AKI

Question 1

Renal Failure based on RIFLE criteria

Answer 1

inc in Cr by 3, or .5 over Cr-4,

Question 2

Prerenal Una, FENA, FEurea

Answer 2

<20, <1%, <35%

Question 3

Renal(ATN) Una, FENA, FEurea

Answer 3

> 40, >2%, >50%

Question 4

muddy brown casts and epithelial casts

Answer 4

ATN

Question 5

WBC casts or waxy casts

Answer 5

AIN

Question 6

type 1 HRS time frame? Type 2 time frame?

Answer 6

2 weeks/weeks to months

Question 7

treatment for HRS?

Answer 7

albumin and vasoconstrictors

Question 8

how does albumin and vasoconstrictors treat HRS?

Answer 8

reverse splanchnic arterial vasodilation and restores effective circulating volume

Question 9

RBC casts, dysmorphic red cells on UA?

Answer 9

Acute GN

Question 10

KDIGO guidelines for contrast?

Answer 10

isotonic fluids, hold metforming 48h after, iso or hypoosmolar contrast

Question 11

Rhabdo UA?

Answer 11

pigmented casts, blood but no RBC

Question 12

UOP goal for rhabdo?

Answer 12

maintain 200-300 cc/hr

Question 13

other treatment modalities for rhabdo?

Answer 13

mannitol- free radicals, urine alkalinization

Question 14

irreversible cellular damage due to prolonged azotemia?

Answer 14

ATN

Question 15

fever, rash, flank pain, eosinophiluria, WBC casts?

Answer 15

AIN

Question 16

treatment for AIN?

Answer 16

fluids, steroids->MMF cyclosporine, cyclophosphamide

Question 17

KDIGO criteria for AKI?

Answer 17

> .3 from baseline, >1.5 in 48h,

Question 18

pathophysiology of rhabdo?

Answer 18

depletion of ATP leads to unregulated calcium and persistent muscle contraction leading to myocyte destruction

Question 19

fluid rate initially for rhabdo?

Answer 19

1-2 L/ hr

Question 20

2 MOA of HRS?

Answer 20

arterial vasodilation with reduced SVR and CO

activation of RAAS

Question 21

timing of atheroemboli AKI post PCI?

Answer 21

weeks

Question 22

Causes of atn

Answer 22

Prolong ischemia, sepsis, surgery, drugs, contrast, Heme

Question 23

Timing of CIN

Answer 23

24-48h

Question 24

rhabdo causes what kind of kidney injury?

Answer 24

ATN from myoglobin

Question 25

in ATN any benefit to lasix?

Answer 25

no

Question 26

mortality difference between oliguric or non oliguric renal failure?

Answer 26

no

Question 27

BUN/Cr ratio > 20:1,

Answer 27

prerenal AKI

Question 28

Uosm 300- 500, uNA 10-30, BUN/Cr ratio 10-20:1

Answer 28

obsrtuctive AKI

Question 29

BUN/Cr <10:1

Answer 29

intrinsic AKI

Question 30

hyaline casts versus granular casts

Answer 30

hyaline in prerenal, and granular in ATN

Question 31

high urine urea?

Answer 31

gout and TLS

Question 32

treatment of bleeding patients with uremia?

Answer 32

DDAVP and dialysis

Question 33

rhabdomyolysis tx?

Answer 33

fluids and alkalinization can be beneficial

Question 34

areas of the nephron most at risk from renal hypoperfusion?

Answer 34

straight segment of the proximal tubule, distal straight tubule