Brainscape's Knowledge GenomeTM

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


See full index

Clin Med 3- Exam 2 > AKI > Flashcards

AKI Flashcards

1
Q

Define AKI.

A

Abrupt decline in renal function manifesting as reversible acute inc in nitrogenous wastes over hours to weeks

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

What 6 conditions are at a higher risk for developing AKI?

A

(1) HTN
(2) congestive cardiac failure
(3) diabetes
(4) multiple myeloma
(5) chronic infection
(6) myeloproliferative disorders

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

What are the 3 big etiologies of AKI?

A

1) renal blood flow (prerenal azotemia): MAP <80mmHg then steep decline in GFR
2) intrinsic renal diseases-affecting small vessels, interstitium, glomeruli or tubules
Toxic, ischemic, obstructive acute tubular necrosis
3) postrenal processes-obstruction to urine flow in ureters, bladder, or urethra

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

What are 4 etiologies of prerenal AKI?

A

(1) hypovolemia
(2) dec CO
(3) dec effective circulating volume
(4) impaired renal autoregulation

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

T/F: prerenal injuries are the most common cause of renal failure.

A

True

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

What is the BUN:Creatinine ratio in prerenal injuries?

A

> 20:1

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

What does a urinalysis often reveal in prerenal injuries?

A

hyaline casts

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

What does a FeNA <1% suggest?

A

Prerenal azotemia

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

What does a FeNA >1% suggest?

A

Intrinsic renal failure

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

What does a FeNA >4% suggest?

A

Postrenal failure

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

What is influenced by diuretics, FeNa or FeUrea?

A

FeNa (FeUrea is not)

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

What does a FeUrea < 35% or FeUA < 9-10% suggest?

A

Prerenal etiology

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

What does a FeUrea > 50% or FeUA > 10-12% suggest?

A

ATN (acute tubular necrosis)

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

What are 3 findings on prerenal labs?

A

(1) volume depletion (hemoconcentration, elevated Na, BUN, Cr)
(2) dec CO/effective arterial volume (edema, low Na, albumin)
(3) urine output altered (oliguria or anuria, high specific gravity, normal sediment or hyaline casts, low urine Na)

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

How do you tx volume depletion in prerenal injury?

A

Free water deficit in L

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

How do you tx dec CO/effective circulating volume in prerenal injury?

A

Diuretics, nitrates, dobutamine

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

What are 7 types of intrinsic renal diseases?

A

(1) AIN
(2) ATN
(3) glomerular diseases
(4) pyelonephritis
(5) multiple myeloma
(6) renal artery thrombus/embolism
(7) vasculitis

18
Q

What is acute interstitial nephritis (AIN) caused by most commonly?

A

Allergic reaction to medication

19
Q

What are 5 findings of classic presentation of AIN?

A

(1) recent new drug exposure
(2) fever
(3) oliguria
(4) skin rash
(5) peripheral eosiniophilia

20
Q

What are 4 classes of medications (and the drug names) that are associated with AIN?

A

(1) antibiotics: vancomycin, beta-lactams, sulfonamides, rifampin, erythromycin
(2) acyclovir
(3) NSAIDs
(4) anticonvulsants (phenytoin, valproate, carbamazepine)

21
Q

What are 2 findings on UA of AIN?

A

(1) pyuria- WBCs (2) hematuria

22
Q

What are 2 tx for AIN?

A

(1) d/c offending agent (2) glucocorticoid therapy-may accelerate renal recovery

23
Q

What is acute tubular necrosis (ATN) and its causes?

A

Acute tubular cell injury that is usually reversible unless severe and prolonged; ischemia, sepsis and toxins (exogenous and endogenous nephrotoxins)

24
Q

What are 3 endogenous nephrotoxins associated with ATN?

A

(1) myoglobinuria
(2) hemoglobinuria
(3) uric acid

25
What is the main finding on UA of ATN?
pigmented granular casts (muddy-brown casts)
26
List the 5 tx options of ATN (and what cause of ATN they are associated with).
(1) aggressive volume replacement if nephrotoxic agent (2) high dose loop-diuretic if oliguria present and extracellular (3) protein restriction (4) d/c offending agent (5) dialysis
27
What are the 10 glomerular diseases and which 5 are associated w/chronic renal failure?
(1) infectious disease associated syndromes-post-streptococcal glomerulonephritis (2) nephrotic syndrome-minimal change disease (3) membranous glomerulonephritis (4) IgA nephropathy (5) Henoch-Schonlein Purpura Associated with chronic renal failure: (1) goodpasture syndrome (2) diabetic nephropathy (3) hypertensive nephropathy (4) progressive glomerulonephritis (5) polycystic kidney disease
28
What causes post-strep glomerulonephritis (PSGN)?
Immune-mediated disease: an immune complex containing strep Ag deposited in affected glomeruli (7-12 days post sore throat/impetigo)
29
What are 7 sx of PSGN?
(1) oliguria (2) cola colored urine (3) edema (4) HTN (5) malaise (6) anorexia (7) flank pain
30
How do you tx PSGN?
Antibiotics and sx tx
31
What 4 things do you find on UA of PSGN?
(1) hematuria (2) proteinuria (3) pyuria (4) RBC casts
32
What causes IgA nephropathy and what are 3 tx options for it?
IgA deposition in glomerulus | tx: ACEI/ARBs, steroids, renal transplant
33
What are 4 classic findings on clinical presentation of Henoch Schonlein Purpura?
(1) rash-especially LE’s and butt (2) abdominal pain/vomiting (3) arthralgias-knees, ankles (4) edema-hands, feet, scalp, ears
34
What are 3 major findings of nephrotic syndrome?
(1) heavy proteinuria (2) hypoalbuminemia (3) peripheral edema
35
What is the characteristic histologic finding of minimal change disease?
Diffuse effacement of the epithelial cell foot processes on electron microscopy
36
What is the first line tx of minimal change disease?
Prednisone
37
What is the tx of postrenal AKI?
Bladder catheterization or nephrostomy tube (b/c d/t obstruction, so tx based on where obstruction is)
38
What is polycystic kidney disease?
Multisystem and progressive genetic disorder w/cyst formation and enlargement of the kidney
39
What are 2 big si/sx of polycystic kidney disease?
Pain (abdomen, flank, back) and HTN
40
What are 4 main tx of polycystic kidney disease?
(1) BP management-ACE/ARB (2) pain control-avoid NSAIDS, cyst decompression, nephrectomy (3) tx recurrent infections (may develop UTI, infected cysts) (4) tx for hematuria-hydrate (transfuse if needed)
41
What are 4 findings that indicate need to dialyze pts?
(1) acidosis electrolytes (2) ingestions (3) overload (4) uremia

Clin Med 3- Exam 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions