Ch. 30 Renal - Book/2 Flashcards

1
Q

intrarenal/intrinsic AKI can result from

A

ischemic acute tubular necrosis ATN

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2
Q

prerenal AKI - poor perfusion can result from

5

A
  1. hypotension
  2. hypovolemia associated with hemorrhage or fluid loss i.e. burns
  3. sepsis
  4. inadequate CO i.e. MI
  5. renal vasoconstriction i.e. NSAIDs
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3
Q

what provide an index of renal function during the AKI recovery phase

A

plasma creatinine concentrations

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4
Q

AKI - prevention of injury is possible in which phase

A

initiation

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5
Q

renal failure refers to

A

significant loss of renal function

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6
Q

prevention of AKI involves avoidance of

3

A
  1. hypotension
  2. hypovolemia
  3. nephrotoxicity
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7
Q

postrenal AKI usually occurs with

A

UTO that affects the kidneys bilaterally

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8
Q

when less than 10% of renal function remains, this is termed

A

ESKD

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9
Q

AKI type - renal vasoconstriction i.e. NSAIDs

A

pre

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10
Q

anuria suggests

A

bilateral renal artery occlusion

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11
Q

caused by inadequate kidney perfusion

A

prerenal AKI

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12
Q

increased blood urea nitrogen levels and frequently increased serum creatinine levels

A

azotemia

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13
Q

rare AKI

A

post

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14
Q

what can serve as a measure of GFR (serum protein)

A

cystatin C

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15
Q

sudden decline in kidney function with a decrease in glomerular filtration and urine output with accumulation of nitrogenous waste products in the blood

A

AKI

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16
Q

interval when glomerular function returns but the regerating tubules cannot concentrate the filtrate

A

AKI recovery/polyuric phase

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17
Q

postrenal AKI causes an increase in intraluminal pressure upstream from the site of obstruction with gradual what

A

decrease in GFR

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18
Q

AKI maintenance phase is the period of

A

established kidney injury and dysfunction after initiating event has been resolved

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19
Q

renal insuff levels of serum creatinine and urea are

A

mildly elevated

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20
Q

AKI results from

4

A
  1. ischemic injury related to extracellular volume depletion
  2. ischemia from decreased renal blood flow
  3. toxic injury from chemicals
  4. sepsis-induced injury
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21
Q

AKI maintenance phase aka

A

oliguric phase

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22
Q

AKI phase in which reduced perfusion or toxicity in which kidney injury is evolving

A

initiation

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23
Q

anuria is uncommon in

A

ATN

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24
Q

AKI phases

A
  1. initiation
  2. maintenance
  3. recovery
25
Q

intrarenal AKI aka

A

intrinsic

26
Q

AKI phase where serum creatinine and blood urea nitrogen BUN increase

A

maintenance

27
Q

AKI recovery phase aka

A

polyuric phase

28
Q

type of renal failure that can occur after diagnostic catheterization of the ureters

A

postrenal AKI

29
Q

mechanisms that contribute to oligura

3

A
  1. alterations in renal blood flow
  2. tubular obstruction
  3. tubular backleak
30
Q

AKI pre renal aka

A

renal hypoperfusion

31
Q

AKI initiation phase is the phase of

A

reduced perfusion or toxicity in which kidney injury is evolving

32
Q

ESKD

A

<10% of renal function remains

33
Q

can result from ischemic acute tubular necrosis ATN

A

intra AKI

34
Q

intra AKI from ATN is related to

6

A
  1. prerenal AKI
  2. nephrotoxic ATN
  3. acute glomerulonephritis
  4. vascular disease
  5. allograft rejection
  6. interstitial disease
35
Q

a decline in renal function to about 25% of normal or a GFR of 25 to 30 ml/min

A

renal insufficiency

36
Q

AKI is a

A

sudden decline in kidney function with a decrease in glomerular filtration and urine output with accumulation of nitrogenous waste products in the blood

37
Q

AKI type - hypotension

A

pre

38
Q

AKI type - hypovolemia

A

pre

39
Q

uremia is a syndrome of renal failure and includes elevated what
2

A
  1. blood urea

2. blood creatinine

40
Q

AKI accumulation of nitrogenous waste products in the blood is to
2

A
  1. creatinine

2. blood urea

41
Q

most common reason for AKI

A

prerenal

42
Q

AKI - urine output is lowest during which phase

A

maintenance

43
Q

how much glomerular filtration must be lost before there is elevation of serum creatitine level

A

50%

44
Q

prerenal AKI is caused by

A

inadequate kidney perfusion

45
Q

AKI stands for

A

acute kidney injury

46
Q

AKI phase where diuresis is common

A

AKI recovery

47
Q

AKI type - shock

A

pre

48
Q

AKI type - inadequate CO i.e. MI

A

pre

49
Q

intra AKI - microcirculatory vasoconstriction occurs in response to

A

injury and inflammation

50
Q

renal insufficiency refers to

A

a decline in renal function to about 25% of normal or a GFR of 25 to 30 ml/min

51
Q

uremia is a syndrome of

A

renal failure

52
Q

Cystatin C

A

serum protein freely filtered at the glumerulus, that can act as a measure of GFR

53
Q

characteristic finding of postrenal AKI

2

A
  1. several hours or anuria

2. flank pain with polyuria

54
Q

AKI phase - established kidney injury and dysfunction

A

maintenance/oliguric phase

55
Q

uremia is accompanied by

6

A
  1. fatigue
  2. anorexia
  3. nausea
  4. vomiting
  5. pruritus
  6. neurologic changes
56
Q

refers to significant loss of renal function

A

renal failure

57
Q

azotemia is characterized by

A

increased blood urea nitrogen levels and frequently increased serum creatinine levels

58
Q

AKI recovery/polyuric phase

A

interval when glomerular function returns but the regeneration tubules cannot concentrate the filtrate