Patient DW has a GFR of 65mL/min/1.73m2. What stage of CKD is this, according to KDOQI?
Stage 2: kidney damage with mild decrease in GFR.
100
Patient JD is indicated for phosphate-lowering therapy. He is looking for a cheap, widely available therapy option to help him achieve the 0.5-1g recommended daily dose of elemental calcium. Provide a drug name, dose, and frequency.
Tums (calcium carbonate) 500mg TID with food (200mg elemental calcium per meal)
100
Provide two advantages of a native AV fistula over a synthetic AV graft.
Longer access survival, lowest rate of complications, increased survival of patients, decreased hospitalizations, most cost-effective.
100
Patient NG is a 43 yo F with a waist-to-hip ratio of 0.77. Is her health risk low, medium, or high?
Low (≤0.8). Medium: 0.81-0.85. High: >0.85.
100
While the AHA/NHLBI and the IDF guidelines may vary slightly, they are composed of the same five components. Provide these components.
Patient DN regularly takes a high dose of omeprazole for his GERD. Which of the following medications would you suggest for him? Tums, sevelamer Hcl, lanthanum carbonate.
Lanthanum carbonate
200
Which type of HD membrane would be most effective for removing high molecular weight substances, such as vancomycin?
High-flux
200
What is the role of PYY, a GI peptide, in the pathophysiology of obesity?
Decreases gastric emptying in the presence of fat, FFA, carbs, protein, bile acid. Produced by large intestine.
200
What is the approximate sodium limit for patients who are attempting the DASH diet to lose weight?
<1.5-2.3 g/day
300
Briefly describe why ACE inhibitors may be helpful in CKD. BONUS: provide two important monitoring parameters in a patient who has recently started an ACE inhibitor.
ACE inhibitors are known to decrease proteinuria and slow the progression of CKD. Watch out for increased serum creatinine and potassium.
300
The target TSat level for a patient on dialysis would be ______.
>20%
300
What are two advantages of hemodialysis over peritoneal dialysis?
Patient NW is a 41 yo F with HTN, DM2, and a BMI of 28. Which of the following recommendations would you make? Weight maintenance, lifestyle modification, Rx therapy, surgery.
Rx therapy.
300
Patient MQ is a 48yo M with DM2 who has just been diagnosed with metabolic syndrome. What medication might you consider adding to his therapy?
Baby aspirin (81mg)
400
In the pathophysiology of hyperphosphatemia, phosphate levels in the body are elevated. What happens next?
Increased Ca x P product --> soft tissue calcification AND hypocalcemia --> secondary hyperparathyroidism.
400
What is the black box warning for iron dextran? BONUS: what do you do to avoid this adverse effect?
Anaphylactic reactions. Use test dose of 25mg first and observe. (normal dose: 100mg)
400
How would you treat an acute case of hypotension during hemodialysis?
Trendelenburg position, normal saline/hypertonic saline/mannitol