Chronic Renal Failure

13 Questions

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Chronic Renal Failure

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Questions and Answers
  • 1. 
    Uremia is symptomatic renal failure accompanied by products of protein metabolism. Azotemia is a LABORATORY diagnosis in which nitrogenous wastes such as BUN and Cr accumulate in the setting or renal insufficiency.
    • A. 

      True

    • B. 

      False

  • 2. 
    • A. 

      CV: sodium and water retention, HTN, pulmonary edema

    • B. 

      GI: Anorexia, hiccups, metallic taste, GI bleeding

    • C. 

      CNS: Neuromuscular irritability, cramps, restless leg, neuropathy, encepalopathy

    • D. 

      Heme: ANEMIA, bleeding, plateley dysfunction

    • E. 

      Bone: Renal osteodystrophy

    • F. 

      Derm: Dry skin, pruritis, calcium phosphate deposite.

  • 3. 
    ESRD is more common in African Americans than Caucasians.
    • A. 

      True

    • B. 

      False

  • 4. 
    HTN is the #1 cause of ESRD.
    • A. 

      True

    • B. 

      False

  • 5. 
    • A. 

      >500 mg/day of protein in the urine is irreversible

    • B. 

      >300 mg/day of protein in the urine is considered microalbumineria and is reversible

    • C. 

      >1000 mg/day of proetin in the urine is reversible

  • 6. 
    We know DM is the #1 cause for ESRD. Therefore, we will need to manage both the renal and DM aspect of the patient. Let's focus on DM. Which of the following is true?
    • A. 

      Intensive glucose control (targeting BG

    • B. 

      ACEI may slow the progression but ARBs have been shown not to slow the progression

    • C. 

      CCBs (nondihydropyridines) such as diltiazem and verapamil have been shown to slow the progression

    • D. 

      CCBS (dihydropyridines) such as diltiazem and verapamil have been shown to slow the progression

  • 7. 
    In our patients with DM and ESRD, we should target an LDL of <130.
    • A. 

      True

    • B. 

      False

  • 8. 
    In our diabetes patients with ESRD, we need to target LDL <100, restrict protein 0.8g/kg/day, blood glucose <110, and blood pressure <130/80. It's super important to control both HTN and DM.
    • A. 

      True

    • B. 

      False

  • 9. 
    In NONdiabetics, we target BP of ? , restrict K, P, and protein, lipids, smoking, and calcium/vitamin D.
    • A. 

    • B. 

    • C. 

  • 10. 
    What are the indications for dialysis?
    • A. 

      N/V (intractable)

    • B. 

      Uremic encepalopathy

    • C. 

      Myoclonus

    • D. 

      Uremic pericarditis

    • E. 

      Peripheral neuropathy

    • F. 

      Pruritis

    • G. 

      Prophylactically prior to surgery

  • 11. 
    In order to manage metabolic acidosis in patients with ESRD, we need to treat with sodium bicarbonate titrating the dose so that we maintain a normal bicarbonate of 12-20. We could also use citrate.
    • A. 

      True

    • B. 

      False

  • 12. 
    Bone disease and anemia are very important to focus on preventing in ESRD.
    • A. 

      True

    • B. 

      False

  • 13. 
    • A. 

      Restricting phosphorous intake to 800-1200 mg/day

    • B. 

      Use a phosphate binder such as aluminum salt

    • C. 

      Use a phosphate binder such as calcium salt

    • D. 

      Calculate the CaxPO4 to see if it is >55.

    • E. 

      Look to sevelamer or lanthanum if CaxPO4 is >55.

    • F. 

      Use c alcitriol (natural active vitamin D) or paricalcitol/doxercalciferon (inactive vitamin D)