Exam 1 thera AKI

Question 1

Nephrotoxic medications

Answer 1

PPI- azole
ARBS- Asartan
ACE-lil
Sulfamethoxazole and trimethoprim
Aminoglycosides- mycin micin
Vancomycin
Chinnese herbal medicine
NSAID
Methotrexate
Amphotericin B
VEGF
Biphosphonates
Polymyxins
Tenofovir

Question 2

Normal urine output

Answer 2

> 0.5mL/kg/hr

Question 3

Anuria

Answer 3

<100mL/day

Question 4

Oliguria

Answer 4

<400mL/day

Question 5

Non-oliguria

Answer 5

> 400mL/day

Question 6

KDGO criteria

Answer 6

Scr increases by 0.3mg/dl in two days
Scr increases by 1.5mg/dl in 7 days
Urine output decrease less than 0.5mL/kg/hr

Question 7

Urine analysis Prerena

Answer 7

Urine is normal

Question 8

Urine analysis Intra renal

Answer 8

-Granular Cast–> ATN
-Crystals
-Myoglobin because of muscle breakdown–>rhabdolysis
-WBC/eosinophils–> Acute interstitial nephritis
-Protein (albumin)–>Acute glomerular nephritis

Question 9

Post renal urine analysis

Answer 9

Crystals

Question 10

Pre renal

Answer 10

-Decrease blood flow to the kidneys
-Volume overload, acute heart failure exacerbation, edema, pulmonary effusion , blood loss, fluid loss in n/v, diarrhea and excercise, Hypotension (sepsis)

Compensatory mechanism:
RAAS and ADH will cause Na+ and H2O reabsorbtion and vasoconstriction
-Afferent artiole is dilated
-Efferent artiole is constricted

Nephrotoxic medications is NSAID, Diuretic, ARBS, ACE

Question 11

Pre renal treatment if volume is depleted

Answer 11

Give lacted ringers better than normal saline

Question 12

Pre renal if volume is overload
-Furosemide
-Bumetanide
-Torsemide

Answer 12

-Lasix
-Bumex
-Demadex

Question 13

When Pt is not responding to IV diuretic and experience little output give

Answer 13

Chlorothalidine PO
Chlorothiazide IV
Metolozone PO

Question 14

Acetazolamide

Answer 14

Diamox
-Give if pt is not respondig to loop diuretics and fluid overload from acute heart failure

Question 15

Intra renal Acute tubular necrosis

Answer 15

Is because of obstruction to the tubules and accumulation of cell debris cause release of granulated cast

Question 16

Intra renal acute tubular necrosis medication that cause it

Answer 16

Antibiotics-penicillin, aminoglycosides mycin and micin
Statins
Amphotecin B
Cocoine
Alcohol

Question 17

Intra renal acute tubular necrosis values

Answer 17

BUN/ScR 10-15
Urineanalysis - granular cast
Urine Na+ - >40
Urine Osm- around 300
FeNa- >2
Feurea - >50

Question 18

Intra renal crystal obstruction medication that cause it

Answer 18

Sulfamethoxazole and trimethoprim- bactrim
Acyclovir -zovirax
Methortrexate
Indinavir
Atazanivir

Question 19

Rhabdomylisis

Answer 19

-See elevated Scr Kinase
-Because of over exertion and prolonge muscle injury
-Statis cause it
BUN/Scr ratio is 5:1
Urineanalysis - brown myoglobin
Urine Na ->20
Urine Osm around 300
Fe Na% - >2
Fe Urea % >50

Question 20

1- Hyperkalemia treatment to stabalize the heart

Answer 20

Give 1g of Calcium Gluconate or 500mg-1000mg of Calcium Chloride

Question 21

2-Hyperkalemia treatment to move K+ into the cell give Insulin Regular

Answer 21

Novalin and Humalin 10 units IV + 25g of Dextrose IV

Question 22

3-Hyperkalemia treatment to move K+ out of the body Give Loop Diuretics
Furosemide
Bumetanide

Answer 22

Lasix 20mg-40mg
Bumex 1mg

Question 23

3-Hyperkalemia treatment to move K+ out of the body give K+ binding resins
1-Sodium polystyrene
2-Sodium Zirconium Cyclosilicate
3-Patiromer

Answer 23

1-Kayexalate
2-Lokelma
3-Veltessa

Question 24

Acidosis

Answer 24

When Bicarbonate is less than 16mEQ/L
Want to give 50MEQ of Sodium Bicarbonate

Question 25

Hyperphosphatemia
The normal range is?
How is it treated?

Answer 25

2.6-4.5
Hyperphosphatemia will be greater than 5
Give:
Calcium acetate
Calcium Citrate
Lanthanum
Ferric Citrate
Sucroferric Oxyhydroxide