AKI

Question 1

what is the serum creatinine + urine output criteria for STAGE 1 AKI

Answer 1

increase of serum creatinine by more than 26umol/l within 48 hours

<0.5ml/kg/hour for > 6 consecutive hours

Question 2

what is the serum creatinine + urine output criteria for STAGE 2 AKI

Answer 2

increase >2-2.9 times reference of serum creatinine

<0.5ml/kg/hour for > 12 hours

Question 3

what is the serum creatinine + urine output criteria for STAGE 3 AKI

Answer 3

increase > 3 x reference level serum creatinine

<0.3ml/kg/hour for > 24 hours
OR anuria for 12 hours

Question 4

what on a urine dipstick indicates intrinsic renal disease?

Answer 4

> 3+ protein

Question 5

What are the 4 complications that arise from AKI that indicate dialysis if not controlled with medical therapy?

Answer 5

1. Pulmonary oedema
2. Hyperkalaemia
3. Metabolic acidosis
4. Uraemic encephalopathy (confusion, coma, seizure, myoclonic jerks) or Uraemic pericarditis

Question 6

What is the SALFORD checklist?

Answer 6

A checklist to improve the care of patients with AKI

S - sepsis
A - assess and review; ACEi, ARBs, NSAIDs
L - labs - repeat daily U+E’s, repeat creatinine within 24 hours
F - fluid assessment; daily weights, urine output, fluid balance chart, if hypovolemic = 250 mls IV bolus
O - obstruction;USS within 24 hrs in non resolving AKI 3
R - renal/critical care referral
D - Dip urine + record

Question 7

what does the histology of acute tubular necrosis show?

Answer 7

sloughing of the renal tubular endothelium causing dilation and obstruction of tubules and some mild leucocyte infiltration

Question 8

what are the 3 phases of acute tubular necrosis?

Answer 8

1) oliguric phase
2) maintenance phase
3) polyuric recovery phase

Question 9

what is average urine output?

Answer 9

0.5-1 ml/kg/hour

Question 10

what is average fluid intake?

Answer 10

30ml/kgl

Question 11

name cyrstalloids

Answer 11

• NaCl 0.9% (saline)
• hartmans solution
• Glucose 5%

Question 12

what is the role of colloid fluids? and name 2

Answer 12

Contain large molecules such as gelatin and responsible for expanding intravascular space.
carry a small risk of anaphylaxis

• isoplex and volplex

Question 13

what are the 3 components of blood products?

Answer 13

Packed red blood cells
Platelets
Fresh frozen plasma

Question 14

name 2 medications that have the side effect of hyponatraemia

Answer 14

• omeprazole

- furosemide

Question 15

vitamin d replacement medication name

Answer 15

ALFACALCIDOL