Acute kidney injury

Question 1

Acute kidney injury is a deterioration of renal function that has lasted….

Answer 1

LESS than 3 months

more is CKD

Question 2

Pre-renal AKI is

Answer 2

secondary to decreased renal blood flow

Question 3

3 reasons for pre-renal AKI

Answer 3

• decreased ECV - ECF
• decreased cardiac output
• decreased plasma oncotic pressure -e.g. liver failure

Question 4

2 drugs that can cause pre-renal AKI

Answer 4

• NSAIDs

- RAAS blocker

Question 5

Hx suggesting ECF volume depletion

Answer 5

• diuretic
• diarrhea
• poor oral intake of sodium

Question 6

3 lab findings supporting pre-renal AKI

Answer 6

• hemoconcentrated
• High urea:creatinine ratio
• bland urine! no RBC, no protein

Question 7

Renal AKI often due to

Answer 7

injury to parenchyma

Question 8

4 clues hinting towards renal AKI

Answer 8

• hypertension
• ECF volume overload
• anemia/thrombocytopenia
• Blood or WBC or protein - abnormal casts

Question 9

3 problems with tubulointerstitial disease

Answer 9

• ATN
• AIN
• tubular obstruction

Question 10

ATN - acute tubular necrosis

Answer 10

usually very sick people

risk factors: CAD, CKD

Question 11

Most common kidney injury and second most common

Answer 11

• pre-renal AKI

- ATN

Question 12

exogenous toxins/drugs that can cause ATN

Answer 12

• aminoglycosides

- IV contrast

Question 13

hemegranular casts, blood and protein are findings of

Answer 13

ATN - acute tubular necrosis

Question 14

Urinary sodium in pre-renal AKI vs ATN

Answer 14

• Low urinary Na in pre-renal and >20 mmol in ATN

Question 15

AIN interstitial nephritis - etiology

Answer 15

Drug reactions
Autoimmune disease
Infection

Question 16

drugs that can cause AIN

Answer 16

antibiotics
NSAIDs
PPIs

Question 17

how long after exposure to drug to get AIN

Answer 17

7-10 days

Question 18

WBC casts are findings of

Answer 18

AIN

Question 19

tubular obstruction can be due to

Answer 19

Uric acid secretion

Myeloma - IgG casts

Question 20

proliferative glomerular disease

Answer 20

nephritic! - present with AKI

Question 21

which glomerular disease presents with AKI?

Answer 21

Proliferative

Question 22

Systemic secondary reasons for glomerular disease

Answer 22

MAID

• Malignancy
• Autoimmune
• Infections
• Drugs

Question 23

Findings in someone with Proliferative GN

Answer 23

• rapid decline in GFR
• ECF vol expanded(cant get rid of sodium)
• blood/protein, RBC casts

Question 24

Dysmorphic RBC or RBC cases feature of

Answer 24

proliferative GN

Question 25

Vascular diseases
Arteries
arterioles
capillaries
veins

Answer 25

renal artery stenosis
atheroembolic disease
TTP/HUS (caps)
Thrombosis

Question 26

pre-renal AKI can lead to

Answer 26

ATN (which can manifest as Hypotensive)

Question 27

post-renal kidney injury

Answer 27

needs imaging - r/o obstruction hydronephrosis

Question 28

complications of AKI

Answer 28

avoid hyperkalemia (cant excrete K+)
avoid volume overload (cant get rid of Na)
renally dose all meds

Question 29

how do you treat glomerular disease nephritis?

Answer 29

immunosuppressive

Question 30

how can you shift potassium into cells

Answer 30

Insulin

beta agonists

Question 31

Dialysis DOES NOT

Answer 31

treat AKI - but replaces function of the kidneys