|
| Courses |
| Home > CME > Courses |
|
Elderly
and Renal Disease
|
Certified
for 1 Category 1 AMA Credit
Jointly
Sponsored
by
the
University
of
Alabama
School
of
Medicine
Division of Continuing Medical Education and
Alabama Quality Assurance Foundation
| Release
Date: May 9, 2006 |
Expiration
Date: May 9, 2009
|
| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity, physicians and other
healthcare professionals should be able to: |
- Recognize
and diagnose acute renal failure
- Recognize
the signs and diagnostic strategies for renal artery
stenosis
- Recognize
and diagnose nephrosclerosis
- Learn
the most appropriate method to estimate renal function
|
| Top of Page |
| SOURCE: |
| FACULTY: |
William T. O'Byrne, MD
General Internist
Albuquerque, New Mexico |
| Top of Page |
| |
| DISCLOSURE: |
The
faculty has no commercial affiliations to disclose.
Because of the nature of preliminary studies, some products
mentioned are unlabeled and investigational. Dosages,
indications, and methods of use of drugs mentioned in
this publication may reflect the experience of the authors,
clinical literature, or other resources. Therefore, please
see the full prescribing information before using any
licensed product mentioned. |
| CME
PARTICIPATION: |
| To participate
in this online course for CME credit, please review
the objectives before beginning the program. Complete
the course and the self-assessment test before May
9, 2009 to receive CME credit. Your certificate will
then be available online. This process should take
approximately 1 hour. |
| ACCREDITATION: |
|
The University of Alabama
School of Medicine is accredited by the Accreditation
Council for Continuing Medical Education to provide
continuing medical education for physicians.
The University of Alabama
School of Medicine designates this educational activity
for a maximum of 1 Category 1 credit toward the AMA
Physician's Recognition Award. Physicians should
only claim credit commensurate with the extent of
their participation in the activity.
The boards of nursing
in many states, including Alabama, recognize Category
1 continuing medical education courses as acceptable
activities for the renewal of license to practice
nursing.
|
| DISCLAIMER: |
| Dosages,
indications, and methods of use of any drug referred
to in this publication may reflect the clinical experience
of the authors, clinical literature, or other clinical
resources. Therefore, please see the full prescribing
information before using any product mentioned. UAB
is an equal opportunity/affirmative action institution. |
| INTRODUCTION: |
|
By
some estimates, chronic kidney disease afflicts 10%
of elderly persons in the United States, while persons
over the age of 75 have the highest incidence of
end-stage renal disease[1].
Furthermore, patients with chronic kidney disease
are at increased risk for cardiovascular disease
and stroke. Also, because it can result in chronic
renal insufficiency, the ability to diagnose and
manage acute renal failure is an essential skill
of the practicing physician.
|
| Top of Page |
| Case
1: |
A
75 year old man presents to your office for an unscheduled
visit at the behest of his wife. She tells you that
she is concerned about her husband's health. You
review his medical record and notice that the patient’s
only other visit occurred more than 3 years ago.
At that time, his blood pressure was 163/110 and
an EKG taken at the time of the visit indicated left
ventricular hypertrophy. You then recommended serum
chemistries and a surface echocardiogram. However,
the patient never obtained these tests. Today, his
wife tells you that "he smokes like a chimney",
and further that "he can barely get around the
house anymore without getting light-headed." The
patient complains that "she won't leave me alone,
is always nagging me about my heart." Because
of worsening arthritis, the patient tells you that
he has been "eating ibuprofen like candy."
On
physical examination, the patient's vital signs are
as follows:
Blood
pressure: 175/112 with no orthostatic changes
Heart rate: 85/min
Respiratory rate: 24/min
Temperature: 37.2C
The
remainder of the physical examination reveals no
jugular venous distension; his cardiac examination
is significant for a laterally displaced PMI; the
neck veins are flat. The pulmonary examination is
significant for increased expiratory phase and scattered
expiratory wheezes. His lower extremities show no
edema bilaterally. The patient agrees to undergo
a repeat electrocardiogram and serum chemistries.
The
electrocardiogram is shown below:
The
serum chemistries and complete blood count are as
follows:
Sodium
141 meq/L
Potassium 4.9 meq/L
Chloride 108 meq/L
Bicarbonate 18 meq/L
BUN 27 mg/dL
Creatinine 3.2 mg/dL
Glucose 154 mg/dL
White cell count 12100/µL
Hemoglobin 10.1 g/dL
Hematocrit 31%
Platelet count 249,000/µL
|
| Top of Page |
 |
|
|
