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N172 Renal (CKD) exam with complete solutions 2024.
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N172 Renal (CKD) exam with complete solutions 2024.
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lOMoARcPSD|41562175N172 Renal (CKD) exam with complete solutions
2024
CKD k(chronic kkidney kdisease) k- kANSWER✓✓-GFR k<60 kmL/min kfor k>3 kmonths
Stage k1 kCKD k- kANSWER✓✓-> kor kequal kto k90 kmL/min kGFR
Stage k5 k(Kidney kFailure) k- kANSWER✓✓-<15 kGFR kor kdialysis k== kneeds ka ktransplant
Leading kcause kof kCKD k- kANSWER✓✓-1. kDiabetes
2. kHTN k(Nephrosclerosis)
**Due kto ksclerosis kof kthe kvessels
Acute kPoststreptococcal kGlomerulonephritis k- kANSWER✓✓--immune kcomplexes kform
kfrom kstrep kantigen kand kbody's kantibody== kinflammation, kproliferation, k& kscarring kof
kglomerulus
**Sx/Sx:
-generalized kbody kedema
-HTN
-Oliguria
-Hematuria
-Proteinuria
-smoky kurine
**Initially, kedema kappears kin klow-pressure ktissues k(periorbital kedema)
Nephrotic kSyndrome k- kANSWER✓✓--increased kglomerular kpermeability k= kproteinuria
-Increased kfluid kretention k(3rd kspacing)
SX:
-peripheral kedema
-foamy kurine
-hypoalbuminemia
DIET:
-low ksodium, kmod kprotein kdiet
Priority:
-focus kon kmanagement kof kedema
1. kweigh kpt kdaily
2. krecord kI/O
3.measure kabdominal kgirth/extremity ksize
Pyelonephritis k- kANSWER✓✓--Acute: kinflammation kof krenal kparenchyma k& kcollecting
ksystem
, lOMoARcPSD|41562175
-Chronic: krecurring kinfections k= kkidneys kbecome kshrunken kand kscarred
polycystic kkidney kdisease k(PKD) k- kANSWER✓✓--grape-like kcyst kclusters k=
kcompress/destroy ksurrounding ktissues
-Need kgenetic kcounseling
Nephrotoxic kDrugs k- kANSWER✓✓--NSAIDS k(ibuprofen, kaspirin, knaproxen)
-contrast kmedia
-aminoglycosides k("mycins"
-heroin
-crack/cocaine
-Ace-I
Chronic krenal kfailure/ESRD k- kANSWER✓✓--Uremia/azotemia k(increased knitrogenous kwaste
kin kthe kblood)
-polyuria kw kdilute kurine
-hyperglycemia k& khyperinsulinemia
-dyslipidemia
-Lytes k& kacid/base kimbalances
Uremia kw kdiabetes k- kANSWER✓✓--May kneed kless kinsulin kbecause kinsulin kremains kin
kcirculation klonger kw kESRD
Potassium k(3.5-5.3) k- kANSWER✓✓--arrhythmias k= kput kin kEKG kmonitor
-peaked kT-waves k& kwidened kQRS kcomplex
Tx:
-10 k% kCa kGluconate kIV kfor kV-fib
-D50 k& kinsulin kIV
-Kayexelate
Sodium k(136-145) k- kANSWER✓✓--initially kretains kNa
-normal kor kdecreased
-hemodilution
Calcium k(9.0- k10.5) k- kANSWER✓✓--decreased k= khyperactive kreflexes, kTrousseau's kor
kChvostek's ksign
Phosphate k(3.0- k4.5) k- kANSWER✓✓--increased
-Administer kphosphate kbinders kto kprevent kCa kdepletion kfrom kthe kbones
**Limit kdietary kphosphorous kto k1g/day
-Phosphate kbinders: kca kacetate k& kca kcarbonate
Magnesium k(1.7-2.2) k- kANSWER✓✓--increase k= kavoids kmeds kw kmagnesium
-hypermagnesemia k= kcardiac karrhythmias
Metabolic kAcidosis kdue kto kretainment kof kacid k(ammonia) k- kANSWER✓✓--Kussmaul
krespirations
-replace kbicarbs
Most kcommon kcause kof kdeath kin kCKD k- kANSWER✓✓--CVD
-Vascular kcalcification/arteriosclerosis k(Ca++ kin kdiet kis kpreferred kover kCa ksupplements)
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