AKF lentele su osm ir ENa 12/13

Question 1

Prerenal. GFR?

Answer 1

decr. blood flow –> less filtered -> decr. GFR

Question 2

Prerenal. what creatinine and urea in blood?

Answer 2

Rass -> na + H2o + urea absorbtion -> urea more than creatinine in blood
BUN:Cr > 20:1

Question 3

Prerenal. whats is azotemia?

Answer 3

Urea and creatinine in blood stays due to decreased blood flow –> decr. GFR –> decr. filtration

Question 4

Prerenal. why oliguria?

Answer 4

decr. GFG +
due to RASS –> na and H2o reabs. –> less H2o in urine

Question 5

Prerenal. What na in urine?
UNa ir FENa?

Answer 5

intact cells -> na is reabsorbed due to influence of RASS
UNa < 20 mEq/l
FENa < 1 proc.

Question 6

Prerenal. Urine osmol?

Answer 6

osm > 500 mOsm/l
because decr. GFR -> decr. urine
and due to RASS influence more H2o is reabsorbed -> more concentrated urine

Question 7

Prerenal. what casts?

Answer 7

hyaline casts

Question 8

Intrarenal. what creatinine and urea in blood?

Answer 8

stays in the blood BUT
cells are damaged –> less urea is reabsorbed –> less in blood
BUN:Cr <15:1

Question 9

Intrarenal. What na in urine?
UNa ir FENa?

Answer 9

Damaged cells –> cannot reabsorb –> more Na stays in urine
UNa > 40 mEq/l
FENa > 2 proc.

Question 10

Intrarenal. urine osmol?

Answer 10

damaged cells cannot reabsorb water (cannot concentrate urine) –> stays in urine
urine osm < 500mOsm/kg (kitur raso <350 mOsm/kg)

Question 11

Intrarenal. Casts? What they do to basement membrane?

Answer 11

brown granular casts.
obstruct the lumen and lead to rupture of the basement membrane

Question 12

Postrenal. early. BUN:Cr?

Answer 12

obstruction forces urea back to blood
BUN:Cr >15:1

Question 13

Postrenal. early. FENA and UNa?

Answer 13

cells are intact.
UNa < 20 mEq/l
FENa <1 proc.

Question 14

Postrenal. early. urine osmol?

Answer 14

intace cells -> reabs. water
urine osmol > 500 mOsm/kg

Question 15

Postrenal. late. BUN:Cr

Answer 15

with long standing obstruction ensues cell damage –> cannot reabsorb ure
BUN: Cr < 15:1

Question 16

Postrenal. late. FENa and UNa?

Answer 16

with long standing obstruction ensues cell damage.
UNa > 40 mEq/l.
FENa > 2 proc.

Question 17

Postrenal. late. Osmol?

Answer 17

with long standing obstruction ensues cell damage –> cannot reabsorb water
osmol < 500 mOsm/kg.

Question 18

Postrenal. GFR, why?

Answer 18

decreased. Increased pressure downstream –> cannot filter

Question 19

Intrarenal - shredded cells form casts -> obstruction -> increase pressue -> decr GFR

Answer 19

.

Question 20

Intrarenal. Due to decr. ability of reabsorbtion/secretion what other component accumulate in the blood and what changes? 2

Answer 20

K –> Hyperkalemia
acids -> Metabolic acidosis

Question 21

Why ischemic ATN during surgery?

Answer 21

due to loss of blood;
requiring cardiopulmonary bypass;
CLAMPING OF AORTA

—> hypoperfusion –> ATN