0301 Acute Kidney Injury

Question 1

Renal failure can be classified as

Answer 1

oliguric or nonoligoric

less than 500 mL/d

Question 2

etiologies of aki are divided into __ categories that are

Answer 2

prerenal postrenal and intrinsic

Question 3

prerenal is due to

Answer 3

hypo perfusion:
1. true hypovolemia
hypotension(including sepsis

Question 4

The term prerenal azotemia implies preserved intrinsic renal function in the setting of renal hypoperfusion and reduced GFR. (T/F)

Answer 4

T

Question 5

how does a patient with AKI that has true hypovolemia present?

Answer 5

• a history of excessive fluid loss, reduced intake, or orthostatic symptoms.
• The physical examination may reveal dry mucous membranes*, poor skin turgor, and orthostatic vital signs (drop in blood pressure by at least 20/10 mm Hg or an increase in heart rate by 10 bpm after standing from a seated or lying position).
• The central venous pressure is typically <8 cm H2O.

Question 6

The use of ultrafiltration (UF) compared to pharmacologic therapies, resulting in more adverse events in the treatment of acute decompensated heart failure (ADHF)

Answer 6

T

Question 7

hepatorenal syndrome (HRS), is characterized by ___

Answer 7

1) a rise in serum creatinine of >1.5 mg/dL that is not reduced with administration of albumin (1 g/kg of body weight)
2) and after a minimum of 2 days off diuretics

Question 8

what can precipitate HRS in a cirrhotic patient?

Answer 8

spontaneous bacterial peritonitis,

*aggressive diuresis, gastrointestinal bleeding,
or large-volume paracentesis

Question 9

what can precipitate HRS in a cirrhotic patient?

Answer 9

spontaneous bacterial peritonitis,

*aggressive diuresis, gastrointestinal bleeding,
or large-volume paracentesis

Question 10

Common causes of Postrenal AKI

Answer 10

prostatic enlargement, bilateral kidney stones, or malignancy

Question 11

Common causes of Postrenal AKI

Answer 11

prostatic enlargement, bilateral kidney stones, or malignancy

Question 12

Viruses (HIV and Herpes) and AKI

Answer 12

some medications like (indinvir and acyclovere) can form crystals and block the flow of urine
can form crystals and cause microinstruction

Question 13

how do you manage ATN

Answer 13

supportive, with avoidance of further nephrotoxic insults.

try to maintain euvolemia

Question 14

what to do if in ATN management volume overload occurs

Answer 14

40–120 mg boluses or a continuous drip at 10–20 mg/h

Question 15

toxic ATN can be caused by
(A) endogenous chemical
(B) exogenous chemical
(C) both

Give examples

Answer 15

(A) myoglobin hemoglobin. Light chains and Uric Acid
(B) Aminoglycosides . 
Iodinated contrast agents. 
Chemotherapy. 
Statins.
Platinum-based antineoplastic

Question 16

positive urine dipstick test for blood but an absence of RBCs on microscopic examination might indicate ___(diagnosis)

Answer 16

pigment nephropathy (myoglobin)

Question 17

atypical HUS treatment

Answer 17

Eculizumab

Question 18

Urinary casts point toward an ____ cause of AKI.

1) prerenal
2) renal (intrinsic)
3) post renal

Answer 18

(2)

Question 19

חלבון בשתן- מעל ____ גרם ליום זה מוגדר נפרוטי, מתחת ל___ גרם ומעל ל____ מ”ג מוגדר נפריטי

Answer 19

מעל ל3 גרם
מתחת ל 3 גרם
צעך ך 300 מ״ג

Question 20

in order to diagnose Post renal AKI you need ______

Answer 20

radiology (CT without contrast agent)

Question 21

Renal (Intrinsic) AKI can be divided into 4 categories ___(list them)___ that are based on ____

Answer 21

categories:

1) Tubular
2) Glomerular
3) Interstitial
4) Vascular

• based on the different tissues comprising the kidneys

Question 22

What happens to creatinine in Iodinated contrast agents associated AKI

Answer 22

rises within 48 hours and stays high for the next 3-5 days