Renal Failure and Management Quiz

A glycoprotein produced by the kidneys that stimulates red blood cell production in the bone marrow.

The final conversion of inactive vitamin D into its active form, 1,25-dihydroxycholecalciferol, takes place in the kidneys. This active form of vitamin D is crucial for maintaining calcium balance in the body.

Kidneys produce prostaglandins such as PGE2 and PGI2, which have vasoactive effects. These prostaglandins help regulate renal blood flow by causing selective vasodilation or vasoconstriction.

The kidneys are responsible for eliminating metabolic waste products from the body. This includes urea, the primary waste product of protein metabolism.

Urea, creatinine, phosphates, sulfates, and uric acid are all waste products that the kidneys eliminate through urine.

The bladder is the reservoir for urine. Filling and emptying of the bladder are controlled by coordinated sympathetic and parasympathetic nervous system mechanisms involving the detrusor muscle and bladder outlet.

As the bladder fills, stretch receptors within the bladder wall are activated, sending signals through sympathetic pathways to the spinal cord (T10-T12). This initiates the urge to urinate.

The kidneys serve a crucial role in eliminating drug metabolites, playing a significant part in drug metabolism overall.

A condition where the kidneys are unable to remove waste products and regulate bodily fluids, leading to the need for dialysis or transplantation.

A measure of the amount of blood filtered by the kidneys per minute.

A test to measure how much creatinine the kidneys remove from the blood in 24 hours.

The underlying cause of CKD can be hypertension, diabetes, or other conditions.

CKD can progress slowly and silently, with few symptoms in the early stages.

Fluid retention, anemia, and electrolyte imbalances are common symptoms of CKD.

Managing high blood pressure, anemia, and blood sugar helps slow down CKD progression.

Early referral for dialysis or transplantation is crucial for patients with advanced CKD.

A condition where the kidneys lose their ability to filter waste products properly, leading to a buildup of toxins in the body.

A specific gravity test measures the concentration of dissolved substances in urine. A fixed specific gravity of 1.010 in CKD indicates the kidneys are not concentrating urine properly.

Proteins in urine are a sign of damage in the kidneys. In CKD, proteinuria can be variable, meaning the amount of protein excreted in the urine fluctuates.

A decrease in glomerular filtration rate (GFR) below 50 mL/min is a hallmark of CKD, indicating impaired kidney function.

The heart, especially the left ventricle, enlarges in CKD due to increased workload from hypertension & fluid buildup. Hyperkalemia's effect on the ECG is characterized by tall, pointed T waves - a distinctive pattern.

CKD can lead to a buildup of phosphorus in the blood due to decreased renal excretion. The body tries to compensate by binding calcium to phosphorus, leading to a decrease in serum calcium.

A pericardial friction rub is a scratching or grating sound heard during auscultation of the heart, characteristic of pericarditis. Pulsus paradoxus, a drop in blood pressure during inspiration, is another sign of pericarditis.

Maintaining a healthy weight and reducing fluid overload is important in managing CKD. Diuretics help remove excess fluid from the body.

Potassium levels are high in the blood (hyperkalemia) and can lead to heart rhythm problems. Kayexalate is a medication that binds to potassium in the gut and helps remove it from the body.

To help remove the Kayexalate medication from the gut, a cleansing enema might be needed. This helps prevent complications like fecal impaction.

When a patient is experiencing dangerously low blood pressure, mental status changes, or abnormal heart rhythms, giving dextrose, insulin, and calcium helps move potassium back into the cells and stabilize the situation.

As many medications are removed by the kidneys, dosages must be adjusted for people with AKI (Acute Kidney Injury). This is to prevent medication buildup and harmful side effects.

Diuretics help with fluid management but haven't been shown to improve AKI recovery.

If a patient with AKI has severe acidosis, monitoring their blood gases and bicarbonate levels is important because they may need sodium bicarbonate treatment or dialysis.

For patients developing respiratory problems due to AKI, appropriate ventilatory measures, such as mechanical ventilation, may be required to ensure good lung function.

Elevated serum phosphate levels in AKI can be controlled with phosphate-binding agents like calcium or lanthanum carbonate. These medications decrease the absorption of phosphate from the intestines, helping prevent further increases in phosphate levels.

The most acute stage of AKI involves reducing metabolic rate by limiting exertion and preventing fever and infection. This approach helps decrease energy demands and minimizes catabolism, protecting the kidneys from further damage.

Maintaining adequate fluid and electrolyte balance is essential for AKI management. Accurate monitoring of daily weight, I&O records, and immediate reporting of any imbalances ensures prompt intervention and prevents complications.

Frequent turning, coughing, and deep breathing are vital for preventing atelectasis and respiratory infections in AKI patients. This helps maintain lung function and oxygenation.

Aseptic technique is crucial when dealing with invasive lines and catheters to minimize infection risk in AKI patients. This reduces the burden on the kidneys and prevents further complications.

Maintaining skin integrity is crucial in AKI patients due to edema and potential breakdown. Regular baths, turning, moisturizing, and nail care help prevent excoriation and discomfort.

Psychological support is crucial for both the patient and their family during AKI treatment. Providing accurate information, addressing concerns, and offering empathy help them cope with the challenges.

Hemodialysis, peritoneal dialysis (PD), or continuous renal replacement therapy (CRRT) may be required to treat severe fluid and electrolyte disturbances in AKI. The duration of these treatments depends on the severity and cause of kidney damage.

Continuous assessment for AKI complications and precipitating causes is essential. This includes monitoring for fluid overload, electrolyte imbalances, infection, and other factors that can worsen kidney function.

The accumulation of waste products in the blood, particularly urea, due to impaired kidney function.

A condition characterized by the accumulation of uremic waste products, affecting multiple organs and systems in the body.

A complication of ESKD where the nerves in the limbs become damaged, leading to various symptoms like pain, numbness, and tingling.

A sign of ESKD seen in the neurological system, characterized by rapid, involuntary jerking movements of the hands or feet.

A buildup of potassium in the blood, a common complication of ESKD that can lead to serious heart rhythm problems.

Inflammation of the sac surrounding the heart, a potential complication of ESKD. The heart's sac gets angry!

A type of breathing pattern associated with ESKD, characterized by deep, rapid breathing.