ACE Review - Renal

Question 1

How does the urine sodium look like in intrarenal oliguria

Answer 1

Urine Na is higher than 40 because it cannot retain sodium

Question 2

How does urine osmolality look like in intrarenal oliguria

Answer 2

It is LESS than 350 because it cannot retain water as we’ll. sodium is being lost, but water is being lost as we’ll

Question 3

What is FENa of intrarenal oliguria

Answer 3

It is greater than 2% because sodium is being lost

Question 4

What is the specific gravity of urine in intrarenal oliguria

Answer 4

It is between 1.01 to 1.015 because sodium is being lost

Question 5

What if the specific gravity of urine is 1.02 or higher

Answer 5

The oliguria is caused by prerenal causes.. The kidney is concentrating the urine and making a higher specific gravity

Question 6

How does the urine osmolaity of a prerenal oliguria look like

Answer 6

Greater than 1000

Question 7

oliguria. what is its definition

Answer 7

less than 0.5ml/kg/hr urine output

Question 8

oliguria. what to fluids are used to compare to each other to define oliguria

Answer 8

compare the urine to plasma values

Question 9

oliguria. what are the categories for oliguria

Answer 9

prerenal, renal, postobstructive

Question 10

oliguria. what 4 things compared in urine and plasma can help you check for the category of oliguria

Answer 10

urea, creatinine, and sodium, and osmolality

Question 11

oliguria. what does urine to plasma osomolality tell

Answer 11

the kidneys concentrating ability

Question 12

oliguria. what urine to plasma osmolality value tell you it is prerenal

Answer 12

when it is greater than 1.5

Question 13

oliguiria. what does it mean when the urine to plasma osmolality equal 1

Answer 13

the kidney concentration power is dead…the blood and urine both have the same osmolality

Question 14

oliguria. what does urine to plasma creatinine measure

Answer 14

it reflects water conservation

Question 15

oliguria. why is creatinine useful in diagnosing the category of oliguria

Answer 15

because most of creatinine is not reabsorbed

Question 16

oliguria. what is seen in prerenal for urine to plasma

Answer 16

value greater than 30…because water is being sucked up and creatinine is being released….so [Cr] is high up to the 30s

Question 17

oliguria. what is seen in renal damage of urine to plasma ratio

Answer 17

a value less than 20 because [Cr] is being diluted

Question 18

oliguria. what is FENa

Answer 18

it is a measure of the kidney’s ability to conserve sodium

Question 19

oliguria. what is the value of prerenal FENa

Answer 19

less than 1%

Question 20

oliguria. what is the value of reanl damage FENa

Answer 20

greater than 2%

Question 21

oliguria. what is so good about FENa

Answer 21

it includes both sodium and creatinine in its calculation

Question 22

oliguira. what is the equation for FEna

Answer 22

(UNa/PNa) / (UCr/PCr )

Question 23

oliguria. how do you compare the FENa to U:PCr for prerenal

Answer 23

if you think about it…they are inversus of eachother…because Na is reabosorb…and Cr is not

Question 24

oliguria. how do you think the values of Urea is similar to….to Na or Cr

Answer 24

it is similar to sodium…it is reabsorbed by the body

Question 25

oliguria. what values of prenal for FEUr

Answer 25

less than 35% is prerenal

Question 26

oliguria. what values of intrarenal damage for FEUr

Answer 26

greater than 50 is intrarenal

Question 27

oliguria. how much of cardiac output is directed to the kidneys

Answer 27

25percent

Question 28

gentamycin. what should be considered during administration of this drug

Answer 28

pt with decrease reanl function. they are increase risk for aminoglycoside nephrotoxicity

Question 29

gentamycin. does one intraop dosing increase risk for renal insufficiency

Answer 29

yes…even on dose can cause acute tubular necrosis

Question 30

gentamycin. low lab value might show pt at risk for aminoglycoside toxicity

Answer 30

low albumin

Question 31

gentamycin. what does low albumin level mean for pt at risk for getting acute tubular necrosis

Answer 31

low albumin might mean pt has low liver function…(some of these pts are hepatorenal syndrom)

Question 32

gentamycin. what can be done in OR to help decrease risk of acute tubular necrosis in renal insufficient pt. what abx can be given

Answer 32

admin it with a betalactaminase (pcn or cephalosporins)

Question 33

gentamycin. what can be done in the OR to help decrease risk of acute tubular necrosis in renal insufficient pt. what antihtn

Answer 33

calcium channel blocker

Question 34

gentamycin. what can the pt take for supplement and help decrease risk for acute tubular necrosis

Answer 34

calcium supplements