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Questions and Answers
What type of renal tubular acidosis is characterized by a decrease in bicarbonate reabsorption?
Which of the following characteristics is indicative of chronic renal failure compared to acute renal failure?
In which classification of acute renal failure does prerenal failure account for the highest percentage of cases?
What is a common finding in urine analysis for patients experiencing proximal renal tubular acidosis?
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What distinguishes acute renal failure from chronic renal failure in the context of urine flow rate?
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What defines nephrotic syndrome?
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Which condition is a primary cause of acute renal failure often associated with hospitalized patients?
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What is typically found in the urine sediment of a patient with Acute Interstitial Nephritis?
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What distinguishes nephritis from nephrotic syndrome in terms of urine examination?
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What is the primary characteristic of nephrotic disease concerning protein loss?
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Which of the following causes is primarily associated with Acute Tubular Necrosis?
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What is a common urinary finding in nephrotic syndrome?
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What does a decrease in GFR indicate in renal disease?
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Study Notes
Renal Failure Overview
- Renal failure can be classified into Acute Renal Failure (ARF) and Chronic Renal Failure (CRF).
- Objectives include understanding anatomy, function, causes, symptoms, and management of both ARF and CRF.
Terminology
- CRF: Chronic Renal Failure
- ARF: Acute Renal Failure
- ESRD: End Stage Renal Disease
- ESRF: End Stage Renal Failure
- GFR: Glomerular Filtration Rate
- Azotemia: Nitrogenous waste retention due to renal insufficiency.
Glomerular Disease
- Nephritis: Inflammation of glomeruli, often presenting with proteinuria and hematuria. Causes include streptococci, SLE, severe acute kidney infections, and some medications.
- Nephrotic Syndrome: Characterized by extensive proteinuria (>3.5 g/day), hyperlipidemia, and edema. Causes include infections (HIV, Hepatitis) and conditions like diabetic nephropathy.
Interstitial/Tubular Disease
- Acute Tubular Necrosis (ATN): A leading cause of ARF in hospitalized patients due to hypotension and nephrotoxins (e.g., aminoglycosides). Urine shows muddy brown granular casts.
- Acute Interstitial Nephritis: Causes include drugs (e.g., NSAIDs, antibiotics), infections, and autoimmune disorders. Urinalysis may reveal eosinophils and white blood cell casts.
- Cast Nephropathy (Multiple Myeloma): Characterized by tubular casts, indicative of renal tubular damage.
Chronic Tubular Disease
- Caused by conditions such as Polycystic Kidney Disease and hypercalcemia, leading to decreased excretion and reduced urinary concentrating ability.
- Renal Tubular Acidosis (RTA) affects acid-base balance, with Proximal RTA resulting in hyperchloremic acidosis. Distal RTA leads to failure in maintaining vital pH gradients.
Acute vs Chronic Renal Failure
- Acute Renal Failure (ARF): Sudden onset, rapid reduction in urine output, often reversible with regeneration of tubular cells. Presenting features include oliguria (<400 mL/day in adults).
- Chronic Renal Failure (CRF): Progressive and irreversible, involving significant nephron loss before symptoms appear (up to 75% functional loss).
Classification of Acute Renal Failure
- Classifications based on urine volume:
- OLIGURIC: <500 cc/24 hours
- ANURIC: absence of urine output.
- Classified into:
- Prerenal: 55% (due to reduced blood flow)
- Intrinsic: 40% (due to direct damage to renal parenchyma)
- Postrenal: 5-15% (due to obstructions in urinary tract).
Diagnosis and Management
- Diagnosis of ARF includes monitoring creatinine levels and urine flow rates.
- Management revolves around identifying and treating the underlying cause to prevent further progression.
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Description
This quiz explores the critical concepts of renal failure, including Acute Renal Failure (ARF) and Chronic Renal Failure (CRF). You will learn about the anatomy, functions, causes, symptoms, and management of both types of renal failure. Key terms and related diseases such as nephritis and nephrotic syndrome are also covered.
