Acute Kidney Injury

Question 1

Definition of AKI

Answer 1

Increase in Creatinine by 26.5> within 48 Hours

Urine Volume <0.5 for 6 Hours

Question 2

AKI Stage 1 Classification

Answer 2

1.15-1.9 Serum Creatinine Basaline or >26.5 Increase

<0.5 for 6-12 hours Urine Output

Question 3

AKI Stage 2 Classification

Answer 3

2.0-2.9 Serum Creatinine Baseline

<0.5 Urine Output for >12 hours

Question 4

AKI Stage 3 Classification

Answer 4

3.0 times baseline for Serum creatinine or initiation of RRT
<0.3 Urine output for 24 hours or Anuria for >12 hours

Question 5

Consequences of AKI

Answer 5

Acidosis
Electrolyte imbalance
Intoxication Toxins
Overload
Uraemic Complications

Question 6

It is too late to treat AKI When

Answer 6

Creatinine more than 400

Question 7

Pre Renal Causes of AKI

Answer 7

Cardiac Failure
Haemorrhage
Sepsis
Vomit + Diarrhoea

Question 8

Post Renal Causes of AKI

Answer 8

Tumours
Prostate Disease
Stones

Question 9

Intrinsic Causes of AKI

Answer 9

Glomerulonephritis
Vasculitis
Radiocontrast
Myeloma
Rhabdomyolitis
Drugs eg NSAIDS, Gentamicin

Question 10

AKI Risk Events

Answer 10

Sepsis
Toxins eg X-Ray Contrast, NSAIDS
Hypotension
Hypovolaemia

Question 11

AKI Risk Factors

Answer 11

Age >75
Previous AKI
Heart Failure
Liver Disease
Chronic Kidney Disease
Diabetes
Vascular Disease
Cognitive Impairment

Question 12

Medicines to stop on sick days

Answer 12

Ace Inhibitors end in Pril
ARBs end in Sartan
NSAIDS
Diuretics 
Metformin

Question 13

Diagnosis of AKI

Answer 13

Increase in Creatinine by >26.5mmol within 48 hours or reduced urine output <0.5

Question 14

If patient is Hypovolaemia in AKI, fluid overload and oliguric

Answer 14

senior review

Question 15

How to treat Hypovoloaemia in AKI

Answer 15

Boluses of Fluid

Question 16

Which condition to suspect in AKI

Answer 16

Sepsis

Question 17

Radiography for AKI

Answer 17

Ultrasound

Question 18

Management of AKI

Answer 18

Bloods

Renal Ultrasound

Question 19

ECG Changes in Hyperkalaemia

Answer 19

Peaked T Waves

Question 20

What is usually earliest sign of Hyperkalaemia

Answer 20

Tall Tented Peaked T Waves

Question 21

What does PR and QRS Segment do in Hyperkalaemia on ECG

Answer 21

Lengthen

Question 22

Which heart condition associated with Hyperkalaemia

Answer 22

Sinus Bradycardia or Slow AF

Question 23

Hyperkalaemia Treatment

Answer 23

Stabilise Myocardium; Calcium Gluconate
Shift K+ Intracellularly: Salbutamol, Insulin-Dextrose
Remove: Diuresis, Dialaysis, Anion Exchange Resins

Question 24

Acute Kidney Injury: Risk is defined by

Answer 24

Increase in serum creatinine level (1.5x) or

decrease in GFR by 25%,

or UO <0.5 mL/kg/h for 6 hours

Question 25

Acute Kidney Injury: Injury is defined by

Answer 25

Increase in serum creatinine level (2.0x) or decrease in GFR by 50%, or UO <0.5 mL/kg/h for 12 hours

Question 26

Acute Kidney Injury Failure is defined by

Answer 26

Increase in serum creatinine level (3.0x), or

decrease in GFR by 75%, or serum creatinine level >355μmol/L with acute increase of >44μmol/L;

or UO <0.3 mL/kg/h for 24 hours, or anuria for 12 hours

Question 27

Acute Kidney Injury Loss id defined by

Answer 27

Persistent ARF or complete loss of kidney function >4 weeks

Question 28

End Stage Kidney Disease is defined by

Answer 28

complete loss of kidney function >3 months

Question 29

The kidneys contribute to which heart condition

Answer 29

Congestive Cardiac Failure

Question 30

The kidneys produce which endocrine hormones

Answer 30

Erythropoeitin and Renin

Question 31

In Acid Base Homeostasis the kidneys excrete

Answer 31

H+

Question 32

In Acid Base homeostasis the kidneys generate

Answer 32

HCO3