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YEAR 3 Manchester Medicine > 13 - AKI > Flashcards

13 - AKI Flashcards

1
Q

ECG:

QRS > 0.12

No disernable waves

Peaked T waves

A

Hyperkalaemia

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2
Q

ECG:

Prolonged PR
Prominant U waves

ST depression

A

Hypokalaemia

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3
Q

What is SALFORD used for?

A

Used for treatment of AKI

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4
Q

What does SALFORD stand for?

A

Sepsis

Ace-i and NSAIDS

Labs and leaflets

Fliud assesment

Obstruction

Renal and critical care referral

Dip urine and document it.

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5
Q

Treatment of hyperkalaemia?

A

IV Calcium gluconate

IV insulin + glucose

Salbutamol nebulised

IV bicabonate

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6
Q

What is the treatment of non urgent hyperkalaemia?

A

PO Polystyrene sulfonate resin

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7
Q

Risk factors for AKI?

A

>65

history of AKI

CKD

obstruction

CCF

liver disease

DM

neurological disability

sepsis

hypovolaemia

oliguria < 0.5 mL/Kg/hour

nephritexic drugs

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8
Q

What drugs are nephrotoxic?

A

ACE-i

ARBs

diuretics

NSAIDS

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9
Q

How is eGFR calculated?

A

eGFR = 1/ creatinine

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10
Q

What does a protienuria > 3 from a urine dipstick indicate?

A

renal disease

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11
Q

What does blood with positive protien in dipstick indicate?

A

Glomulonephritis

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12
Q

Urea is a broken down from what?

A

Amino acids and ammonia

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13
Q

What is ATN?

A

Acute tubular necrosis

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14
Q

What are the 3 phases of ATN?

A

Oliguric

Maintenance

Polyuric recovery

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15
Q

What happens to creatin in the Oliguric phase of ATN?

A

rises quickly

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16
Q

What happens to creatin in the maintenance phase of ATN

A

rises slowly or remains the same

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17
Q

What happens to creatin in the polyuric recovery phase of ATN?

A

Decreases

18
Q

What is the urine output for the oliguric phase of ATN?

A

<500 ml

19
Q

What phase of ATN has a risk of hyperkalaemia?

A

Oliguric due to renal impairment

20
Q

What phase of ATN is at risk of hypokalaemia?

A

Polyuric recovery phase - lots of water and electrolyte loss

21
Q

What is urea recycling?

A

Urea can be excreted via the kidneys or the GI system. In the GI system microbes produce ammonia which is reabsorbed from the urea.

This means that urea is not a reliable indicator kidney function

22
Q

What medicine should be stopped in AKI due to toxicity?

A

Digoxin

Lithium

Metformin

23
Q

Should ACEi or ARB be continued or stopped during ATI?

A

Thye should be stopped

24
Q

Should warfarin be continued during AKI?

A

Yes, warfarin should be continued

25
Q

Should clopidogrel and asprin be stopped during AKI?

A

No, continue use of clopidogrel and aspirin

26
Q

What are the criteria for AKI stage 1

A

< 0.5 ml per Kg for > 6 hours

50% increase serum creatinine

27
Q

Definition of AKI?

A

increase of serum creatinine by 50%

< 0.5 ml/Kg of urine

-25% eGFR

28
Q

Loop diuretics are not recommended in AKI excpet when?

A

Fliud overloaded

+ recovering renal function/ renal replacement therapy

29
Q

Indications for renal replacment therapy?

A

Hyperkalaemia

Pulmonary oedema

Fluid overload

Metabolic acidosis

Ureamic complactions - pericarditis and encephalopathy

30
Q

What is the intial fluid delivery in resuscitation?

A

500ml crystaloid in < 15 mins

31
Q

What is a side effect of omeprazole?

A

Hyponatraemia

32
Q

What is ACR?

A

Albumin creatinine ratio

33
Q

What does ACR show?

A

Shows proteinurea

Clinically significant > 3mg/mmol

34
Q

What is the most common intrinsic renal cause of AKI?

A

ATN - acute tubular necrosis

35
Q

What are the pre renal cuases of AKI?

A

Hypoperfusion - spesis, hypovolaemia

Renal artery stenosis +/- ACEi

36
Q

How much K+ is needed for fluid maintence?

A

1 mmol/kg/24hr

37
Q

How much Na+ is needed for fliud maintenance?

A

2 mmol/kg/24 hr

38
Q

NICE risk stratisification tool for sepsis

A

PLEASE LOOK UP YOU LAZY BASTARD

39
Q

What affect does IV insulin and dextrose have on during hyperkalaemia?

A) Remove K+ from the body

B) Short-term shift in potassium from extracellular to intracellular fluid compartment

C) Stabilise cardiac membrane potential

A

B - Short-term shift in potassium from extracellular to intracellular fluid compartment

40
Q
A

YEAR 3 Manchester Medicine (34 decks)

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