Brainscape's Knowledge GenomeTM

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


See full index

Genitourinary > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

1
Q

What is the difference between acute kidney injury and acute renal failure?

A

Nothing!

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

What is AKI?

A

Acute kidney injury

Abrupt rise in serum urea and creatinine caused by a loss of kidney function that develops within 7 days

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

What is nephropathy?

A

Disease of the kidney

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

What is nephritis?

A

Nephropathy caused by inflammation

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

What is nephrosis?

A

Nephropathy not caused by inflammation

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

What does the kidney usually do?

A 
Filter blood
Clear waste
Control blood pressure
Help make blood (erythropoietin)
Control Ca and K levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens to blood pressure in AKI? Why?

A

It increases

Could be something to do with the kidney not being perfused as well due to narrowing/damage to blood vessels
So the kidney thinks blood pressure is low and raises it using the RAAS

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

What categories of causes of AKI are there?

A

Pre-renal
Intrinsic renal
Post-renal

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

What is meant by pre-renal causes of AKI?

List some.

A

Impaired perfusion of the kidneys

Hypovolaemia of any cause

  • infection
  • haemorrhage
  • cardiac failure
  • dehydration
  • many more
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is meant by intrinsic renal causes of AKI?

List some.

A

Damage to renal parenchyma

Vasculitis

Glomerulonephritis

Drugs

Ischaemia: due to oxygen deprivation

Obstruction: tumours, casts/plugs in renal tubules

Many more

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

What are the components of renal parenchyma?

A

Vessels

Glomeruli (capillaries associated with nephrons)

Tubulointerstitium (tubes where filtering occurs)

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

What is meant by post-renal causes of AKI?

List some.

A

Outflow obstruction

Obstruction of ureters, bladder, prostate, urethra

  • tumour
  • stone
  • fibrosis
  • benign prostatic hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of uraemia?

A

Uraemia = urea in the blood

Lethargy
Nausea
Anorexia
Itch
Confusion
Pericardial rub (caused by pericarditis?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the SYMPTOMS of AKI?

A

Can be asymptomatic

Uraemia related symptoms:

  • lethargy
  • nausea
  • confusion

Systemic features

  • rash
  • joint pain
  • haemoptysis
  • bleeding
  • oliguria or anuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some risk factors of AKI?

A 
Being elderly
Already having CKD
Diabetes
Prostate cancer
Heart failure
Sepsis
Dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the SIGNS of AKI?

A

Haematuria + proteinuria

Hypertension, raised JVP

Oedema in peripheries and in lungs

Pericardial rub

Abdomen:

  • distended bladder
  • dull suprapubic percussion

Low O2 stats + high resp rate

17
Q

What is a pericardial rub?

When does it occur?

A

Occurs if they are very uraemic

A crunchy snow type noise when listening to heart

Caused by pericarditis, rubbing of the two layers of the pericardium

18
Q

What should you do immediately if you hear a pericardial rub?

A

Start dialysis, they are very uraemic

19
Q

Baseline investigations of AKI?

A

Blood tests

Urinalysis:

  • protein
  • blood

USS: look for kidney abnormalities, obstructions,

ECG: to check if high K+ levels are affecting the heart

CXR: look for pulmonary oedema

ABG: look at K+ levels and pH

20
Q

What blood tests should you do when investigating AKI?

A

Urea + electrolytes

Glucose: check for diabetes

Liver function

Coagulation

CRP/ESR: look for signs of inflammation

Blood film: look at shape of RBCs, is there anaemia?

Serology: look for autoantibodies

21
Q

What investigations should you do if the baseline investigations don’t identify a cause of AKI?

A

Did they have a fall and were lying there for a while? Could be rhabdomyolysis

Have they had any recent chemotherapy or do they have lymphoma? Could be tumour lysis causing intrinsic renal failure

Screen for myeloma

Renal biopsy

22
Q

What type of investigations should you avoid in cases of AKI?

A

Contrast imaging
Because contrast will need to be cleared by the kidneys and if they are failing this won’t happen

You’ll get build up of contrast, toxicity

23
Q

How does myeloma cause renal failure?

A

Myeloma causes abnormal plasma cells which divide uncontrollably

They release an antibody called paraprotein which builds up in places it shouldn’t

These causes casts or plugs to form in the kidney, impairing its function

24
Q

What is rhabdomyolysis?

A

Breakdown / wasting of skeletal muscle

The breakdown products (myoglobin) enter the blood stream and damage the kidney

25
Q

How would you check for rhabdomyolysis?

A

They get tea coloured urine

26
Q

Management of AKI?

A

Identify the cause and treat it

Stop any nephrotoxins: drugs that could damage the kidneys

Treat fluid imbalance: give IV fluid or blood

Treat hyperkalaemia

Monitor urine output, U+E, BP etc.

Follow AKI care bundle

Consider ITU or renal referral

27
Q

How to treat pre-renal AKI?

A

Correct hypovolaemia with fluids, blood

Treat sepsis with antibiotics

28
Q

How to treat intrinsic renal AKI?

A

Refer to nephrology!

There’s not much you can really do since the problem is within the kidney

Supportive treatment until specialist referral

29
Q

How to treat post-renal AKI?

A

Catheterise to remove obstruction

Cystoscopy, stent

Treat the cause of the infection

Consider referral to urology

30
Q

When should you refer to nephrology?

A

AKI not responding to treatment

Unknown cause

If it is very severe

In a renal transplant patient

In a patient with late stage CKD

If there is a need for dialysis

31
Q

When would you start dialysis in an AKI patient?

A

If other treatments cannot correct the following:

  • High potassium
  • Fluid overload
  • Metabolic acidosis
  • Pulmonary oedema

If they are severely uraemic:

  • pericardial rub
  • encephalopathy

Toxin removal

32
Q

When should you refer to urology?

A

Infected + obstructed urinary tract

Renal stones

Suspected malignancy

Prostatic hyperplasia

Renal trauma

Frank haematuria

33
Q

Is the damage caused by AKI reversible?

A

Usually yes

34
Q

What stages of AKI are there?

How do you establish what stage a patient is?

A

Stage 1: early
Stage 2: moderate
Stage 3: severe

Using serum creatinine levels or urine output measurements

Genitourinary (13 decks)

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