NR507- Advanced Pathophysiology
Final Exam
Acute7renal7failure7-7correct7answer✔ ✔ Reversible
Determining7prognosis-
kidneys7respond7to7diuretic7with7good7output;7this7indicates7that7kidneys7are7functioning7w
7
ell
Acute7Pyelonephritis7-7correct7answer✔ ✔
Diagnosing7by7clinical7symptoms7alone7can7be7difficult;7can7be7similar7to7cystitis
Diagnosis7established7by:
-Urine7culture
-Urinalysis7(WBC7casts7indicates7pyelonephritis,7but7may7not7always7be7present)
-Signs/Symptoms
-Complicated7pyelonephritis7requires7blood7cultures7and7urinary7tract7imaging
Renal7Calculi7(Renal7Stones)7-7correct7answer✔ ✔ Goals7of7Treatment:
Manage7acute7pain
Promote7passage7of7stone
Reduce7size7of7stone
Prevent7new7stone7formation
Chronic7Renal7Failure7-7correct7answer✔ ✔
Chronic7Kidney7Disease7(CKD)7is7a7progressive7loss7of7renal7function7associated7with7s
ystemic7disease7such7as7hypertension,7diabetes7mellitus7(most7significant7risk7factor),7sys
temic7lupus7erythematosus7or7intrinsic7kidney7disease
CKD7stage7is7determined7by7estimates7of7GFR7and7albuminuria
, Who7is7a7candidate7for7dialysis?7-7correct7answer✔ ✔ End-
stage7renal7disease7(ESRD)7is7the7final7stage7of7CKD7with7the7number7one7cause7being7di
abetes7mellitus7combined7with7hypertension.7At7this7point,7the7patient7is7completely7depen
dent7on7dialysis7to7survive.
CKD7is7classified7into7five7stages7and7is7based7on7the7patient's7GFR7rather7than7symptom
s.
Patients7will7need7dialysis7when7the7following7symptoms7are7present:
--Metabolic7acidosis.
--Hyperkalemia:7Hyperkalemia7in7the7presence7of7EKG7changes7(peaked7T-
waves)7is7an7indication7for7dialysis.7--
Hyperkalemia7by7itself7is7not7an7indication7for7dialysis.
--
Drug7toxicity:7Drug7toxicity7due7to7the7following7drugs7is7an7indication7for7dialysis7and7inclu
de7salicylates,7Lithium,7Isopropanol,7Methanol7and7Ethylene7glycol).
--Fluid7volume7overload7that7is7not7responsive7to7diuretics.
--Uremic7symptoms7due7to7nitrogenous7wastes7in7the7blood7stream.
Stage7I7CKD7-7correct7answer✔ ✔
There7is7kidney7damage7with7normal7or7elevated7GFR
90-120
Stage7II7CKD7-7correct7answer✔ ✔ There7is7kidney7damage7with7mild7decrease7in7GFR
60-89
Stage7III7CKD7-7correct7answer✔ ✔ There7is7a7moderate7decrease7in7GFR
30-59
Stage7IV7CKD7-7correct7answer✔ ✔ There7is7a7severe7decrease7in7GFR
15-29
Final Exam
Acute7renal7failure7-7correct7answer✔ ✔ Reversible
Determining7prognosis-
kidneys7respond7to7diuretic7with7good7output;7this7indicates7that7kidneys7are7functioning7w
7
ell
Acute7Pyelonephritis7-7correct7answer✔ ✔
Diagnosing7by7clinical7symptoms7alone7can7be7difficult;7can7be7similar7to7cystitis
Diagnosis7established7by:
-Urine7culture
-Urinalysis7(WBC7casts7indicates7pyelonephritis,7but7may7not7always7be7present)
-Signs/Symptoms
-Complicated7pyelonephritis7requires7blood7cultures7and7urinary7tract7imaging
Renal7Calculi7(Renal7Stones)7-7correct7answer✔ ✔ Goals7of7Treatment:
Manage7acute7pain
Promote7passage7of7stone
Reduce7size7of7stone
Prevent7new7stone7formation
Chronic7Renal7Failure7-7correct7answer✔ ✔
Chronic7Kidney7Disease7(CKD)7is7a7progressive7loss7of7renal7function7associated7with7s
ystemic7disease7such7as7hypertension,7diabetes7mellitus7(most7significant7risk7factor),7sys
temic7lupus7erythematosus7or7intrinsic7kidney7disease
CKD7stage7is7determined7by7estimates7of7GFR7and7albuminuria
, Who7is7a7candidate7for7dialysis?7-7correct7answer✔ ✔ End-
stage7renal7disease7(ESRD)7is7the7final7stage7of7CKD7with7the7number7one7cause7being7di
abetes7mellitus7combined7with7hypertension.7At7this7point,7the7patient7is7completely7depen
dent7on7dialysis7to7survive.
CKD7is7classified7into7five7stages7and7is7based7on7the7patient's7GFR7rather7than7symptom
s.
Patients7will7need7dialysis7when7the7following7symptoms7are7present:
--Metabolic7acidosis.
--Hyperkalemia:7Hyperkalemia7in7the7presence7of7EKG7changes7(peaked7T-
waves)7is7an7indication7for7dialysis.7--
Hyperkalemia7by7itself7is7not7an7indication7for7dialysis.
--
Drug7toxicity:7Drug7toxicity7due7to7the7following7drugs7is7an7indication7for7dialysis7and7inclu
de7salicylates,7Lithium,7Isopropanol,7Methanol7and7Ethylene7glycol).
--Fluid7volume7overload7that7is7not7responsive7to7diuretics.
--Uremic7symptoms7due7to7nitrogenous7wastes7in7the7blood7stream.
Stage7I7CKD7-7correct7answer✔ ✔
There7is7kidney7damage7with7normal7or7elevated7GFR
90-120
Stage7II7CKD7-7correct7answer✔ ✔ There7is7kidney7damage7with7mild7decrease7in7GFR
60-89
Stage7III7CKD7-7correct7answer✔ ✔ There7is7a7moderate7decrease7in7GFR
30-59
Stage7IV7CKD7-7correct7answer✔ ✔ There7is7a7severe7decrease7in7GFR
15-29
