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ENDO-RENAL > AKI > Flashcards

AKI Flashcards

1
Q

All of the following are TRUE about AKI EXCEPT:

A. Impairment of kidney filtration and excretory function over days to weeks
B. Increase in SCr with oliguria
C. May be asymptomatic or symptomatic
D. May involve injury to the kidney parenchyma
E. Two of the options
F. None of the options

A

F. None of the options

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2
Q

All of the following are causes of community-acquired AKI EXCEPT:

A. Heart failure
B. Use of NSAIDs
C. Sepsis
D. Obstruction of urinary tract
D. Malignancy
A

C. Sepsis

Hospital acquired:
> Sepsis
> Major surgery
> CHF / Liver failure
> Nephrotoxic medications
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3
Q

All of the following are clinical conditions associated with prerenal azotemia EXCEPT:

A. Hypovolemia
B. Hyponatremia
C. Decreased cardiac output
D. Impaired renal autoregulation
E. Two of the options
F. None of the options
A

B. Hyponatremia

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4
Q

All of the following are TRUE about prerenal azotemia EXCEPT:

A. Increase in SCr or BUN concentration
B. Occurs due to inadequate RPF and intraglomerular hydrostatic pressure
C. May involve parenchymal damage and rapidly reversible
D. Prolonged periods may lead to ischemic injury
E. Two of the options
F. None of the options

A

C. May involve parenchymal damage and rapidly reversible

Prerenal azotemia = NO parenchymal damage

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5
Q

Renal blood flow accounts for how much of the cardiac output?

A. 10%
B. 20%
C. 25%
D. 30%
E. 40%
A

B. 20%

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6
Q

Renal autoregulation usually fails once the systolic blood pressure falls below __________

A. 100 mmHg
B. 90 mmHg
C. 80 mmHg
D. 70 mmHg
E. 60 mmHg
A

C. 80 mmHg

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7
Q

Which of the following drugs limit/s renal efferent vasoconstriction?

A. Acetaminophen
B. Captopril
C. Losartan
D. Both A and B
E. Both B and C
F. All of the options
A

E. Both B and C

NSAID = Limit renal AFFERENT vasodilation –> Vasoconstriction

ACEIs and ARBs = Limit renal EFFERENT vasoconstriction –> vasodilation

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8
Q

All of the following are causes of intrinsic AKI in small vessels EXCEPT:

A. Glomerulonephritis
B. Vasculitis
C. TTP/HUS/DIC
D. Malignant HTN
E. Renal vein thrombosis
A

E. Renal vein thrombosis = large vessels

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9
Q

Which of the following drugs may cause INTRATUBULAR renal parenchymal damage?

A. Cisplatin
B. Gentamicin
C. Acyclovir
D. Rifampin
E. Two of the options
F. All of the options
A

C. Acyclovir

Tubular = Cisplatin/Gentamicin
Intratubular = Acyclovir/MTX
Interstitium = NSAIDs/Rifampin
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10
Q

Which of the following parts of the kidney is one of the most hypoxic regions in the body?

A. Renal pelvis
B. Renal medulla
C. Renal cortex
D. Fibrous capsule

A

B. Renal medulla

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11
Q

All of the following are TRUE about nephrotoxin-associated AKI EXCEPT:

A. Occurs due to extremely high blood perfusion
B. All structures of the kidney are vulnerable to toxic injury
C. Risk factors include older age, CKD, and prerenal azotemia
D. Hypoalbuminemia may increase the risk
E. Two of the options
F. None of the options

A

F. None of the options

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12
Q

All of the following are clinical courses of contrast nephropathy EXCEPT:

A. Rise in SCr beginning 72 hr after exposure
B. Peaking with 1-2 days
C. Resolving within 2 weeks
D. Two of the options
E. All of the options
A

E. All of the options

Contrast nephropathy:
> Rise in SCr beginning 24-48 hr after exposure
> Peaking with 3-5 days
> Resolving within 1 week

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13
Q

Which of the following chemotherapeutic agents may cause hemorrhagic cystitis and tubular toxicity?

A. Cisplatin
B. Carboplatin
C. Ifosfamide
D. Bevacizumab
E. Mitomycin C
A

C. Ifosfamide

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14
Q

Which of the following is the most common protein in urine?

A. Albumin
B. Uroerythrin
C. Uromodulin
D. Urobilinogen

A

C. Uromodulin = Tamm-Horsfall protein

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15
Q

Tamm-Horsfall protein is produced in what part of the nephron?

A. Proximal convoluted tubule
B. Distal convoluted tubule
C. Thick ascending limb of loop of Henle
D. Thin descending limb of loop of Henle
E. Collecting duct
A

C. Thick ascending limb of loop of Henle

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16
Q

Which of the following is TRUE about the pathophysiology of postrenal AKI?

A. Bidirectional flow of urine blockage (partially or totally)
B. Decreased interference with GFR
C. Increased intratubular pressures
D. Infiltration of ureteric wall
E. All of the options
A

C. Increased intratubular pressures

17
Q

All of the following are TRUE about diagnosis of AKI EXCEPT:

A. Rise from baseline of at least 0.3mg/dL within 48h
B. At least 50% higher than baseline within 1 week
C. Reduction in urine output to <0.5 mL/kg per h for longer than 6h
D. Two of the options
E. None of the options

A

E. None of the options

18
Q

A history of prostatic disease would highly suggest the possibility of what type of AKI?

A. Prerenal azotemia
B. Intrinsic AKI
C. Postrenal AKI
D. Any of the options

A

C. Postrenal AKI

19
Q

A 55 year old patient comes to visit your clinic. Upon diagnosis, you found out that he has systemic hypotension. Which of the following abnormalities would you suspect to be present?

A. Prerenal azotemia
B. Sepsis-associated AKI
C. Ischemia-associated AKI
D. Nephrotoxin-associated AKI
E. Postrenal AKI
A

C. Ischemia-associated AKI

20
Q

A 35 year old patient comes to visit your clinic. She has a history of poor fluid intake and occasionally uses NSAIDs as pain relievers. Which of the following would you suspect when laboratory results come out?

A. BUN/Cr ratio > 20
B. FeNa <1%
C. Granular casts in urine sediment
D. Positive culture
E. Two of the options
F. All of the options
A

E. Two of the options

Prerenal azotemia

BUN/Cr ratio >20
FeNA <1%
Hyaline casts
Urine specific gravity >1.018
Urine osmolality >500 mOsm/kg
21
Q

Which of the following would you see in a patient’s urine with malignant hypertension?

A. RBC casts
B. WBC casts
C. RTE casts
D. Granular casts
E. Eosinophils
F. Crystals
A

A. RBC casts

22
Q

Which of the following would you see in a patient’s urine with myoglobinuria and hemoglobinuria?

A. RBC casts
B. WBC casts
C. RTE casts
D. Granular casts
E. Eosinophils
F. Crystals
A

C. RTE casts

23
Q

Which of the following would you see in a patient’s urine with tubulo-interstitial nephritis

A. RBC casts
B. WBC casts
C. RTE casts
D. Granular casts
E. Eosinophils
F. Crystals
A

C. RTE casts

D. Granular casts

24
Q

Which of the following would you see in a patient’s urine if he/she uses acyclovir?

A. RBC casts
B. WBC casts
C. RTE casts
D. Granular casts
E. Eosinophils
F. Crystals
A

F. Crystals

25
Q

Which of the following would you see in a patient’s urine with cystitis?

A. RBC casts
B. WBC casts
C. RTE casts
D. Granular casts
E. Eosinophils
F. Crystals
A

E. Eosinophils

26
Q

Oliguria is defined by which of the following?

A. <500 mL/24hr
B. <400 mL/24hr
C. <350 mL/24hr
D. <300 mL/24hr

A

B. <400 mL/24hr

27
Q

AKI often leads to all of the following electrolyte abnormalities EXCEPT:

A. Hyperkalemia
B. Hyperphosphatemia
C. Hypocalcemia
D. Hypomagnesemia
E. None of the options
A

D. Hypomagnesemia

28
Q

All of the following are general guidelines in management of AKI EXCEPT:

A. Optimization of systemic and renal hemodynamics through volume resuscitation
B. Elimination of ACEIs, ARBs, etc.
C. Renal replacement therapy when indicated
D. Calorie intake (20-30 kcal/kg per day) to avoid negative nitrogen balance
E. None of the options

A

D. Calorie intake (20-30 kcal/kg per day) to avoid negative nitrogen balance

29
Q

The use of calcium gluconate or calcium chloride is indicated to which of the following specific issues of AKI?

A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hyperphosphatemia
E. Two of the options
F. All of the options
A

E. Two of the options

30
Q

The administration of regular insulin and glucose is indicated to which of the following specific issues of AKI?

A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hyperphosphatemia
E. Two of the options
F. All of the options
A

B. Hyperkalemia

31
Q

Which of the following has the best prognosis?

A. Prerenal azotemia
B. Sepsis associated AKI
C. Ischemia associated AKI
D. Nephrotoxin associated AKI
E. Postrenal AKI
A

A. Prerenal azotemia

32
Q

Kidney failure has a GFR of which of the following?

A. >90
B. 45 - 89
C. 30 - 44
D. 15 - 29
E. <15
A

E. <15

G1: Normal; >90
G2: Mildly decreased; 60 - 89
G3a: Mildly to moderately decreased; 45 - 59
G3b: Moderately to severely decreased; 30 - 44
G4: Severely decreased; 15 - 29
G5: Kidney failure; <15

ENDO-RENAL (4 decks)

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