AKI

Question 1

First step in expected AKI

Answer 1

Urinalysis

Question 2

AIN leads to

Answer 2

Cellular/fluid exudation in IS

Question 3

AIN etiology

Answer 3

Allergic/drugs mc (beta lactams, quinolones) (7-10 days after exposure)
Infectious
Autoimmune
Idio

Question 4

AIN Presentation

Answer 4

Fever, maculopapular rash, eosinophilia, hematuria

Different for diff classes of medications

Question 5

AIN labs

Answer 5

elevated BUN/Cr
Eosinophilia
Ab LFT
Anemia
IgE up

Question 6

AIN Eosinophiluria test

Answer 6

Hansel Stain, not hallmark

Question 7

AIN Path

Answer 7

Interstitial inflamm and tubulitis

Lymphocytes (Tcells) and monocytes

Question 8

AIN Dx

Treatment

Answer 8

Renal scan with gallium scintigraphy

Discontinue agent
Steroids
MMF

If AKI <3 wks, try steroids
If KF improves, contin steroids for 4-6 wk, taper for 4

Question 9

ATN Rhabdo Therapy

Answer 9

IV isotonic fluids
Avoid nephrotoxics
Close monitorying

Question 10

Rhabdo AKI path

Answer 10

Intrarenal vasoconstriction, generation of free radicals
Direct ischemic toxic injury
Tubular obstruction

Question 11

Rhabdo manifestations

Treatment

Answer 11

Pigmented granular casts
Elevated CK
Dipstick + for blood but no RBC

Conservative hypocalcemia management