Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YR6: Renal + Urology > AKI > Flashcards

AKI Flashcards

1
Q

What is AKI?

A

Sudden decrease in kidney function manifested by an increase in serum creatinine or oliguria over ,<7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the diagnostic criteria of AKI

A

KDIGO Classification
Rise in serum creatinine >,26 umol/L within 48h
OR
Increase in serum creatinine to > 1.5X baseline within preceding 7 days
OR
Urine volume < 0.5ml/kg/hr for 6h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of AKI split into? Which is most common?

A

Pre-renal (most common): reduced perfusion +/ or hypotension leading to reduced GFR

Renal: structural damage to kidney

Post renal (least common): obstruction resulting in increased intratubular pressure + reduced GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes should be excluded first in AKI? Why?

A

Pre renal + post renal
Renal causes require a biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 3 broad pre renal causes of AKI

A

Hypovolaemia (e.g. haemorrhage, severe vomiting)

Reduced cardiac CO leading to hypotension: HF, Liver failure, sepsis, drugs

Renal hypoperfusion (e.g. NSAIDs, ACEi, ARBs, renal artery stenosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can prolonged pre-renal injury lead to intrinsic renal injury?

A

Decreased renal perfusion causes tubular necrosis

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List 4 renal causes of AKI

A

Glomerular: MCD, membranous GN
Tubular: acute tubular necrosis
Interstitial: acute interstitial nephritis (e.g. NSAIDs, AI)
Vasculitides (e.g. Wegener’s granulomatosis, HUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes HUS? What triad of S/S does it present with?

A

E.coli toxin 0157

MAHA
Thrombocytopenia
AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What pentad of signs and symptoms characterises TTP?

A

MAHA
Thrombocytopenia
AKI
Neurological impairment
Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes post renal AKI? List 4 specific examples

A 
Obstruction:
Calculi  
Urethral stricture 
Prostatic hypertrophy or malignancy  
Bladder tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give 9 risk factors for developing AKI

A 
Age >65 
CKD
Comorbidities (e.g. HF, DM, liver failure)  
Sepsis  
Hypovolaemia/ hypotension/ dehydration 
Use of nephrotoxic medications  
Emergency surgery 
Use of iodinated contrast agents within the past week 
Hx of AKI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most common causes of AKI?

A

STOP:
- Sepsis/ dehydration
- Toxins (NSAIDs, nephrotoxic drugs),
- Obstruction in urinary tract
- Parenchymal kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List 4 symptoms of AKI

A

Oliguria/ anuria
N+V
Dehydration
Confusion, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List 4 possible types of signs of AKI

A

Dehydration: orthostatic hypotension + reduced skin turgor
Fluid overload: raised JVP, pulmonary + peripheral oedema, SOB
Uraemia: encephalopathy, nausea
Renal obstruction: Distended bladder, incomplete voiding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe investigations for AKI

A

FBC
Metabolic panel inc. Urea + Creatinine + LFTs
CRP
UO monitoring
Urinalysis
Renal US if no identifiable cause/ risk of obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 main components of AKI management?

A

Prevent/ Tx hyperkalaemia
Optimise fluid balance
Stop nephrotoxic drugs
Consider for dialysis

17
Q

Describe initial management of hypovolaemic AKI

A

500ml IV bolus over 15 mins

18
Q

List 6 drugs safe to continue in AKI

A

Paracetamol
Warfarin
Statins
Aspirin (cardio protective dose of 75mg)
Clopidogrel
B-blockers

19
Q

List 5 drugs that should be stopped in AKI as may worsen renal function

A

NSAIDs
Aminoglycosides
ACEi
ARBs
Diuretics

20
Q

List 3 drugs that need to be stopped in AKI due to increased risk of toxicity

A

Metformin
Lithium
Digoxin

21
Q

List 4 additional steps to take in management of AKI?

A

Monitor serum creatinine, Na+, K+, Ca2+, phosphate + glucose
Identify + treat infection
Urgent relief of urinary tract obstruction
Refer to nephrology if intrinsic renal disease is suspected

22
Q

In which 4 situiations is renal replacement therapy considered? (PUSH)

A

Pulmonary oedema refractory to medical management
Uraemic complications
Severe metabolic acidaemia
Hyperkalaemia refractory to medical management

23
Q

List 6 complications of AKI

A 
Pulmonary oedema  
Acidaemia  
Uraemia  
Hyperkalaemia  
Bleeding 
Increased risk of developing CKD
24
Q

What is the prognosis in AKI? List 5 indicators of poor prognosis

A 
Mortality varies- depends on cause + comorbidities  
Indicators of poor prognosis: 
Age  
Multiple organ failure  
Oliguria 
Hypotension  
CKD
25
Q

Describe the epidemiology of AKI

A

15% of adults admitted to hospital develop an AKI
Most common in ELDERLY

26
Q

What does abrupt anuria suggest?

A

Post-renal obstruction

YR6: Renal + Urology (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions