AKI and Critical care Flashcards
What are the 3 Cs you look for in urine microscopy?
cells, casts and crystals
Identify hyaline and waxy casts
Identify crystals in Perazella’s video
volume depletion
CKD
Two preparations name of Tenofovir
Tenofovir disoproxil fumarate vs Tenofovir Alafenamide
Which group of anti HIV medication do you want to avoid in kidney transplant recipients?
Protease inhibitors because of interaction( PI inhibit cytochrome p 450 3A4 and increases CNI level)
NNRTI: induces cyt 450 3A4 and decreases CNI level
NRTI like Tenofovir: no interaction
Integrase inhibitors: no interaction
HCV related kidney disease: name 4
1) Cryoglobulinemic GN and MPGN without Cryo
2) Membranous GN
3) PAN
4) Immunotactoid and Fibrillary
HCV cryoglobulinemic GN distinguishig feature
-low C4 and IFE: IgM Kappa + Polyclonal IgG
AL amyloidosis kidney involvement
1) proteinuria , AKI, CKD
2) non proteinuria, AKI/CKD due to amyloid deposition on vessels or interstitium
Differences between fibrillary and immunotactoid GN other than fibril size
-Immunotactoid: more in elderly, association with monoclonal gammopathy more 66% vs 15%
Which MGRS has least chances of having spike/ abnormal electrophoresis/ Bone marrow in periphery?
-PGNMID
What are the three tests you need to order for TTP?
-ADAMTS13 antigen level, activity <10% and inhibitor
What is the commonest genetic abnormality in c-TMA?
-heterozygous knock out of complement factor H
What is the nutrition recommendation for AKI on CRRT patients?
-protein intake of 2gm/kg/day
-25-35 KCal/kg/day
10-17% aminoacids lost in effluent
What is the calcium gap in citrate toxicity?
-total calcium/ iCa both in mol: >2.5
-total Ca/iCa mg/dl /mmol:>10
Suprisingly studies that looked didnt take serum albumin into account
What are the trials for early vs late initiation of RRT in AKI?
- AKIKI
- ELAIN
- IDEAL ICU
