monitoring a patient's daily weight during dialysis primarily helps to assess what?

    <p>Fluid retention (B)</p> Signup and view all the answers

    Study Notes

    Kidney Function and Disease

    • Kidneys filter waste products, regulate blood pressure, acid-base balance, and produce erythropoietin for red blood cell production.
    • Kidney disease increases risk of anemia (low hemoglobin) due to decreased erythropoietin.
    • Vitamin D activation is impaired in kidney disease, affecting calcium regulation.
    • Kidney failure can be pre-renal, intra-renal, or post-renal.

    Risk Factors for Kidney Disease

    • Trauma
    • Infections (e.g., systemic, UTI, pyelonephritis)
    • Obstructions (e.g., kidney stones)
    • Uncontrolled hypertension (leading to nephrosclerosis)
    • Diabetes (vascular problems)
    • Cancers (various types)
    • Streptococcal infections (acute post-streptococcal glomerulonephritis)
    • Surgeries
    • Genetic factors (familial history of kidney stones, polycystic kidney disease)
    • Smoking (vascular problems)
    • Sexually transmitted infections
    • Medications (certain drugs, including some diuretics)

    Altered Urinary Elimination in Kidney Disease

    • Fluid retention is a concern in kidney disease, leading to fluid volume overload.
    • Waste product buildup can cause cognitive impairment (dizziness, lightheadedness, confusion, altered level of consciousness).
    • Acid-base imbalance: kidney disease commonly causes metabolic acidosis (low pH, low bicarbonate).
    • Reduced cardiac output is a risk factor due to fluid overload and dialysis.
    • Symptoms include dysuria, flank pain (associated with conditions like pyelonephritis, polycystic kidney disease), abdominal fullness, trouble initiating urine stream, oliguria (low urine output), anuria (no urine output).
    • Muscle weakness, fatigue, and reflex problems can occur due to electrolyte imbalances and waste product buildup.
    • Skin discoloration (sallow pigmentation, yellowish-greenish) or pallor (low blood count) can appear.

    Laboratory Tests

    • CBC: Hemoglobin is a key parameter, often low due to anemia.
    • BMP: Waste products in the blood (creatinine, elevated in kidney disease), helping determine kidney function.
    • Electrolytes: Potassium is particularly important – elevated levels (hyperkalemia) can cause serious cardiac issues. Calcium, magnesium, and phosphorus levels may also be abnormal.
    • Uric acid: Elevated uric acid can contribute to kidney stones.
    • Glomerular Filtration Rate (GFR): Measures kidney function, used to stage kidney disease, lower GFR indicates worse kidney function.
    • Blood Cultures: Used to identify bacterial growth in the blood – relevant in urinary tract infections that travel to the kidneys (pyelonephritis).
    • 24-hour Urine Tests: Measure creatinine clearance, etc., discarding the first urine sample; subsequent samples must be stored on ice/refrigerated and sent to the lab promptly.
    • Urinalysis: Analyzes urine for glucose, protein, red blood cells, ketones, white blood cells, osmolality, specific gravity, etc.
    • Urine Culture: Identifies the bacteria causing a urinary tract infection; results take 3 days.

    Radiology Tests and Procedures

    • Imaging (e.g., CT scan, ultrasound): Used to assess kidney size, check for stones, hydronephrosis, tumors, or abscesses.
    • Contrast imaging: Use of dye to highlight the kidneys, but remember the kidney toxicity risk associated with contrast. Ensure patient drinks extra fluids to flush the dye. Metformin should be held in patients undergoing procedures with contrast.
    • Cystoscopy: Direct visualization of the urethra and bladder to detect issues such as tumors or bleeding. Requires anesthesia.
    • Biopsy: Tissue sample taken (e.g., from a kidney) to diagnose conditions like cancer. Close monitoring for post-biopsy bleeding (signs like tachycardia, low blood pressure, hematuria) and restrictions on lifting heavy objects for 5–7 days after.
    • Urodynamic studies: Evaluate urine outflow or flow rate.

    Conditions Associated with Kidney Problems

    • Uncontrolled Hypertension: Damages kidneys by reducing blood flow.
    • Diabetes: Vascular complications increase the risk of kidney problems.
    • Kidney Stones: Increased risk with dehydration; treated with lithotripsy or surgical removal.
    • Urinary Tract Infections (UTIs): Prevention is crucial (hydration, good hygiene); treat with antibiotics; watch out for complications like pyelonephritis.

    Acute Kidney Injury (AKI)

    • Pre-renal AKI: Poor blood flow to the kidneys (e.g., shock, dysrhythmias, heart failure).
    • Intra-renal AKI: Problems within the kidney (e.g., nephrotoxic medications, blood clots, lupus).
    • Post-renal AKI: Obstructions after the kidneys (e.g., enlarged prostate, bladder problems).
    • Phases: Oliguric (low urine output); diuretic (increased urine output); recovery.
    • Treatment: Managing fluid overload/deficit; addressing electrolyte imbalances (e.g., hyperkalemia); using appropriate diuretics and other medications (e.g., calcium, insulin, glucose, sodium polystyrene sulfonate); supportive care.

    Chronic Kidney Disease (CKD)

    • General Concerns: Confusion, weakness, electrolyte abnormalities (high phosphate, low calcium).
    • Treatment: Dietary restrictions (sodium, potassium, phosphorus), medications (e.g., phosphate binders, calcium supplements), blood pressure control, erythropoietin, lipid-lowering medications.
    • Dialysis: Essential for severe CKD and AKI; necessitates a specialized access site (catheter, graft); careful monitoring for infection. Important to monitor for bruits and thrill of the fistula.

    Dialysis

    • Access: AV fistula, AV graft, catheter
    • Monitoring: For infection signs; no blood pressure or glucose checks on the dialysis access side; assessing for bruits and thrill in the access area
    • Fluid shifts: Monitor for dehydration and orthostatic hypotension post-dialysis, adjusting fluid and medication to compensate for shifts during and after procedure.

    Sepsis

    • Definition: Systemic infection from a localized source, characterized by altered mental status, high/low temperatures, tachycardia, hypotension, low urine output.
    • Additional: Sepsis warning signs are potentially life threatening, immediate medical attention is needed.

    Peritoneal Dialysis

    • Different approach than hemodialysis using the peritoneum as a filter.

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    Description

    This quiz tests your knowledge on the primary functions of the kidneys, their roles in hormone production, and the consequences of kidney disorders. Questions cover topics such as electrolyte balance, renal disease implications, and treatments for hyperkalemia. Perfect for medical students or health professionals seeking to refresh their understanding of renal physiology.

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