AKI

Question 1

Abrupt loss of kidney function w/ serum creatinine ≥ 3 w/in 48 hours (or ≥ 1.5x baseline) is concerning for what?

Answer 1

AKI DX test could also be decreased urine output, <0.5 ml/kg/hr x 6 hrs

Question 2

Three general causes of AKI? And which the most common?

Answer 2

Intrinsic > Prerenal > Postrenal

Question 3

Pt w/ AKI presents with hypovolemia, renal aa stenosis and edema. What should you suspects as the cause?

Answer 3

Prerenal

Question 4

Pt presents with AKI secondary to IV contrast use. What cause should you suspect?

Answer 4

Intrinsic

Question 5

Pt w/ obstruction of bilateral ureters resulting in decreased GFR. How should you classify at the cause?

Answer 5

Postenal

Question 6

What drug affect GFR?

Answer 6

NSAIDS ACE-I

Question 7

What is most common cause of postrenal ARF?

Answer 7

CA

Question 8

Muddy brown casts are pathognomonic for what?

Answer 8

Acute Tubular Necrosis

Question 9

What is the most common cause of intrinsic AKI?

Answer 9

ATN

Question 10

What is the relationship b/w GFR and creatinine?

Answer 10

Inverse

Question 11

If FENa is < 1% should you be concerned for prerenal cause of AKI or ANT?

Answer 11

AKI

Question 12

If FENa is >2% should you be concerned for prerenal cause of AKI or ANT?

Answer 12

ANT

Question 13

T or F: PTs w/ AKI will never recover renal function?

Answer 13

FALSE Most recover renal function but left with some dysfunction

Question 14

AKI can increased risk of what 2 diseases?

Answer 14

CKD ESRD

Question 15

What should you assess with every AKI pt?

Answer 15

Volume status

Question 16

TX for pt that is volume overloaded and is producing urine?

Answer 16

Diuretics (short term) Dialysis (long term)

Question 17

TX for pt w/ volume over load, low urine output, and severe metabolic acidosis?

Answer 17

Dialysis

Question 18

When would you give bicarb for tx of AKI?

Answer 18

No volume overload Diarrhea Awaiting dialysis

Question 19

What electrolyte, if elevated, can cause impaired NM transmission, and cardiac conduction abn?

Answer 19

Hyperkalemia

Question 20

Is hypocalcemia or hypercalcemia more common w/ AKI?

Answer 20

Hypocalcemia

Question 21

TX for Hypocalcemia w/ AKI?

Answer 21

IV Ca

Question 22

Pt w/ Trousseau’s sign, Chvostek’s sign and prolonged QT, what electrolyte should you be concerned about?

Answer 22

Hypocalcemia

Question 23

Is uremia more common w/ AKI or CKD?

Answer 23

CKD

Question 24

What is the tx for hyerphosphatemia (>5.5 mg/dl)

Answer 24

Dietary phosphate binders (Low serum ionized Ca = Ca containing High serum ionized Ca = non-Ca containing)

Question 25

Fluid, hormone, electrolyte, and metabolic ab will parallel renal function deterioration when what is in the blood?

Answer 25

urea (uremia)