RENAL NUTRITION FOR CSR EXAM 2024 – QUESTIONS
WITH COMPLETE ANSWERS
Hormones made by the kidneys Correct Ans - renin (BP), erythropoeitin (RBC production), calcitriol (calcium regulator) Renin Correct Ans - hormone secreted by the kidney; it raises blood pressure by influencing vasoconstriction (narrowing of blood vessels) Erythropoietin (EPO) Correct Ans - hormone secreted by the kidney to stimulate the production of red blood cells by bone marrow azotemia Correct Ans - (excessive) urea, uric acid, creatinine and other nitrogenous substances in blood.uremic syndrome Correct Ans - increase in nitrogeneous wastes in the blood, marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, and convulsions Nephrocaps Correct Ans - B vitamins + folic acid High Vitamin B12 causes Correct Ans - Associated with cirrhosis and hepatitis Elevated Ferritin level Correct Ans - Associated with iron storage Calcitriol Correct Ans - A hormone produced from vitamin D that acts in essentially the same manner as parathyroid hormone.HBV protein sources Correct Ans - Meat, fish, poultry, soy, eggs Renal osteodystrphy Correct Ans - Alterations in bone morphology associated with CKD Bowman's capsule Correct Ans - Surrounds the glomerulus where ultrafiltration takes place 1 / 3
proximal convoluted tubule Correct Ans - first section of the renal tubule that the blood flows through; reabsorption of water, ions, and all organic nutrients Loop of Henle Correct Ans - section of the nephron tubule that is responsible for conserving water and minimizing the volume of the filtrate Types of cells in collecting duct Correct Ans - principal cells and intercalated cells principal Correct Ans - Reabsorption of NaCl and secretion of k+ intercalated cells Correct Ans - cells in the collecting ducts of the kidneys that can absorb potassium if necessary. Secretion of hydrogen and bicarbonate for acid-base balance Prerenal AKI Correct Ans - (50-60% of AKI) Hypo perfusion due to intravascular volume depletion.Causes of prerenal AKI Correct Ans - - Absolute loss of fluid: major hemorrhage, vomiting, diarrhea, severe burns
- Relative loss of fluid: distributive shockm congestive HF
- Mechanical: renal artery stenosis, renal artery thrombus or embolus, septic
abortion Prevalence of nephrotic syndrome Correct Ans - 12% of kidney failure in adults 20% in children Diagnostic signs of postrenal AKI Correct Ans - Severe sudden onset of oliguria/anuria
Urine osmo >400 early and >300 later with BUN: Cr ratio of 10% to 20%
oliguria Correct Ans - Decreased urine output intrinsic (parenchymal) acute kidney injury Correct Ans - 20-30% of AKI cases - kidney injury associated with damage to the renal cell 2 / 3
acute tubular necrosis Correct Ans - damage to the renal tubules due to presence of toxins in the urine or to ischemia
- Phases of ATN (Acute Tubular Necrosis) Correct Ans - Initial-
hours/days - usually reversible Maintenance- epithelial cell injury. Lasts 10-16 days in oliguria patients, 5-8 days in non oliguric Recovery- tubular epithelial cell regeneration, gradual GFR return Lasts days - months
Potential complications: diuresis, dehydration, fluid/electrolyte imbalance
(high Na, low K+) azotemia Correct Ans - (excessive) urea and nitrogenous substances in the blood Bellamo's first principle of nutrition support in AKI Correct Ans - Nutrition should not be limited Types of CRRT Correct Ans - 1. *Continuous veno-venous hemofiltration (CVVH)*
- *Used most often*
- Slow fluid and solute removal via convection and filtration
- *Large volumes fluid removed hourly, then replaced (200-800 mL/hr)*
- Requires pump to generate pressure to drive blood through the circuit;
- Requires replacement fluid prior to filter
- May use replacement fluids after the filter to aid in maintaining patient
*does not use dialysate*
stability
- Limitation: low solute removal due to lack of diffusion
- Slow continuous ultrafiltration (SCUF)
- Slow fluid removal via filtration
- Requires a pump to generate pressure to drive blood through a circuit with
venovenous access; does not use dialysate or replacement fluid
- Limitation: low filtration rates
- *Continuous veno-venous hemodialysis (CVVHD)*
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