Acute Renal Failure

Question 1

ESRD is comfirmed by what

Answer 1

Need RRT for > 3 months prior to the diagnosis

Question 2

RIFLE criteria

Answer 2

1.5X increase in creatinine

GFR decrease by 25% or UOP < 0.5 cc/kg/hr for 6 hours

Question 3

In what conditions can NSAIDS cause AKI

Answer 3

Dehydration or allergic reaction causing allergic interstial nephritis

Question 4

Can mannitol, lasix or low dose dopamine help with AKI

Answer 4

inconclusive results in the literature

Question 5

Isostenuria

Answer 5

concentrating defect in kidneys in SS disease patients

Note - upper end normal CR in SS disease patients - can be abnormal

Question 6

Biggest risk factor for contrast nephropathy

Answer 6

Dehydration and/or pre-existing renal disease

Question 7

Sickle cell trait patients - nephro complications

Answer 7

Acute meduallary necrosis and medullary carcinoma

Question 8

What should you get if patient has glomeular hematuria

Answer 8

C3/C4 +/- ASO +/- ANA, anti Ds DNA, SLE serologies

Question 9

Gn is divided into 2:

Answer 9

Low complement and complement associated

Question 10

Hypocomplemtemic GN

Answer 10

PIGN, MPGN, SLE Chronic bacteremia HUS( not truly a GN) - everything else is non-complementemia

Question 11

Acute GN - divided into

Answer 11

rapidly progressive and non rapidly progressive

Question 12

RPGN -

Answer 12

50% decline in GFR days - months - SLE , PIGN, MPGN IgA

Question 13

Intra-renal AKI - Acute intersitial nephritis - causes

Answer 13

Meds - e.g. NSAIDs
Abx - PCNs
Virals
Infiltrative disease

Question 14

AIN - what does the urine look like

Answer 14

Tubular injury and dead tubular cells - but you may see eosinophils and tub

Question 15

What is a granular cast

Answer 15

Tubular cells have necrosed and sloughed off -

Question 16

‘Bland urine’ - new medications

Answer 16

Think of intra-renal AKI

Question 17

PSGN - indications for admission

Answer 17

Hypertension and abnormal kidney function

Question 18

Kayexalate - what is it high in - cautions ?

Answer 18

High sodium - - uses sodium to kick out K - best to give rectal - but it is hyper osmolar - caution with bowel disease - can precipitate bowel perf

Question 19

After you have corrected dehydration what rehydraion regimen would you start

Answer 19

1/3 MIVF + UOP + strool losses

Question 20

Bottom age cut off for ibuprofen

Answer 20

Try and avoid under 1 year due to renal immaturity