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RENAL II Exam 3 > Acute Renal Failure CIS > Flashcards

Acute Renal Failure CIS Flashcards

1
Q

aleve

A

NSAID

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2
Q

elevated creatinine

A

represent renal failure**

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3
Q

creatinine represents

A

GFR

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4
Q

acute kidney injury

A

acute renal failure

  • 50% increased in serum Cr
  • increase in serum Cr - 0.3
  • reduction in urine output less than 0.5 longer than 6 hours
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5
Q

acute or chronic kidney problem?

A
  • sediment
  • kidney size
  • compare previous Cr
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6
Q

acute sediment

A

active - casts

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7
Q

chronic sediment

A

bland

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8
Q

acute kidney size

A

normal

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9
Q

chronic kidney size

A

small and scarred

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10
Q

stigmata for chronic renal failure

A
  • anemia
  • hyperPTH
  • A/V fistula
  • hyperP
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11
Q

acute kidney injury

A

prerenal
renal
post renal

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12
Q

renal causes of acute kidney

A 
ischemia
toxic
glomerulonephritis
acute interstitial nephritis
renovascular obstruction
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13
Q

endogenous toxins

A

cause AKI > renal > toxic

-Mg, Hg, light chain, calcium, uric acid

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14
Q

hyaline casts

A

prerenal AKI**

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15
Q

muddy brown casts

A

intrarenal tubular cell injury
-ATN** - acute tubular necrosis

epithelial casts

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16
Q

eosinophils

A

intrarenal - interstitial nephritis

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17
Q

RBC casts

A

glomerularnephritis AKI

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18
Q

FeNa

A

urine Na x plasma Cr x 100 / plasma Na x Urine Cr

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19
Q

pre-renal FeNa

A

<10

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20
Q

urine Na

A

usually looked a for AKI work up

low in pre-renal
high in renal - can’t reabsorb

21
Q

prerenal urine Na

A

<10

22
Q

ATN urine Na

A

> 20

23
Q

toxic injury urine Na

A

> 20

24
Q

renal ultrasound

A 
hydronephrosis
kidney size
cysts
stones
tumors
25
Q

prerenal azotemia

A

no change to kidney

-hypoperfusion will recover normally

26
Q

causes of prerenal azotemia

A

shock , dehydration, hemorrhage, sepsis, vomiting, diarrhea, sweating, diuretics, DM, cirrhosis, CHF, hepatorenal syndrome, peritonitis, hepatorenal syndrome, renal a stenosis, embolism

27
Q

meds make prerenal azotemia worse

A 
NSAIDs
ACE (-)
diuretics
contrast dye
tacrolimus
cyclosporine
ARBs
28
Q

urinary sodium >20

A

think acute tubular necrosis

29
Q

acute interstitial nephritis

A

with NSAIDs

30
Q

upper GI bleed

A

can result in very high BUN

31
Q

muddy brown casts

A

ATN

-acute tubular necrosis

32
Q

stages of ATN

A

initiation - polarized cell
extension - depolarized cell
maintenance - dedifferentiated cell
recovery - polarized again

usually takes 1 week to recover**

33
Q

initation of ATN

A

falling GFR

polarized cell

34
Q

extension of ATN

A

depolarized cell

  • apoptosic/necrosis/lumen obstruction
  • GFR falling
35
Q

maintenance of ATN

A

dedifferentiated cells are reestablishing as tubular epithelium

36
Q

recovery of ATN

A

cell repolarization

-GRF rising

37
Q

neurogenic bladder

A

can be due to multiple sclerosis

-Tx catheter

38
Q

unilateral ureter obstruction

A

causes postrenal azotemia if they have one kidney or chronic kidney disease

39
Q

majority of postrenal azotemia

A

from bilateral ureter obstruction

40
Q

nephrotoxic meds

A 
aminoglycosides
contrast
acyclovir
cisplatin
sulfa
methotrexate
cyclosporine
tacrolimus
amphotericin B
foscarnet
pentamidine
ethylene glycol
toluene
cocaine
HMG-CoA recuctase (-)
41
Q

legs petechia, lung consolidations, RBC casts in urine,

A

wegeners granulomatosis

42
Q

causes of acute interstitial nephritis

A

beta-lactam antibiotics
diuretics
other antibiotics
NSAIDs

**eosiniphils in urine, rash, and elevated Cr

43
Q

RBC casts

A

something wrong with glomerulus

44
Q

wegeners

A

kidney, lung, sinus

45
Q

goodpasture

A

anti-GBM antibodies

46
Q

wegeners

A

c-ANCAs

47
Q

polyareritis nodosa

A

p-ANCAs

48
Q

final step if nothing else works

A

urinalysis, ultrasound, antibody check

do biopsy

RENAL II Exam 3 (17 decks)

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