Acute Kidney Injury

Question 1

Define AKI.

Answer 1

Question 2

What are the RFs for developing an AKI?

Answer 2

Question 3

What are the pre-renal causes of AKI?

Answer 3

Question 4

What are the symptoms of a pre-renal AKI?

Answer 4

Question 5

What are the intra-renal causes of AKI?

Answer 5

Question 6

What are the symptoms of an intra-renal AKI?

Answer 6

Question 7

What are the symptoms of uraemia?

Answer 7

Question 8

What are the possible causes of a rash in the presence of a decreased urine output?

Answer 8

Question 9

Describe the pathogenesis of glomerulonephritis including its clinical effects.

Answer 9

Question 10

What are the two main causes of ATN?

Answer 10

Ischaemia and nephrotoxins.

Question 11

What are key investigations for ATN?

Answer 11

(urine analysis) + for casts

Question 12

What would you expect to see on urine analysis in ATN?

Answer 12

A urinalysis of Acute Tubular Necrosis (ATN) typically shows the following key findings:

Microscopic Examination:

Muddy Brown Casts: Granular casts made of degenerated tubular epithelial cells and proteins; a hallmark of ATN.

Epithelial Cell Casts: Shed tubular cells clumped together; also highly suggestive of ATN.

Tubular Epithelial Cells: Free tubular epithelial cells may also be visible in the urine.

Chemical Analysis:

Low Urine Specific Gravity (<1.015): Indicates the kidney’s inability to concentrate urine due to tubular damage.

Low Urine Osmolality (<350 mOsm/kg): Poor tubular reabsorption capacity.

High Urine Sodium (>40 mmol/L): Reflects impaired sodium reabsorption in damaged tubules.

Fractional Excretion of Sodium (FENa >2%):
Helps differentiate ATN from prerenal azotemia.
In ATN, damaged tubules cannot retain sodium efficiently.

BUN/Creatinine Ratio (<20:1):
Suggests intrinsic renal damage rather than prerenal causes of AKI.

Question 13

How would you differentiate between pre-renal AKI and ATN?

Answer 13

Question 14

What triggers AIN?

Answer 14

Question 15

What are the types of AIN and what are the features of each?

Answer 15

Question 16

What are the post-renal causes of AKI? Include symptoms.

Answer 16

Question 17

What are ALL the causes of AKI?

Answer 17

Question 18

What are ALL the causes of AKI? Include symptoms

Answer 18

Question 19

What would you expect on general and closer inspection of an AKI case?

Answer 19

Question 20

What would you expect on palpation, percussion and auscultation of an AKI case?

Answer 20

Question 21

What special tests would you offer for an AKI case? (physical exam)

Answer 21

Question 22

What are all the exam findings of AKI?

Answer 22

Question 23

How would you grade AKI?

Answer 23

Question 24

What are all the investigations for an AKI?

Answer 24

Question 25

What are all the investigations for AKI, including those exclusine to CKD?

Answer 25

Question 26

What ECG changes would you expect in hyperkalemia?

Answer 26

Question 27

What is the management of hyperkalemia?

Answer 27

DO NOT USE HARTMANN'S!!

Question 28

What is the conservative management of an AKI?

Answer 28

Question 29

What is the full management of an AKI?

Answer 29

Question 30

List the complications of an AKI.

Answer 30