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Renal Week 3 > Acute Kidney Disease > Flashcards

Acute Kidney Disease Flashcards

1
Q

what is the length threshold between chronic and acute kidney disease?

A

3 months

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2
Q

will CKD present with large small or regular sized kidneys?

A

small kidneys

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3
Q

name the three classes of AKD?

A

pre post and intra renal

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4
Q

what is the least common type of AKD?

A

post renal

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5
Q

name the two mechanisms to get pre renal AKD?

A

decreased blood volume

adjusted blood flow or hemodynamics

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6
Q

name three ECF volume losses that can cause pre renal AKD

A

diuretics
GI loss
hemorrhage

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7
Q

what is a drug that commonly leads to pre renal AKD?

A

NSAIDS…constricts afferent arteriole

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8
Q

what type of AKD do sepsis and heart failure cause?

A

pre renal AKD

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9
Q

what are the three main classes of intra renal AKD?

A

acute interstitial nephritis
tubular block
acute tubular necrosis

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10
Q

what are two common causes of acute tubular necrosis

A

ischemia

nephrotoxic drugs

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11
Q

what are three common causes of acute interstitial nephritis?

A

medications…hypersensitivity
autoimmune
infections

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12
Q

acute tubular necrosis caused by nephrotoxic drugs includes three common drug types…name them

A

aminoglycosides
iodinated radiocontrast
heme pigments

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13
Q

name three common post renal AKD causes

A

stones
prostate enlargement
uterine canal enlargement

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14
Q

if a patient has signs of low ECF volume…what type of AKD is most likely?

A

pre renal

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15
Q

what do we use to rule out post renal AKD?

A

foley catheter insertion and ultrasound

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16
Q

in acute tubular necrosis or ATN…what can be seen in urine?

A

granular muddy brown casts from sloughing off of cells

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17
Q

specific gravity in pre renal is above what number?

A

1.020

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18
Q

specific gravity in intra renal is equal to what?

A

1.010

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19
Q

is urine osmolality higher or lower than 500 in pre renal?

A

higher

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20
Q

is urine osmolality higher or lower than 500 in intra renal?

A

lower

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21
Q

is urine sodium higher or lower than 20 in pre renal?

A

lower

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22
Q

is urine sodium higher or lower than 20 in ATN?

A

higher than 30

23
Q

what is the FENa cutoff for pre renal?

A

always less than 1%

24
Q

what is the FENa cutoff for ATN?

A

above 2%

25
Q

what is the FEurea cutoff for pre renal

A

less than 35%

26
Q

what is the FEurea cutoff for ATN

A

greater than 50%

27
Q

in prenal what is the BUN:creatinine ratio?

A

greater than 15

28
Q

in intra renal what is the BUN:creatinine ratio?

A

less than 15

29
Q

what are the two most common sites of ischemic intra renal ATN?

A

PCT and ascending thick limb of the loop

30
Q

name three common causes of nephrotoxic ATN?

A

ethylene glycol
aminoglycosides
radiocontrast dye

31
Q

acute interstitial nephritis is associated with three drug classes…name them

A

NSAIDS
penicillin
diuretics

32
Q

with acute interstitial nephritis…what can you have in the urine that is a sign?

A

eosinophils

33
Q

eosinophils are a sign of what AKD if in urine?

A

acute interstitial nephritis

34
Q

what is renal papillary necrosis?

A

necrosis and sloughing off of the papillae from blood flow impairment

35
Q

name three things that are associated withe renal papillary necrosis

A

sickle cell disease
NSAIDs use
diabetes mellitus

36
Q

with renal papillary necrosis…what does the urine look like?

A

cloudy

37
Q

patient has flank pain…high NSAID use…blood in urine….protein in urine…and urine is cloudy….what do they have?

A

renal papillary necrosis

38
Q

name three histologic changes seen in ischemic tubular necrosis

A

dilated tubules
proteinaceous fluid filling the tubules
brush border lost

39
Q

name the histologic changes seen in nephrotoxic tubular necrosis

A

epithelial sloughed off and killed

dead cells filling the tubules

40
Q

are nephrotoxic tubular necrosis and ischemic tubular necrosis reversible or irreversible?

A

reversible

41
Q

what can light chains cause if they accumulate?

A

they can accumulate in the tubules of the kidney and cause light chain cast nephropathy

42
Q

what is the histologic finding in pyelonephritis?

A

lots of neutrophils in the interstitium of the cortex…including the glomerulus

43
Q

is pyelonephritis reversible or irreversible? what does it leave behind?

A

it is irreversible and leaves scar tissue

44
Q

what are the histologic changes seen in acute hypersensitivity tubulointerstitial nephritis?

A

eosinophils accumulation

WBC infiltration

45
Q

is acute hypersensitivity tubulointerstitial nephritis reversible or irreversible?

A

reversible

46
Q

what can cholesterol emboli lead to if prolonged?

A

ischemic tubular necrosis and inflammation

47
Q

what is thrombotic microangiopathy?

A

small blood vessel disease that causes thrombosis and microangiopathis hemolytic anemia

48
Q

what is a common cell seen in thrombotic microangiopathy?

A

schistocytes

49
Q

what is the most common infectious agent related to thrombotic microangiopathy?

A

e coli

50
Q

what is HUS? when is HUS most common?

A

hemolytic uremic syndrome…most common cause of ARF in children

51
Q

what is the triad of HUS?

A

hemolytic anemia
thormbocytopnenia
uremia

52
Q

what happens to blood vessels in HUS?

A

they get blocked off due to infection of endothelial cell leading to intimal proliferation

53
Q

if you have TMA (thrombotic microangiopathy) or HUS (hemolytic uremic syndrome) what can that lead to?

A

ischemic tubular necrosis

Renal Week 3 (10 decks)

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