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Phar 503 > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

1
Q

What are the types AKI

A

Prerenal AKI, intrinsic, Postrenal

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2
Q

What are the 3 types of Intrinsic AKI

A

acute glomerulonephropathy, acute tubular necrosis, acute interstitial nephritis

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3
Q

When does AKI become CKD

A

established renal dysfunction for three or more months

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4
Q

What are non preventable risk factors for AKI

A

Chronic kidney disease, age greater than 75, heart failure, liver disease, diabetes

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5
Q

What are preventable risk factors for AKI

A

Medications, hypotension, sepsis,cirrhosis

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6
Q

What can cause pre renal AKI causes

A

intravascular volume delpletion (dehydration), reduced cardiac output, vascular obstruction

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7
Q

What is a marker than is affected by AKI, what happens

A

increased SCr

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8
Q

What are some labs and urine tests that can evaluate for AKI

A

BUN: Scr greater than 20, urine specific gravity greater than 1.015

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9
Q

What are the characteristics of urine for a patient with pre-renal AKI

A

Highly concentrated urine with low sodium

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10
Q

What is the best way to check for post renal AKI

A

kidney ultrasound

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11
Q

What is the best way to check for pre renal AKI, what should the change be , what does it mean if there is not change

A

Give Normal Saline bolus, if the SCr significantly improves the AKI is prerenal, if there is no change in SCr the AKI is likely intrinsic

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12
Q

What does FENA stand for

A

Fractional Excretion of Sodium

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13
Q

What are the circumstances when the FENA can be used

A

only accurate in oliguric (urine output less than 400ml/day) AKI

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14
Q

What are values for FENA and what do they mean

A

< 1 : suggests pre renal AKI, 1-2: either prerenal or intrinsic, >2: suggests intrinsic AKI

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15
Q

When would the FENA be falsely high, why, If it is still low what does this mean

A

If the patient is on diuretics, diuretics should cause a large excretion of Sodium, if FENA is low despit being on diuretics there is likely pre renal AKI

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16
Q

What is usually the cause of glomerulonephropathies

A

autoimmune disease

17
Q

What is a characteristic finding of GN

A

Proteinuria

18
Q

What is the best way to check for GN

A

Protein to creatinine Ratio

19
Q

What is a hallmark feature of nephrotic syndrome

A

Facial edema and frothy urine

20
Q

What can be given for treatment of proteinuria

A

ACEIs or ARBs with salt restriction as well

21
Q

T/F: ACEIs and ARBS cause efferent vasodilation that causes less filtration leading to more retention of protiens

A

True

22
Q

What is the most common of cause of AKI

A

Acute tubular necrosis

23
Q

What can lead to Acute tubular necrosis

A

Prolonged or severe pre-renal AKI leading to ischemia

24
Q

What can cause Acute Interstital nephritis

A

Drug allergy or autoimmune diseases

25
Q

What are the 4 ways to manage AKI

A

removal of cause if possible, immunosuppresion if autoimmune, prevent hypotension and/or hypovolemia, avoid nephrotoxins

26
Q

What are the indications for dialysis

A

Metabolic Acidosis (ph less than 7.1), Electrolytes (K greater than 6.5), Intoxication, Refractory fluid Overload, uremia- confusion (A,E,I,O,U)

27
Q

T/F: Starting dialysis is more likely to better patient’s renal function in the future

A

False: Starting dialysis earlier in the coure of renal failure does not improve outcomes

28
Q

What is the most common cause of post renal AKI

A

Kidney stones or obstruction

29
Q

Whatis hydronephrosis

A

backup of urine into kidneys

30
Q

What are the most common stones

A

calcium and oxalate

31
Q

What is the reatement for stones

A

Usually pass on its own or give fluids

32
Q

What drugs can be used to pass big stones

A

Tamsulosin

33
Q

What are ways to prevent stones

A

increase fluid intake (urine output to 2 to 2.5 liters per day), avoid calcium, sodium restriction, avoid dark colas

34
Q

What meds can prevent calcium stones

A

thiazide diuretics and potassium citrate

Phar 503 (25 decks)

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