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Genitourinary System > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

0
Q

Which 2 drugs prevent secretion of creatinine in the tubules?

A
  • trimethoprim

- cimetidine

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1
Q

What are the criteria for AKI?

A
  • increase in serum creatinine 44 mEq/L

- increase in serum creatinine of more than 50% from baseline

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2
Q

What are the pre-renal causes of AKI?

A
  • decreased effective circulating volume (CHF, volume depletion, sepsis)
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3
Q

What are the renal causes of AKI?

A
  • ATN
  • AIN
  • glomerulonephritis
  • atheroemboli
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4
Q

What are the post-renal causes of AKI?

A
  • post-obstructive uropathy (stones, tumours)
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5
Q

The mortality rate of AKI ranges from 7-80%. Why has this rate not changed over the years?

A
  • increasing age

- increasing co-morbidities

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6
Q

What are the most common causes of death associated with ARF?

A
  • cardiac failure
  • sepsis
  • respiratory failure
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7
Q

How do you treat pre-renal AKI?

A
  • fluid boluses or continuous IVF
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8
Q

What urine sediments would you expect for pre-renal, renal, and post-renal AKI?

A
  • pre-renal: hyaline casts
  • renal: brown, granular casts
  • post-renal: bland
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9
Q

What is the FENa in pre-renal, renal, and post-renal AKI?

A
  • pre-renal: 2%

- post-renal: >2%

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10
Q

What other causes of AKI are associated with low FENa?

A
  • drugs that cause vasoconstriction mediated intrinsic renal failure
  • tacrolimus, cyclosporine, NSAIDs, cocaine
  • hepatorenal syndrome
  • radiocontrast injury
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11
Q

What are some primary causes of post-renal AKI?

A
  • BPH
  • prostate or cervical cancer
  • stones
  • stricture
  • retroperitoneal fibrosis
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12
Q

What do you need to monitor for after catheterization of post-obstructive uropathy to relieve hydronephrosis?

A
  • post-obstructive diuresis
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13
Q

What is the most common cause of ARF in hospitalized patients?

A
  • ATN
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14
Q

What are the three phases of ATN?

A
  • initiation
  • maintenance (GFR and urine output lowest)
  • recovery (post-acute tubular necrosis diuresis)
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15
Q

What are some causes of ischemic ATN?

A
  • hypovolemia
  • decreased cardiac output
  • sepsis
  • DIC
  • systemic vasodilation
  • renal vasoconstriction
16
Q

What are some causes of nephrotoxic ATN?

A
  • exogenous toxins (gentamicin, contrast, cisplatin, tacrolimus, cyclosporine)
  • endogenous toxins (hemoglobulinuria, myoglobinuria, crystals, light chains)
17
Q

How is ischemic and nephrotoxic ATN treated?

A
  • remove underlying cause
  • correct fluid/electrolyte balances
  • supportive treatment
18
Q

What are 4 causes of AIN? Which is most common?

A
  • drug hypersensitivity (70%)
  • infection (15%)
  • idiopathic (8%)
  • autoimmune (6%)
19
Q

What drugs can cause AIN?

A
  • antibiotics
  • NSAIDs
  • sulfa drugs
  • allopurinol
20
Q

What do you look for in urine microscopy of AIN?

A
  • WBC casts
21
Q

How is drug hypersensitivity AIN treated?

A
  • remove offending drug
22
Q

What are the criteria for glomerulonephritis?

A
  • hematuria (RBC casts, dystrophic RBCs)
  • moderate proteinuria (<3 g/day)
  • elevated serum creatinine
  • hypertension
  • oliguria
23
Q

What are 3 etiologies and their associated causes of glomerulonephritis?

A
  • anti-GBM disease (Goodpasture’s)
  • immune complex diseases (post-infectious GN, IgA nephropathy, SLE, mixed cryoglobulinemia, MPGN)
  • pauci-immune/classic systemic vasculitis diseases (Wegener’s, microscopic polyangitis, Churgg-Strauss)
24
Q

What test is used for Goodpasture’s disease?

A
  • anti-GBM
25
Q

What test is used for IgA nephropathy?

A
  • IgA
26
Q

What test is used for SLE?

A
  • ANA

- anti-DNA

27
Q

What test is used for post-infectious glomerulonephritis?

A
  • ASOT
28
Q

What test is used for mixed cryoglobulinemia?

A
  • cold Abs, Hep B/C surface antigen
29
Q

What test is used for Wegener’s granulomatosis?

A
  • c-ANCA
30
Q

What test is used for microscopic polyangitis?

A
  • p-ANCA
31
Q

What test is used for Churgg-Strauss syndrome?

A
  • c-ANCA

- p-ANCA

32
Q

How is nephrotic syndrome treated?

A
  • treat underlying cause
33
Q

What is the main cause of renal atheroembolic disease?

A
  • embolization of debris scraped from aortic wall during catherization
34
Q

How do you treat renal atheroembolic disease?

A
  • supportive treatment
35
Q

How do you treat hyperkalemia?

A
  • calcium gluconate
  • insulin/glucose
  • sodium bicarbonate
  • diuretics (lasix)
  • kayexalate
  • dialysis
36
Q

What are acute indications for dialysis?

A
  • acidosis (metabolic)
  • electrolytes (hyperkalemia)
  • ingestion of drugs/ischemia
  • overload (fluid)
  • uremia
37
Q

What are medical emergencies of uremia?

A
  • uremic encephalopathy

- uremic pericarditis

Genitourinary System (10 decks)

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