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35 Cards in this Set

  • Front
  • Back
A patient is under anesthesia how much is there urine output expected to decreased?
What is normal urine pH ranges? & what affect these ranges?
4-8.5/ fluid & salt intake, environmental temp, presence of disease, meds
How much of renal blood flow is plasma blood flow?
What is the equation for auto-regulation of renal blood flow?
If afferent arterioles are increased what will happen to GFR & gloumerular blood flow?
GFR will decrease and glomerular blood flow will decrease.
An increase in efferent arteriolar resistance does what to the glomerular capillary hydrostatic pressure?
increases the outcome increase GFR.
Regional & general anesthesia causes a decrease in RBF, GFR, urinary flow on NA excretion but changes are less marked in which one?
Cardiac which is an indirect effect on renal function how does it affect renal func under general & regional anesthesia?
General: results from cardiac depression or vasodilation
Regional: result from sympathetic blockade (leads to increase venous capacitance & arterial vasodilation
Neural effect is from sympathetic activation what are the cause of this?
light anesthesia, intense surgical stimulation, tissue trauma, circulatory depression
(outcome: reduction in RBF, GFR, & urinary output)
What does catecholamines, ADH and antiotensin do to the renal system?
reduce RBF by inducing renal arterial vasoconstriction.
What does aldosterone do to decrease urine output for the right reasons?
enhances sodium reabsorption in the distal tubule & collecting duct.
What volatile anesthesics can decrease renal vascular resistance?
halothane, enflurane, isoflurane (methoxyflurane is associated with polyuric renal failure 2ndary to its release of inorganic fluoride in amts >50
True or false. Ketamine have miinimal effects on renal function?
true (preserves renal function during hemorrhagic hypovolemia)
Ketoralac prevents the renal production of vasodilatory prostaglandins in does what to GFR?
reduce GFR..
What percent of pancuronium is excreted by the kidneys?
What is the primary source of nitrogen?
This is a byproduct of protein catabolism?
What are the 2 steps that break amino acids down to urea?
deamination of amino acids produces ammonia and hepatic enzymes converts ammonia to urea..(rationale prevents the build up of toxic ammonia levels)
BUN is directly related to what and indirectly related to what?
directly related to protein catabolism and inversly related to GFR
True or false BUN is not a reliable indicator of the GFR unless protein metabolism is normal and constant?
what is normal BUN
What can cause high levels of BUN?
high catabolic state (trauma/sepsis), degradation of blood in GI tract, presence of large hematoma, high protein diet. (higher levels is observed when the GFR decrease or protein catabolism increases.
What percent of urea is passively reabsorbed by the renal tubules?
A BUN >50 is associated with what?
Renal impairement
What is the men and women average muscle mass?
men= 20-25mg/kg
Creatinine is directly related to GFR why?
because none of it is reabsorbed..
What is the normal creatinine is males?
what is the norm creatinine in females?
What is the cause of increase BUN/Creat ratio?
volume depletion or edematous disorders (decrease tubular flow, CHF, cirrhosis, nephrotic syndrome, dehydration), conditions that increae protein from GI bleed, increae protein from diet.
What is the cause of decrease BUN/Creat ratio?
liver disease
What is the normal GFR for decrease renal reserve?
What is the nomral GFR for mild renal impairment?
What is the normal GFR for mod renal insufficiency?
What is the normal GFR for renal failure?
What is the normal GFR for ESRD?