Acute Kidney Injury Flashcards

1
Q

What is uraemia?

A

When nitrogenous metabolic waste products accumulate in blood (e.g creatinine and urea)

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2
Q

Why do levels of creatinine and urea rise rapidly in AKI?

A

Poor clearance of these substances by the kidneys

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3
Q

What is acute kidney injury?

A

Deterioration of renal function over hours or days

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4
Q

What are three dangerous consequences associated with AKI?

A

Volume overload, hyperkalaemia, and metabolic acidosis

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5
Q

How is the staging of AKI severity determined?

A

Creatinine levels compared to normal baseline
Stage 1: 1.5-1.9 times higher
Stage 2: 2-2.9 times higher
Stage 3: 3-3.9 times higher

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6
Q

What are the three types of causes of AKI?

A

Pre-renal, intrinsic renal and post renal

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7
Q

What medications can predispose the kidney to pre-renal AKI?

A

NSAIDS and ACE inhibitors, as these impair the renal autoregulation mechanisms

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8
Q

What things can cause post renal AKI?

A

Tumours, stones, urethral strictures, BPH

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9
Q

How would you investigate for AKI?

A

Urine tests, blood tests, renal imagining

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10
Q

In the biochemical changes that occur following AKI which substances will increase in their plasma concentrations?

A

Urea, creatinine, irate, potassium, phosphate

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11
Q

Following AKI which chemicals can there be a decrease in?

A

Sodium, calcium (due to rise in phosphate)

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12
Q

Which of the three categories of AKI would be indicated in a patient with history of: Thirst, weight loss, on diuretics. And signs of: low BP with postural drop, elevated pulse and low JVP

A

Pre-renal

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13
Q

Which of the three categories of AKI would be indicated in a patient with history of: exposure to toxic agents, hypertension

A

Intrinsic renal AKI

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14
Q

Which of the three categories of AKI would be indicated in a patient with history of: frequency, hesitancy. And on examination find an enlarged prostate?
What is the most likely cause?

A

Post renal AKI

Most likely BPH or tumour of the prostate

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15
Q

How would you manage a patient with pre-renal AKI?

A

Treat hypovolaemia with fluids, correct any electrolyte imbalances

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16
Q

How would you manage a patient with post-renal AKI?

A

If bladder outflow is obstructed use a urinary or suprapubic catheter
If ureter obstructed, use a drainage tube (nephrostomy)

17
Q

What is the most common cause of acute interstitial nephritis?

A

Drugs e.g Penicillin, rifampicin, NSAIDs, allopurinol, furosemide

18
Q

What are clinical features of acute interstitial nephritis?

A

Fever, rash, arthralgia, eosinophilia, mild renal impairment, hypertension

19
Q

What is seen on urinalysis in acute interstitial nephritis?

A

Sterile pyuria and white cell casts