Acute Kidney Injury Cases

Question 1

AIN most common meds

Answer 1

Beta lactams and quinolones

Question 2

Clinical presentation of AIN

Answer 2

Eosinophiluria (Hansel stain)

May also be present in others

Question 3

Path of AIN

Answer 3

Interstitial inflammation and tubulitis with T cell and monocyte infiltrates

Question 4

Dx of AIN

Answer 4

Renal scan with gallium scintigrtaphy (Se 58-100, sp 50-60)

Question 5

AIN tx

Answer 5

If <3 weeks, mininimal IF on bx, no contraindiciation to steroid…try steroid

if kidney function improves, continues steroids for 4-6 weeks followed by a taper

Question 6

Rhabdo induced AKI patho

Answer 6

Intrarenal vasoconstriciton

Myoglobin breakdown into ROS

Direct and ishcemic tubuar injury to proximal tubules

Tubular obstrciuton

Question 7

Rhabdo renal manifestations

Answer 7

Pigmented granular casts

Elevated CK

Dipstick pos for blood but no RBCs

Hypocalcemia

Question 8

TX of rhabdol

Answer 8

Conservative hypocalcemia managmeent