ACE Review - Renal Flashcards

1
Q

How does the urine sodium look like in intrarenal oliguria

A

Urine Na is higher than 40 because it cannot retain sodium

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2
Q

How does urine osmolality look like in intrarenal oliguria

A

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

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3
Q

What is FENa of intrarenal oliguria

A

It is greater than 2% because sodium is being lost

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4
Q

What is the specific gravity of urine in intrarenal oliguria

A

It is between 1.01 to 1.015 because sodium is being lost

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5
Q

What if the specific gravity of urine is 1.02 or higher

A

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

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6
Q

How does the urine osmolaity of a prerenal oliguria look like

A

Greater than 1000

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7
Q

oliguria. what is its definition

A

less than 0.5ml/kg/hr urine output

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8
Q

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

A

compare the urine to plasma values

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9
Q

oliguria. what are the categories for oliguria

A

prerenal, renal, postobstructive

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10
Q

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

A

urea, creatinine, and sodium, and osmolality

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11
Q

oliguria. what does urine to plasma osomolality tell

A

the kidneys concentrating ability

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12
Q

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

A

when it is greater than 1.5

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13
Q

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

A

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

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14
Q

oliguria. what does urine to plasma creatinine measure

A

it reflects water conservation

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15
Q

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

A

because most of creatinine is not reabsorbed

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16
Q

oliguria. what is seen in prerenal for urine to plasma

A

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

17
Q

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

A

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

18
Q

oliguria. what is FENa

A

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

19
Q

oliguria. what is the value of prerenal FENa

A

less than 1%

20
Q

oliguria. what is the value of reanl damage FENa

A

greater than 2%

21
Q

oliguria. what is so good about FENa

A

it includes both sodium and creatinine in its calculation

22
Q

oliguira. what is the equation for FEna

A

(UNa/PNa) / (UCr/PCr )

23
Q

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

A

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

24
Q

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

A

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

25
oliguria. what values of prenal for FEUr
less than 35% is prerenal
26
oliguria. what values of intrarenal damage for FEUr
greater than 50 is intrarenal
27
oliguria. how much of cardiac output is directed to the kidneys
25percent
28
gentamycin. what should be considered during administration of this drug
pt with decrease reanl function. they are increase risk for aminoglycoside nephrotoxicity
29
gentamycin. does one intraop dosing increase risk for renal insufficiency
yes...even on dose can cause acute tubular necrosis
30
gentamycin. low lab value might show pt at risk for aminoglycoside toxicity
low albumin
31
gentamycin. what does low albumin level mean for pt at risk for getting acute tubular necrosis
low albumin might mean pt has low liver function...(some of these pts are hepatorenal syndrom)
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
admin it with a betalactaminase (pcn or cephalosporins)
33
gentamycin. what can be done in the OR to help decrease risk of acute tubular necrosis in renal insufficient pt. what antihtn
calcium channel blocker
34
gentamycin. what can the pt take for supplement and help decrease risk for acute tubular necrosis
calcium supplements