AKI

Question 1

OBSTRUCTION BY AGE

Answer 1

YOUNG ADULT STONES

OLDER PROSTATE; STONES; RETROPERITONEAL MASS

Question 2

BLAND UA

Answer 2

NO BLOOD; NO PROTEIN; NO CELLS 
R/O GNF AND NEPHROTIC SYNDROME 
DDX 
MM - dipstick only check albumin
pre-renal 
post -renal 
hypercalcemia 
acute phosphate nephropathy 
tumor lysis syndrome 
ischemia with no infarction

Question 3

disptick proteinuria

Answer 3

really albuminuria
does not r/o MM
depends on urine concentration as well

Question 4

hematuria

Answer 4

if no RBCs – rhabdo
possible GNF
Foley
can be as well part of nephrotic sy

Question 5

WBC in urine

Answer 5

UTI /PYELO
dirty urine - women 
GNF 
sterile pyuria 
AIN

Question 6

PROTEIN/ CREATININ RATION

Answer 6

NOT GOOD IN AKI /CREATININ IS CHANGING

Question 7

AKI WITH LOW FE NA

Answer 7

ATN
SEPSIS
ANY PROCESS WHEN GLOMERULAR FILTRATION IS PRESERVED BUT TUBULAR FUNCTION IS IMPAIRED
CONTRAST
MYOGLOBULINURIA
LES THEN 1 % PRERENAL
ONLY IF OLIGURIA
DIURETIC CAN INCREASE FENA EVEN IF PRERENAL
NORMAL FGR FENA DEPEND ON PO INTAKE OF SODIUM

Question 8

More sensitive then FeNA in patient on diuretics is ?

Answer 8

FeCrea

if less then 35% it is prerenal AKI

Question 9

URINE CONCENTRATION IS NOT AS PRECISE AND THUS HELPFUL COMPARE TO FeNa

Answer 9

it depends on urine volume

Question 10

hyaline cast

Answer 10

poor perfusion

Question 11

granular casts

Answer 11

nonspecific CKD
POOR PERFUSION
ATN

Question 12

WAXY CAST

Answer 12

CKD

Question 13

WBC CAST

Answer 13

ATN
GNF
PYELO

Question 14

RBC CAST

Answer 14

GN

Question 15

GN UA

Answer 15

BLOOD WITH PROTEIN
SHOULD NOT BE LEUK ESTERASE –> UTI
NO RBC CAST DOES NOT R/O GN

Question 16

WHEN TO SUSPECT GN CLINICALLY

Answer 16

RESPIRATORY SYMPTOMS
SINUS SYMPTOMS
JOINTS
UA PROTEIN AND BLOOD

Question 17

AIN

Answer 17

RASH
FEVER
EOSINOPHILIA

Question 18

PPI AND KIDNEY

Answer 18

AIN WITHOUT TYPICAL TRIAD / RASH, FEVER, EOSINOPHILIA/
4-6 MONTHS LATER
STOP MEDICATION DOES NOT RESOLVE IT
STEROIDS

Question 19

URINE EOSINOPHILIA

Answer 19

NO SPECIFIC FOR AIN
RAPID GNF
POST CATH ATHEROEMBOLIC
AIN 
CYSTITIS, PROSTATITIS, PYELO

Question 20

CONTRAST NEPHROPATHY

Answer 20

DM2, PROTEINURIA
NS PREVENTION 
2-3 DAYS PEAK 
GRANULAR CAST 
FeNa <1%

Question 21

NSAIDS EFFECT ON KIDNY

Answer 21

• MCD
• IAN
• DECREASE AFFERENT VASODILATION–> GFR drops
• membranous
• NOT FSGN

Question 22

OLIGURIC AKI

Answer 22

RESPONSE TO DIURETICS DAY 4 PREDICT BETTER PROGNOSIS
DO NOT GIVE PROPHYLACTIC DIURETICS
SHORTER PERIOD OF OLIGURIA BETTER OUTCOME

Question 23

COVID19 AND AKI

Answer 23

• COLLAPSING GLOMERULONEPHROPATHY AFROAMERICAN
• AIN COMMON
• SOMETIMES VACCINE CAN BE ASSOCIATED WITH AKI
• UNCLEAR MECHANISM OF ACTION