Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal Exam 1 > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

1
Q

AKI Epidemiology

A

30% of ICU admissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Acute Renal Failure/AKI

A

Sudden impairment of kidney function resulting int he retention of nitrogenous and other waste products normally cleared by the kidneys
Increased BUN and SCr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Anuria

A

No urine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Oliguria

A

Decreased production of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

BUN

A

End product of protein catabolism

Produced from ammonia converted to urea and excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Increased BUN =

A

Increased protein catabolisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

No BUN =

A

Liver failure or dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Creatinine

A

End metabolite from our muscles

Proportional or associated to the amount of muscles in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pre-renal AKI

A

Outside the kidneys
Leads to decreased blood supply of the kidneys
Associated with decreased amounts of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Post-renal AKI

A

Blockage of the urine outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pre-renal + BUN

A

Reabsorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pre-renal + GFR

A

Decreased GF bc decreased BF

Lower amount of filtrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lower amount of filtrate =

A

Increased reabsorption bc slower flow of filtrate

–> increased BUN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Creatinine reabsorption

A

NOT reabsorbed!!

Decreased GFR = increased creatinine bc of decreased excretion not reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Renal AKI

A

GFR decreased
Disease is effecting kidney parenchyma (nephron malfunction)
REDUCED FILTRATION AND REABSORPTION
Increased BUN (not as much as pre-renal) and creatinine (not bc of reabsorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BUN:creatinine Maintain vs Increased

A

M: problem with the kidney itself
I: Pre-renal kidney failure

17
Q

Pre-renal =

A

Hypovolemia
Decreased CO (ischemic heart disease or MI)
Decreased effective circulating volume (CHF and liver failure)
Impaired renal autoregulation (NSAIDs, ACEI/ARBs, cyclosporine)

18
Q

Intrinsic/Renal =

A 
Acute glomerulonephritits
Ischemia
Sepsis/infection
Vasculitis 
Maliginant hypertension
Nephrotoxins
19
Q

Nephrotoxins are

A 
Iodinated contrast
AG
Cisplatin
Amp B
Rhabdomyolysis
Myeloma
Crystals
20
Q

Post-renal =

A

Bladder obstruction

21
Q

Pre-renal Azotemia

A

Most common form of AKI
Inadequate renal plasma flow and intraglomerular hydrostic pressure
No parenchymal damage to kidney

22
Q

Autoregulation

A

Pressure that is inside the capillary can be controlled in a certain range
Independent of fluctuations of BP
Important to maintain constant GFR

23
Q

Drop in BP bc of NSAID + Autoregulation

A

Decreased PGs

Increased Ang II

24
Q

Drop in BP bc of ACEi/ARB + autoregulation

A

Increase PGs

Decreased Ang II

25
Q

Autoregulation of GFR is adversely affected by:

A 
Atherosclerosis
HTN
Increased age
NSAIDs
ACEI/AT1 blockers
26
Q

Pre-renal Hepatorenal Syndrome

A

Systemic vascular resistance is markedly redued due to primary aterial vasodilation in the splanchnic circulation –> activation of vasoconstrictor response
Blood is trapped in splanchnic circulation so there is not enough blood for the kidney so it thinks is hypovolemic

27
Q

Sepsis

A

Can affect function of the endothelial cells (bacteria + inflammatory cytokines = bad for cells)
Interstitial and tubules are affected as well

28
Q

Ischemia leads to

A

Microvascular injury and tubular injury due to lack of oxygen cells die and cause inflammation –> kidney injury

29
Q

Surgery could leads to

A

Severe hemorrhage and loss of blood volume which can lead to hypoperfusion of the kidney –> injury

30
Q

Nephrotoxins are

A 
Contrast agents
Abx (AG)
Chemo agents
Environmental toxins
Myoglobin, hgb, urate, meyloma light chains
31
Q

Post-renal AKI resembles:

A

Pre-renal but last longer and will have a clinical picture of renal + kidney damage
Anything that blocks the UT

32
Q

Post-renal considerations

A

Bilateral vs unilateral

Time

33
Q

Blockages caused by

A

Kidney stones
Prostatic enlargement
Cancer/tumors
Infections

34
Q

Diagnosis of AKI

A

SCr rise of 0.3 mg/dL or 50% higher than baseline within a 24-48 period OR reduction of urine output to 0.5 mL/kg for greater than 6 hours
Ultrasound or CT for postrenal AKI
Kidney biopsy
Biomarkers: KIM-1 or NGAL

35
Q

Urine findings in AKI

A 
Anuria is rare
Oliguria is less than 400mL/24 hours
Red/brown urine
Mild proteinuria
Hyaline casts
36
Q

AKI complications

A 
Volume status
BP
Electrolytes
Acid and base
Excretion of waste products
Uremia 
Hypervolemia (Na and water retension, PE)
Recovery: Hypovolemia, polyuria, and osmotic diuresis
Hyperkalemia (arrhythmias)
37
Q

Common principles of AKI management

A

Optimization of hemodynamics
Correction of fluid and electrolyte
Discontinuation of nephrotoxic medications
Dose adjustments for meds

Renal Exam 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions