Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

JG Year 2 > 227 AKI > Flashcards

227 AKI Flashcards

1
Q

What is the effect of renal failure on the drug action of teicoplanin?

A

Has a prolonged half life in renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the effect of renal failure on the drug action of teicoplanin?

A

Has a prolonged half life in renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At which level of creatinine clearance is nitrofurantoin contra-indicated for treatment of UTIs?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does bendroflumethiazide act in the renal system?

A

At the beginning of the distal convoluted tubules - inhibits water and salt absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 2 types drugs which can cause pre-renal AKI

5 types listed

A 
NSAIDs
Loop diuretics e.g. furosemide and bumetanide
Laxatives e.g. bisacodyl/ senna
ACEI - ramipril/ lisinopril
ARBs - losartan/ candesartan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 2 drugs which can cause pre-renal AKI

A

NSAIDs
Loop diuretics e.g. furosemide and bumetanide
Laxatives e.g. bisacodyl/ senna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do NSAIDs inhibit the production of in the kidney which are potent vasodilators?

A

Prostaglandin E2, I2 and D2 - maintain renal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do NSAIDs inhibit the production of in the kidney which are potent vasodilators?

A

Prostaglandin E2, I2 and D2 - maintain renal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

At which level of creatinine clearance is nitrofurantoin contra-indicated for treatment of UTIs?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where does bendroflumethiazide act in the renal system?

A

At the beginning of the distal convoluted tubules - inhibits water and salt absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Below which GFR are thiazide diuretics unlikely to be of use?

A

GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 2 drugs which can cause pre-renal AKI

A

NSAIDs
Loop diuretics e.g. furosemide and bumetanide
Laxatives e.g. bisacodyl/ senna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name a type of drug which can cause hypokalaemia

A

Loop diuretics e..g. furosemide, bumetanide

Thiazide diuretics e.g. bendroflumethazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do NSAIDs inhibit the production of in the kidney which are potent vasodilators?

A

Prostaglandin E2, I2 and D2 - maintain renal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which anti rejection meds are used in renal transplant? What is their effect?

A

Ciclosporin and tacrolimus - causes intense vasoconstriciton of the microvasculature of the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where in the kidney do ACEIs exert their effects?

A

Efferent arteriole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is released from the adrenal cortex in response to increased potassium in the extracellular fluid of the cortex?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give 2 e.g’s of what can cause an increase in serum urea

3 listed

A

Corticosteroid treatment
Tetracycline treatment
GIT bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 3 types of drug which can cause hyperkalaemia

6 listed

A 
ACEI
ARBs
Spironolactone
Amiloride
NSAIDs
Potassium supplements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name a type of drug which can cause hypokalaemia

A

Loop diuretics e..g. furosemide, bumetanide

Thiazide diuretics e.g. bendroflumethazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does metformin cause lactic acidosis?

A

Decreases gluconeogenesis - from lactate in the liver + promotes conversion of glucose to lactate which results in additional lactate in the blood.
Can happen in diabetic patients with renal impairment - metformin renally excreted - will accumulate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which anti rejection meds are used in renal transplant? What is their effect?

A

Ciclosporin and tacrolimus - causes intense vasoconstriciton of the microvasculature of the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

At what level of serum creatinine is severe AKI considered?

A

> 500umol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the RIFLE classification of AKI?

A

Risk - SCr x1.5 within 48 hours UO 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Give 1 eg of what can cause a decrease in serum urea | 3 listed
Decrease protein intake Liver failure Sodium valporate
26
What is the most common cause of intrinsic injury to kidneys?
Renal ischaemia causing acute tubular necrosis
27
Name 2 causes of increased serum creatinine
Increased muscle mass Ingestion of red meat Rhabdomyolysis Decreased tubular secretion eg trimethoprim
28
What are the S&S of pre-renal injury - uraemia?
Hypotension Weak and rapid pulse Decreased JVP
29
Which markers on urinalysis differentiates between a pre-renal injury and an intrinsic injury?
SG Osmolality Sodium
30
Where is the injury (pre-renal/intrinsic) here: SG >1.020 Osmolality >500 Na
Pre-renal
31
Where is the injury here (pre-renal/intrinsic) here: SG 40 Ratio >1%
Intrinsic
32
What is the most common cause of intrinsic injury to kidneys?
Acute tubular necrosis
33
Which 2 types of drugs can cause rhabdomyolysis?
Statins | Calcineurin inhibs - ciclosporin
34
Name 2 types of drugs which can cause hyperkalaemia
ACEI ARBs Spironolactone
35
Which drug can cause increased serum creat?
Trimethoprim
36
Name 2 drugs which can cause irreversible renal damage
Gentamicin | Ibuprofen
37
Name a drug which can cause hypercalcaemia, increased Ca excretion in urine/renal stones
Calcium preps | Vit D
38
Which drugs can cause high serum uric acid/urate stones
Chemo
39
Which 2 types of drugs can cause rhabdomyolysis?
Statins | Calcineurin inhibs - ciclosporin
40
What investigation should be performed to identify the cause of renal disease in: ARF, chest symptoms, +++haematuria, +++proteinuria
Kidney Bx
41
What investigation should be performed to identify the cause of renal disease in: ARF, fever, night sweats, dysutia, loin pain
MC&S looking for white cell casts
42
What investigation should be performed to identify the cause of renal disease in: Elderly patient developing ARF 4 days after elective knee replacement
Urinary Na
43
What investigation should be performed to identify the cause of renal disease in: Pt with poor stream, dribbling, hesitancy and nocturia + increasing serum urea and creatinine
Physical examination and bladder scan
44
Which electrolyte abnormality is likely to be associated with: ARF post marathon
Hyponatraemia
45
Which electrolyte abnormality is likely to be associated with: Recovery phase of ARF due to rhabdomyolysis
Hypocalcaemia
46
Which electrolyte abnormality is likely to be associated with: ARF after introduction of ACEI in a patient with CHF
Hypercalcaemia
47
Which electrolyte abnormality is likely to be associated with: Chronic use of thiazide diuretics
Hyperkalaemia
48
Which electrolyte abnormality is likely to be associated with: Chronic laxative abuse
Hypokalaemia
49
Which pathological condition is associated with: | RBC casts
Glomerulonephritis
50
Which biochemical abnormality is associated with: | Chemo for bulky sarcoma of R thigh
Hyperuricaemia
51
Which pathological condition is associated with: | Fatty casts
Nephrotic syndrome
52
Which pathological condition is associated with: | Pigmented casts
Rhabdomyolysis
53
Which biochemical abnormality is associated with: | ARB use for HTN
High CK
54
Which biochemical abnormality is associated with: | Ecstasy use
Hyponatraemia
55
Which biochemical abnormality is associated with: | prostatic carcinoma
Metabolic acidosis
56
Which biochemical abnormality is associated with: | Chemo for bulky sarcoma of R thigh
Hyperuricaemia
57
Which drugs can cause: | AKI with hyperkalaemia
Spironolactone and ACEI
58
What histopathological changes are seen in: | Obstructive uropathy
Tubular dilatation
59
Which drugs can cause: | AKI with high CK
Statin and ciclosporin
60
Which drugs can cause: | AKI with hyponatraemia
Loop diuretic and thiazide
61
What histopathological changes are seen in: | Rapidly progressive glomerulonephritis
Crescenteric change in Bowman's space
62
What histopathological changes are seen in: | Acute interstitial nephritis
Eosinophils in the interstitium
63
What histopathological changes are seen in: | Acute tubular necrosis
Mitotic figures in tubular epithelial nuclei
64
What histopathological changes are seen in: | Obstructive uropathy
Tubular dilatation
65
What test could establish the cause of: 24 yo construction worker in an accident - thighs have been trapped under rubble for hours - in A&E with swollen right thigh and AKI
Plasma creatinine phosphokinase
66
Aetiology of AKI in: | 28yo male develops AKI with haematuria after 2 weeks of sore throat
Glomerulonephritis
67
What test could establish the cause of: 63 yo male with normal serum creat, started on lisinopril 20mg/day for HTN, routine test 4 weeks later = serum creat 330and K 5.8
MRA renal arteries
68
What test could establish the cause of: 41yo male treated with amoxicillin for chest infection. 2 weeks later developed poor appetite and W/L - serum creat of 250umol/l
Renal Bx - mesangial leucocytes and eosinophil infiltration
69
Aetiology of AKI in: 71yo male + permanent ileostomy following pan colecomy for UC, investigated for recent onset W/L. Barium swallow showed increased stoma output >3L/day and serum creat was normal, now 220umol/l
Pre-renal failure
70
Aetiology of AKI in: | 76 yo female with AKI post elective hip replacement, treated with normal saline pre op and gent
Acute tubular necrosis
71
Aetiology of AKI in: | 55yo female completed course of RTx for treatment of advanced cervical cancer
Obstructive uropathy
72
Aetiology of AKI in: | 28yo male develops AKI with haematuria after 2 weeks of sore throat
Glomerulonephritis
73
What is the most likely cause of HTN in: | Normal sized kidneys on renal USS
Essential HTN
74
What is the most likely cause of HTN in: | Asymmetrical kidneys with acute rise in serum creat after introduction of ACEI
Bilateral renal artery stenosis
75
What is the most likely cause of HTN in: | Asymmetrical kidneys with minimal/no change in serum creat after introduction of ACEI
Unilateral renal artery stenosis
76
What is the most likely cause of HTN in: | Normal sized kidneys on USS, micro aneurysms on fundoscopy
Diabetic neuropathy
77
Which investigation: | Useful in differentiating renal from pre-renal failure
Urinary Na
78
Which investigation? | May cause AKI in patients with renal disease
Coronary angiogram
79
Which investigation: | Safe to perform in patients with renal impairment to investigate obstruction
Renal USS
80
Which investigation: | Values may be falsely low in patients with decreased muscle mass
eGFR
81
Cause of renal injury? | Laxative abuse
Vol depletion
82
Which drug...? | May cause ureteric calcium stone formation
Large doses of vit D
83
Cause of renal injury? | NSAIDs
Reduction of vasodilatory prostaglandins
84
Cause of renal injury? | Radiocontrast agents
Afferent arteriolar vasoconstriction/ renal ischaemia
85
Which drug...? | Can cause rhabdomyolysis
Statins
86
Which drug...? | Dose reduction is needed in patients with chronic kidney disease
Gabapentin
87
What are the clinical limitations of plasma urea?
Disproportionately high in patients with dehydration | Disproportionately low in patients with liver disease
88
Which drug...? | May cause ureteric calcium stone formation
Large doses of vit D
89
What is the clinical diagnosis if the urine is: | Frothy
Nephrotic syndrome
90
What is the clinical diagnosis if the urine is: | Cloudy with red cell casts
Acute post streptococcal glomerulonephritis
91
What is the clinical diagnosis if the urine is: | Dark with no red cells/red cell casts
Rhabdomyolysis
92
What is the clinical diagnosis if the urine has: | Macroscopic haematuria with no red cell casts
Transitional cell carcinoma of the bladder
93
What is the clinical limitations of serum creatinine?
Undergoes tubular secretion Increased in those with high muscle mass Used as a variable in MDRD eGFR equation
94
What is the clinical limitation of urinary sodium?
Invalid in patients on diuretics

JG Year 2 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions