Brainscape's Knowledge GenomeTM

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


See full index

Renal > AKI > Flashcards

AKI Flashcards

1
Q

What is an abrupt (<48hrs) reduction in kidney function defined as?

A

an absolute increase in serum creatinine by >26.4µmol/l

OR increase in creatinine by >50%

OR a reduction in UO (urine output)

Can only be applied following adequate fluid resuscitation & exclusion of obstruction

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

Increase >26µmol/L or
Increase > 1.5-1.9 x reference Cr

< 0.5 mL/kg/hr for > 6 consecutive hrs

A

KDIGO stage 1

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

Increase > 2 to 2.9 x reference SCr

< 0.5mL/kg/hr for > 12 hrs

A

KDIGO stage 2

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

Increase > 3 x reference SCr or increase to > 354
µmol/L or need for RRT

24hrs or 12 hrs for anuria

A

KDIGO stage 3

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

Drugs which could cause renal hypoperfusion?

A

NSAIDs/COX-2
ACEi/ARBs
Hepatorenal syndrome

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

Normal urine output?

A

0.5ml/kg/hour

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

What is oliguria?

A

<0.5ml/kg/hour

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

Antiotensin II and arteriolar vasoconstriction and ACEi’s

A

ACE inhibitors reduce Angiotensin II. Angiotension II mediates arteriolar vasoconstriction therefore increasing GFR. ACE I therefore can cause a fall in GFR by causing effferent arteriolar vasodilation.

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

Why can volume depletion/sepsis cause AKI?

A

Volume depletion/sepsis lead to decreased effective intravascular volume

This leads to increased ADH & aldosterone

Salt and water are retained

Then you get OLIGURIA

= AKI!

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

Untreated pre-renal AKI leads to what?

A

Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the commonest form of AKI in hospital?

A

Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Commonest causes of acute tubular necrosis?

A

Sepsis and severe dehydration

-other causes include rhabdomyolosis and drug toxicity

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

Treatment for pre-renal AKI?

A
  • Access for hydration

- Fluid challenge for hypovolaemia

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

How would you assess for hydration?

A

Clinical observations (BP, HR, UO)
JVP, capillary refill time, oedema
Pulmonary oedema

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

What is the fluid challenge for hypovolaemia in AKI?

A

Crystalloid (0.9% NaCl) or Colloid (gelofusin)
DO NOT USE 5% DEXTROSE

Give a bolus of fluid and then reassess and repeat as necessary
If >1000mls IN and no improvement, seek help!!

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

Cast nephropathy is a typical renal complication found in patients with which condition?

A

Multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diseases causing inflammation or damage to cells causing AKI?

A

RENAL AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vascular causes of renal AKI?

A

Vasculitis

Renovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Glomerular causes of renal AKI?

A

Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Interstitial nephritis causes of renal AKI?

A

Drugs
Infection (TB)
Systemic (sarcoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tubular injury as cause of renal AKI?

A

Ischaemia—prolonged renal hypoperfusion
Drugs (gentamicin)
Contrast
Rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs and symptoms of AKI?

A

Non specific symptoms

Anorexia, weight loss, fatigue, lethargy
Nausea & Vomiting
Itch
Fluid overload
Oedema, SOB

Signs
Fluid overload incl HTN, Oedema, Pul oedema, effusions (pleural & pulmonary)
Uraemia incl itch, pericarditis
Oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cardio complication of renal AKI?

A

Uraemic pericarditis

24
Q

Renal causes of eosinophila?

A

Interstitial nephritis
Infection
Eosinophilic cystitis

25
Q

HUS triad?

A

Anemia
Thrombocytopenia
Acute kidney injury

26
Q

Haematoproteinuria suggests what?

A

Active glomerulonephritis

27
Q

ANA

A

SLE

28
Q

ANCA

A

Vasculitis

29
Q

GBM

A

Goodpastures

30
Q

BJP?

A

Bence jones protein

-Used to diagnose and monitor mutliple myeloma

31
Q

Initial invesitgations for MM?

A

Protein electrophoresis and BJP (bence-jones protein)

-Everyone over 50 years

32
Q

What might low platelets suggest?

A

HUS

TTP

33
Q

What might abnormal clotting suggest?

A

DIC

Septic

34
Q

What might anaemia suggest?

A

CKD

Myeloma

35
Q

How would you diagnose a recent streptococal infection? e.g. if looking for cause of glomerulonephritis?

A

Culture (swab from throat or infected skin)

Serum antistrepsolysin-O titre

36
Q

Culture (swab from throat or infected skin)

Serum antistrepsolysin-O titre

A

Used to diagnose streptococcal infection

37
Q

Urgent indications for renal biopsy?

A

Suspected rapidly progressive GN

Positive Immunology & AKI

38
Q

Semi-urgent indications for renal biopsy?

A

Unexplained AKI to gain a diagnosis

Rule out obstruction, Volume depletion & ATN

39
Q

Life-threatening complications of AKI?

A 
Hyperkalaemia 
Fluid Overload (Pulmonary oedema)
Severe Acidosis (pH < 7.15)
Uraemic pericardial effusion
Severe Uraemia (Ur >40)
40
Q

What is severe acidosis?

A

pH <7.15

41
Q

What is severe uraemia?

A

Ur >40

42
Q

What is thrombotic microangiopathy?

A

Thrombosis in capillaries and arterioles due to endothelial injury

43
Q

What is post renal AKI?

A

Obstruction of urine flow leading to back pressure (hydronephrosis) and thus loss of concentrating ability

44
Q

Normal ranges of potassium?

A

3.5-5

45
Q

Hyperkalemia?

A

> 5.5

46
Q

Life threatening hyperkalemia?

A

> 6.5

47
Q

How could you assess hyperkalemia?

A

ECG

Muscle weakness

48
Q

ECG changes associated with hyperkalemia?

A

Normal

Peaked T waves

Flattened P waves, prolonged PR interval, depressed ST segment, peaked T wave

Atrial standstill, prolonged QRS duration, further peaking T waves

Sine-wave pattern

49
Q

Treatment for hyperkalemia?

A

Cardiac monitor & IV access

Protect myocardium!
(10mls 10% calcium gluconate)

Move K+ back into the cells

  • insulin (actrapid 10 units) with 50mls 50% dextrose (30 minutes)
  • Salbutamole nebs (90minutes)

Prevent absorption from GI tract
(calcium resonium–> but not in acute setting)

50
Q

Urgent indications for HD?

A

Hyperkalemia (>7, >6.5 unresponsive to medical therapy)

Severe acidosis (pH 40, pericardial rub/effusion

51
Q

Urgent indications for hemodialysis? HAFU

A

Hyperkalemia
Acidosis, severe
Fluid overload
Urea

52
Q

Consequences of AKI?

A

Increased hospital stay
Higher costs
Increased mortality
Increased risk of future CKD

53
Q

40 year old male presenting with general malaise & haemoptysis (Urea 28, Creatinine 600, elevated ant-GBM)

A

Goodpasture’s syndrome

54
Q

25 year old IVDA found collapsed at home

A

Rhabdomyolosis

55
Q

82 year old man admitted with BP 70 30, T 39, pulse 140bpm, K+ 7.0, urea 48, Cr 789, CRP 250, CXR left basal consolidation

A

Acute tubular necrosis

56
Q

72 year old man presenting with difficulty passing urine and reduced urine output

A

Obstructive uropathy

Renal (44 decks)

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