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What is the recommended GFR level to initiate Kidney Replacement Therapy (KRT)?
Hemodialysis is typically done at home for patients.
False
What is the advantage of peritoneal dialysis compared to hemodialysis?
Better hypertension control.
The definitive treatment for kidney failure after finding a donor is __________.
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Match the type of dialysis with its key characteristics:
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What is a primary characteristic of Vesico-Ureteric Reflux (VUR)?
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Vesico-Ureteric Reflux (VUR) is commonly caused by infections in children.
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What is the primary diagnostic tool used to confirm Vesico-Ureteric Reflux (VUR)?
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What is the minimum absolute increase in serum creatinine that indicates Acute Kidney Injury (AKI)?
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Decreased urine output is defined as less than 0.5 ml/kg/hr for over 6 hours in AKI.
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Vesico-Ureteric Reflux may lead to __________ of the kidneys due to recurrent urinary tract infections.
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What are the two main characteristics used to define acute kidney injury?
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Match the following features of VUR with their correct descriptions:
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An absolute serum creatinine level of _____ mg/dl or greater indicates a significant decline in kidney function.
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Match the following stages of AKI with their corresponding serum creatinine increases:
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What is the mode of inheritance of Liddle Syndrome?
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Liddle Syndrome is caused by a loss of function mutation in the SCNN1 gene.
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What is the result of ENAC overactivity in Liddle Syndrome?
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In Liddle Syndrome, the primary electrolyte imbalance seen is __________.
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Match the following features with their related conditions:
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Which of the following is a consequence of ENAC overexpression in Liddle Syndrome?
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Inhibition of aldosterone secretion is a feature of Liddle Syndrome.
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Name one type of evaluation associated with Liddle Syndrome.
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What is the primary mode of inheritance of Gitelman syndrome?
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Gitelman syndrome is characterized by hyperkalemia.
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Which region of the nephron is primarily affected in Gitelman syndrome?
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Gitelman syndrome results in excretion of __________ and __________ in urine, leading to metabolic alkalosis.
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Match the following consequences of Gitelman syndrome with their descriptions:
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What is the typical pH level of urine?
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Urine is typically neutral in pH.
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What is the primary characteristic of urine concerning its pH level?
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The pH of urine is generally considered to be __________.
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Match the following urine properties with their characteristics:
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Which of the following is a clinical presentation of inherited tubular disorders?
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Electrolyte imbalances are not associated with inherited tubular disorders.
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What is the primary defect seen in Fanconi syndrome?
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The reabsorption of bicarbonate, glucose, and amino acids primarily occurs in the ________.
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Match the inherited tubular disorders with their characteristics:
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What is the most common presentation of D+ HUS?
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The Coombs' test is typically positive in cases of D+ HUS.
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What are schistocytes, and where are they typically found?
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The duration of symptoms in D+ HUS typically lasts for __________ days.
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Match the following stages of Chronic Kidney Disease (CKD) with their corresponding GFR values:
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Which of the following is a common cause of obstructive uropathy?
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Reflex nephropathy causes scars in the kidneys.
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What is the recommended management for short stature in patients with renal complications?
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The primary management for anemia in patients with GFR less than 30 ml/min/1.73 m² is __________.
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Match the following management strategies with their corresponding complications:
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Which of the following is a pre-renal cause of Acute Kidney Injury (AKI)?
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Hemolytic Uremic Syndrome (HUS) can be classified into two types: D+ and D-.
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What is the primary goal in the management of pre-renal AKI?
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In the case of hyperkalemia, _________ can be used to shift potassium intracellularly.
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Match the complications of AKI with their management:
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Study Notes
Kidney Replacement Therapy (KRT)
- For patients with End Stage Kidney Disease (ESKD).
- Starts when Glomerular Filtration Rate (GFR) is below 12 ml/min/1.73 m².
- Two main types:
- Dialysis:
- Peritoneal dialysis: Done at home, involves fluid exchange in the peritoneal cavity.
- Hemodialysis: Done in hospital, involves filtering blood through a machine.
- Renal transplantation: The preferred treatment, involves receiving a kidney transplant.
- Dialysis:
Vesico-Ureteric Reflux (VUR)
- Backflow of urine from the bladder to the ureters.
- Usually present at birth.
- Can cause scarring of the kidneys and lead to CKD.
- Diagnosed using micturating cysto urethrogram (MCU), also known as voiding cysto urethrogram (VCUG).
Acute Kidney Injury (AKI)
- Sudden decrease in kidney function.
- Key features:
- Increase in serum creatinine levels, either absolute or relative.
- Decreased urine output.
- Staged based on severity of creatinine elevation and urine output.
Inherited Tubular Disorders (ITDs)
- Group of disorders affecting the kidneys' ability to reabsorb water, electrolytes, and nutrients.
- Common symptoms:
- Polyuria (excess urine production)
- Electrolyte imbalances
- Failure to thrive
- Some common ITDs:
- Fanconi syndrome
- Bartter syndrome
- Gitelman syndrome
- Liddle syndrome
Fanconi Syndrome
- Generalized proximal tubule dysfunction.
- Key features:
- Impaired bicarbonate reabsorption leading to metabolic acidosis with normal anion gap.
- Glycosuria (glucose in urine)
- Aminoaciduria (amino acids in urine)
- Phosphaturia (phosphate in urine)
D+ HUS
- Hemolytic Uremic Syndrome associated with diarrhea.
- Caused by Shiga-toxin producing bacteria like Shigella dysenteriae or Enterohemorrhagic E.coli (EHEC).
- Key features:
- Most common age group: under 4 years old.
- Usually presents with diarrhea.
- Symptoms: pallor, weakness, oliguria (reduced urine output).
- Often self-resolving, but supportive care and antibiotics are needed. Dialysis may be required in severe cases.
Chronic Kidney Disease (CKD)
- Progressive decline in kidney function over time.
- Staged based on GFR and other factors.
- Management focuses on slowing the progression of CKD and treating complications.
Genitourinary System
- The system responsible for the production, storage, and elimination of urine.
- Includes kidneys, ureters, bladder, and urethra.
Etiology of Chronic Kidney Disease (CKD)
- Variety of causes:
- Active space (structural):
- Obstructive uropathy: blockage in the urinary tract.
- Reflex nephropathy: damage caused by vesicoureteric reflux.
- Chronic glomerulonephritis: inflammation of the filtering units of the kidneys.
- Congenital anomalies: birth defects in the urinary system.
- Active space (structural):
Management of Chronic Kidney Disease (CKD)
- Focuses on addressing the cause and managing complications:
- Surgical correction: for structural anomalies.
- Medical management for irreversible damage.
- Nutritional guidance: No protein restrictions, but emphasis on polyunsaturated fatty acids (PUFAs) and complex carbohydrates to promote growth.
Complications of Chronic Kidney Disease (CKD)
- Common complications and their management:
- Anemia:
- Cause: reduced erythropoietin production.
- Management: Darbopoetin (recombinant erythropoietin).
- Mineral Bone Disease:
- Cause: imbalance of calcium, phosphorus, and Vitamin D.
- Management: Calcitriol supplementation, calcium supplementation, phosphate binders (calcium-based or non-calcium based).
- Short stature:
- Management: Recombinant growth hormone (rGH).
- Hypertension (HTN):
- Management: Lifestyle modifications, ACE inhibitors, ARBs.
- Anemia:
Acute Kidney Injury (AKI)
- Etiology of AKI:
- Pre-renal causes (most common): Reduced blood flow to the kidneys.
- Renal causes: Direct damage to the kidney tissues.
- Post-renal causes: Blockage in the urinary tract.
Management of AKI
- Focuses on identifying the cause and providing appropriate treatment:
- Pre-renal AKI: Fluid resuscitation
- Renal AKI: Fluid management and preventing further kidney injury.
Complications of AKI
- Include:
- Anemia: Managed with PRBC transfusion if needed.
- Metabolic acidosis: Managed with IV sodium bicarbonate.
- Hyponatremia: May require fluid management.
- Hyperkalemia: Managed with fluid management, K+ binding resins, or dialysis in refractory cases.
Hemolytic Uremic Syndrome (HUS)
- Two main types:
- D+ HUS: Associated with diarrhea, caused by Shiga-toxin producing bacteria.
- D- HUS: Not associated with diarrhea, caused by a defect in the alternate complement pathway.
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Description
Test your knowledge on crucial kidney health topics such as Kidney Replacement Therapy, Vesico-Ureteric Reflux, and Acute Kidney Injury. This quiz covers definitions, diagnostics, and treatment options that are essential for understanding these conditions. Perfect for healthcare students and professionals alike.