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169 Cards in this Set
- Front
- Back
ARF
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acute renal failure
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ATN
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acute tubular necrosis
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BUN
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Blood, urea, nitrogen
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CAPD
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continuous ambulatory periteneal dialysis
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CrCl
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Creatin Clearance
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CRF
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Chronic renal failure
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ESRD
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end stage renal disease
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GFR
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glomerular filtration rate
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HD
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Hemodialysis
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IVP
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Intravenous pyelography
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What is pyelography?
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Dye injected and observed
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PD
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peritenal dialysis
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RF
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Renal failure
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SCr
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Serum creatanin
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UTI
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Urinary Tract Infection
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Anuria/Anuresis
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Definition: Inability to form/excrete urine (<50ml/day)
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How much urine is excreted in pt. with anuria?
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<50 ml/day
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How much urine is extreted in normal adults?
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1000-1500 mL/day
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How much urine per day is excreted in pt. with oliguria?
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50-450 ml/day
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Azotemia
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Definition: excess of nitrogen in the blood, result of kidney insuficiency
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Cystitis
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Definition: Inflamation of the bladder
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Dysuria
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Definition: Painful urination
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Enuresis
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Definition: Involuntary discharge of urine
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Incontinence
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Definition: Inability to control evacuative function (urine & bowel)
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What is another word for urination?
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Micturition
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Nephrolithiasis
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Definition: Kidney Stones
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Medical term for "kidney stones"?
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Nephrolithiasis
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Nocturia
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Definition: Urination at night, excessive (common in men with benign prostate infection and women in their 9th month of pregnancy)
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Oliguria
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Definition: reduced urination (50-450 ml/day)
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Prostatis
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Definition: Inflamation of the prostate gland
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Proteinuria
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Definition: protein in the urine
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Pyelonephritis
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Definition: Inflamation of the kidney
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Uremia
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Definition: buildup of waste products in blood; toxic condition
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Urosepsis
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Definition: buildup of waste products in the blood; urine that is not eliminated goes into body tissues
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Voiding
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Definition: Elimination of solid or liquid waste
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Hpf
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High power field (refers to microscope)
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I&O
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Intake and Output (found in graphic portion of chart)
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U/A
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urinalysis
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UhCG
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Urine human chorionic gonadotropin; excreted in certain conditions
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Albuminuria
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protein in the urine
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Dysuria
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painful urination
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Glucosuria
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glucose in the urine
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Hematuria
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blood in the urine
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Proteinuria
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protein in the urine
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Name the 7 types of urine collection.
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Random
Clean catch (midstream) Double/Second Voided First morning Fasting Timed Catheter Collection |
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Identify the normal physiochemical properties in an analysis of urine:
Color - Volume - Appearance - Specific Gravity - Osmolality - Odor - |
Color - straw is normal
Volume - depends on intake Appearance - clear is normal Specific Gravity - depends on intake (1.001-1.035) Osmolality - 50-1400mOsm/kg Odor - |
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What is the normal specific gravity of urine?
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Depends on intake; 1.001-1.035
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What is the normal osmolality for urine?
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50-1400mOsm/kg
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In a chemical exam. what is the pH range of urine?
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depends on intake; 4.5-8.5
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In a chemical exam. what is the pH range of urine?
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depends on intake; 4.5-8.5
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In a chemical exam. what is the normal range of protein in urine?
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0-150mg/day
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What chemicals should NOT appear in urine?
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glucose, ketones, bilirubin, occult blood, nitrate
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What is bilirubin?
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A by product of the liver; will make the urine REALLY dark
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What are the 4 things examined in an analysis of urine?
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Physiochemical properties
Chemical Examination Microscopic Examination Bacterial Screen |
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If the amount of protein in the urine is reported as "negative" how many mg/dl of protien is the pt. excreting?
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0-5mg/dl
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If the amount of protein in the urine is reported as "trace" how many mg/dl of protien is the pt. excreting?
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5-20mg/dl
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If the amount of protein in the urine is reported as "+1" how many mg/dl of protien is the pt. excreting?
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>20-100 mg/dl
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If the amount of protein in the urine is reported as "+2" how many mg/dl of protien is the pt. excreting?
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>100-300 mg/dl
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If the amount of protein in the urine is reported as "+3" how many mg/dl of protien is the pt. excreting?
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>300-1000 mg/dl
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If the amount of protein in the urine is reported as "+4" how many mg/dl of protien is the pt. excreting?
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>1000mg/dl
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What are the two parts of a bacterial screen?
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Gram Stain
Colony count |
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In a microscopic examination of the urine what is a normal finding for the following?
Epithelial cells |
0-2/hpf
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In a microscopic examination of the urine what is a normal finding for the following?
Casts |
hyaline (normal)
wbc, rbc, granular-waxy and braod casts |
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In a microscopic examination of the urine what is a normal finding for the following?
Crystals |
uric acid, oxalate
if numerous it is abnormal |
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In a microscopic examination of the urine what is a normal finding for the following?
WBC |
0-5/hpf
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In a microscopic examination of the urine what is a normal finding for the following?
WBC exterase |
none is normal; may suggest there is a UTI if present
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In a microscopic examination of the urine what is a normal finding for the following?
Bacteria |
none is normal
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In a microscopic examination of the urine what is a normal finding for the following?
Yeast |
none is normal (both males and females can have yeast infections)
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In a microscopic examination of the urine what is a normal finding for the following?
RBCs |
0-3/hpf is normal
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In a microscopic examination of the urine what is a normal finding for the following?
Other organisms (ex: trichomonas, parasites) |
none is normal
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What are some types of urine tests?
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Diabetes urine tests, pregnancy tests, ovulation test, toxicology screening, etc.
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What does a diabetes urine test examine?
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glucose and ketones
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What hormone is detected in pregnancy tests?
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UhCG
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What hormone is tested in an ovulation test?
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Leutinizing hormone test
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What does a toxicology screening test examine?
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illicit drug use, other drugs/substances
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APAP
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Acetometaphin
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ASA
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asprin
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Main example of a barbiturate?
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Phenobarbital
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What are phenothiazines?
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Anti-psychotics
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What are the main catecholamines?
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epinephrine and norepinephrine
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What type of urine test is usually administered to pt. with multiple myeloma?
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24hour collection of urine (examined for protein)
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What substance changes the color of urine to light (due to diuresis)?
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alcohol
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What drugs change the color of urine to blue/green?
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amitriptyline and triamterene
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What drug changes the color of urine red?
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deferoxamine
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What drug changes the color of urine black or dark?
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iron salts
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What drug changes the color of urine dark?
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metronidazole (antibiotic)
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What drug changes the color of urine orange?
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Warfarin
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What drugs change the color of urine orange/red?
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Phenazopyridine and Rifampin
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What class is the drug amitriptyline?
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antidepressant, tricyclic antidepressant
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Alcohol changes urine color to....?
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light (due to diuresis)
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Amitriptyline changes urine color to....?
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blue/green
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Deferoxamine changes urine color to....?
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red
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Iron salts change urine color to....?
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black or dark
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Metronidazole changes urine color to....?
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dark
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What class is the drug Metronidazole?
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antibiotic
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Warfarin changes urine color to....?
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orange
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Phenazopyridine changes urine color to....?
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orange/red
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Riboflavin changes urine color to....?
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yellow (bright)
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Rifampin changes urine color to....?
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orange/red
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Triamterene changes urine color to....?
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blue/green
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Triamterene is used to....?
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incease blood pressure
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Does the following drug increase or decrease pH?
Acetazolamide |
increase
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Does the following drug increase or decrease pH?
amphotericin B |
increase
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Does the following drug increase or decrease pH?
sodium bicarbonate |
increase
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Does the following drug increase or decrease pH?
potassium citrate |
increase
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Does the following drug increase or decrease pH?
ammonium chloride |
decrease
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Does the following drug increase or decrease pH?
ascorbic acid |
decrease
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List some diagnostic tests to evaluate the kidneys.
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urinalysis, KUB, IVP, renal angiography, renal bniopsy, cystoscopy, renal ultrasound, serum chemistries
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FeNa
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Fractional excretion of sodium
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What is the FeNa used for?
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to differentiate between prerenal and parenchymal acute renal failure
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What is parenchymal acute renal failure?
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not a problem with the kidney itself but a problem somewhere else that affects the kidneys (ex: heart, profusion issues)
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Equation for FeNa
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FeNa = [(Urine Na)(Plasma Cr) / (Urine Cr) (Plasma Na)] * 100
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Creatinine is a by-product of ________ __________.
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muscle metabolism
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T/F: Creatine is reabsorbed
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False; creatine is produced and excreted at a constate rate, it is NOT absorbed
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Measuring creatinine clearance gived an adequate estimate of ___________.
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Glomerular Filtration Rate
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What represents the results of protein metabolism and provides an index of glomerular filtration?
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BUN
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T/F: Urea does not undergo reabsorption
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False, urea undergoes reabsorption and therefore is an inaccurate indicator of renal fxn
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What percent of urea undergoes reabsorption?
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40-60%
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Normal CrCl for males? (ml/min)
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85-125ml/min
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Normal CrCl for females? (ml/min)
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75-115 ml/min
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Uses of CrCl
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1. Determine efficience of the kidneys clearing creatinine from the blood
2. assess renal fnx especially GFR 3. monitor progression of renal failure |
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What equation is used to estimate CrCl?
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Cockcroft-Gault equation
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Equation for CrCl for males? for females?
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CrCl = [(140-age)(wt in kg)] / [(72)(SCr)]
**multiply by 0.85 for females** |
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Multiply the Cockcroft-Gault equation by _____ for females.
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0.85
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What are the three phases of ARF?
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1. oliguric phase
2.non-oliguric (diabetic) 3. recovery phase/convalescent phase |
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Is the following a diagnostic test for acute renal failure or chronic renal failure?:
fluid and electrolyte status |
acute
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Is the following a diagnostic test for ARF or CRF?:
fluid and electrolyte status |
acute
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Is the following a diagnostic test for ARF or CRF?:
BUN/Scr ratio |
acute
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Is the following a diagnostic test for ARF or CRF?:
urinalysis |
acute
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Is the following a diagnostic test for ARF or CRF?:
KUB |
acute
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KUB
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Kidneys, Ureters, Bladder
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Is the following a diagnostic test for ARF or CRF?:
Renal ultrasound |
acute
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Is the following a diagnostic test for ARF or CRF?:
IVP |
acute
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Is the following a diagnostic test for ARF or CRF?:
renal biopsy |
both acute and chronic
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What type of test is a KUB?
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abdominal xray
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IVP
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intravenous pyelography
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Is the following a diagnostic test for ARF or CRF?:
CrCl (measured or calculated) |
acute
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Is the following a diagnostic test for ARF or CRF?:
assessment of symptomatology |
chronic
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Is the following a diagnostic test for ARF or CRF?:
physical findings |
chronic
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Is the following a diagnostic test for ARF or CRF?:
Labs - BUN, SCr, CrCl, fluid, serum and urinary electrolytes, etc. |
chronic
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Is the following a diagnostic test for ARF or CRF?:
Xrays (chest, bone, kidney size/renal scan) |
chronic
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Is the following a diagnostic test for ARF or CRF?:
neurologic tests (PE, nerve conduction, velocity tests, EEG) |
CHRONIC
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What are the two main drawbacks to estimating CrCl?
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-estimation
-must assume creatinine production and excretion are CONSTANT |
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Causes of ARF
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1. Prerenal azotemia
2. Renal (intrinsic) failure 3. Post renal azotemia |
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Etiologies:
1. Prerenal azotemia 2. Renal (intrinsic) failure 3. Post renal azotemia |
ARF
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Cause of Prerenal azotemia
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result of combination of hypovolemia, hypotension and decreased renal perfusion
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S/S of ARF
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S/S:
-related to cause -azotemia, increased SCr, other electrolyte disturbances |
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S/S:
-related to cause -azotemia, increased SCr, other electrolyte disturbances |
S/S of ARF
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What are the main factors that allow for diagnosis of ARF?
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-Sudden increase in BUN or SCr
-Often accompanied by oliguria -Oliguria is self-limiting over a few days to 4-6 weeks |
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-Sudden increase in BUN or SCr
-Often accompanied by oliguria -Oliguria is self-limiting over a few days to 4-6 weeks |
ARF
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Etiologies of CRF
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Etiologies:
-Worsening ARF -Glomerulonephritis/glomerulopathy -Polycystic kidney disease (genetic) -Interstitial nephritis -Obstructive uropathy -Congentital or inherited disorders -DM -Hypertension -Gout nephropathy -Nephrolithiasis |
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Etiologies:
-Worsening ARF -Glomerulonephritis/glomerulopathy -Polycystic kidney disease (genetic) -Interstitial nephritis -Obstructive uropathy -Congentital or inherited disorders -DM -Hypertension -Gout nephropathy -Nephrolithiasis |
CRF
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Define nephrolithiasis
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untreated kidney stones
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What are some key factors in diagnosis of CRF?
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Diagnosis:
-Progressive azotemia over weeks and months -May be a consequence of many primary glomerular and tubular diseases -ypertension develops in the majority of patient |
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Diagnosis:
-Progressive azotemia over weeks and months -May be a consequence of many primary glomerular and tubular diseases -ypertension develops in the majority of patient |
CRF
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Fluid and Electrolyte S/S of CRF
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1.Hyponatremia/Hypernatremia
2.Hyperkalemia 3.Hypocalcemia 4. Hyperphosphatemia 5. Fluid retention 6. Metabolic acidosis |
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1.Hyponatremia/Hypernatremia
2.Hyperkalemia 3.Hypocalcemia 4. Hyperphosphatemia 5. Fluid retention 6. Metabolic acidosis |
Fluid and electrolyte S/S of CRF
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Define uremia
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A toxic condition resulting from kidney disease in which there is retention in the bloodstream of waste products normally excreted in the urine. Also called azotemia .
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Definition: A toxic condition resulting from kidney disease in which there is retention in the bloodstream of waste products normally excreted in the urine.
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uremia/azotemia
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Another name for uremia?
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azotemia
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General S/S of CRF (uremic manifestation)
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fatigue, weakness, ill-appearance, muscle wasting
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GI S/S of CRF (uremic manifestation)
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anorexia, n/v, dysguesia, GI bleeding, ulcers
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Skin S/S of CRF (uremic manifestation)
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pallor or hyperpigmentation, itching, bruising, uremica frost
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HEENT S/S of CRF (uremic manifestation)
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uriniferous breath, retinopathy
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Neuro/psych S/S of CRF (uremic manifestation)
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numbness, twitching, irritability, insomnia, muscle cramps, drowsiness, asterixis, myoclonus, coma, depression, anxiety, psychosis
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GU S/S of CRF (uremic manifestation)
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loss of libido, nocturia
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CV S/S of CRF (uremic manifestation)
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dyspnea, edema, pericardial pain or inflamation
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HEME S/S of CRF (uremic manifestation)
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anemia, hemostatic abnormalities, immune suppression
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ENDOCRINE S/S of CRF (uremic manifestation)
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metabolic bone disease de to decreased vit D an calcium absorption, altered thyroid fnx, gonadal dysfunction
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