Exam 3- Acute Renal Failure Pales Flashcards

1
Q

elevated creatinine is indicative of

A

renal failure

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2
Q

how do you know if renal failure is acute or chronic

A

compare to creatinine from before
size of kidneys on US
sediment on U/A

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3
Q

stigmata of chronic renal failure

A

anemia
hyperparathyroidism
A/V fistula
hyperphosphatemia

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4
Q

sediment on UA is indicative of acute or chronic renal failure

A

acute

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5
Q

What are the 2 tests you must order for kidney failure

A

Ultrasound

UA

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6
Q

What is indicatice of pre-renal damage on UA

A

normal or hyaline casts

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7
Q

What does muddy brown, granular epithelial casts mean on UA

A

tubular cell injury

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8
Q

pyuria, hematuria, mild proteinuira, granular and epithelial casts with eosinophils is indicative of what on UA

A

interstitial nephritis

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9
Q

hematuria, marked proteinuria, RBC casts and granular casts are indicative of what on UA

A

glomerulonephritis

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10
Q

normal or hematrual and mild proteinuria are indicative of what infrarenal acture kidney injury

A

vascular disorders

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11
Q

what does a post renal AKI UA look like

A

normal or hematuria, granular casts, pyuria

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12
Q

if fractional excretion Na is less than 1% what is location of AKI

A

pre renal

glomerulonephritis or vascular disorders

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13
Q

if urine Na is less than 10 what is location of AKI

A

pre-renal

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14
Q

if urine Na is more than 20 what is location of AKI

A

ATN, toxic injury

intrarenal

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15
Q

What can you see on renal ultrasound

A

hydronephrosis, stones, kidney size, PCKD, tumors

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16
Q

If Normal saline corrects BUN and creatinine, what does that tell you about the injury

17
Q

what damage do kidneys get from pre-renal damage

18
Q

why can albumin decrease in pre-renal AKI

A

because is an acute phase reactant

changes composition under certain stressors

19
Q

what are causes of pre-renal azothemia

A
intravascular volume depletion
decreased effective intravascular volume (cirrhosis, CHFm peritonitis)
systemic vasodilation (sepsis, hepatorenal syndrome)
large vessel renal vascular disease
20
Q

What meds make prerenal AKI worse

A
NSAIDs
ACEI
cyclosporine
tacrolimus
radiocontrast dyes
21
Q

ulnar deviation of wrist and fingers is indicative of what

A

rheumatoid arthritis

22
Q

what is the hypersensitivty reaction to med causing renal issues called

A

acute interstitial nephritis

23
Q

What can cause an extreme high BUN in an intra renal caused AKI

A

GI bleed

ulcer

24
Q

What would US look like from intrarenal ATN

A

looks normal

25
Why would creatinine go up after a surgery for GI ulcer and dehydrated man suffering from acute interstitial nephritis that was just reperfused
part of the maintenance phase of kidney recovery from AKI
26
what are the phases of recovery in AKI
initiation, extension, maintenance, recovery
27
how do you Tx post renal ARF from obstruction
remove obstruction
28
What is DIC
increased coagulopaty | more Hb etc..
29
When giving fluids over period of time and shows worsening renal conditions what must you look at
intake and output of fluids each day
30
what are some nephrotoxic medications
``` radiocontrast dye acyclovir sulfonamides methotrexate cyclosprine tacrolimus amphotericin B aminoglycosides cisplatin pentamidine ethylene glycol toluene cocaine HMG-CoA reductase inhibirors ```
31
what is prognosis of radiocontrast related nephropathy
gets better with time
32
patient with purpura on skin and URI that won't go away with hemoptysis scan shows lung nodules 3-5 days at hospital, creatinine increased and patient had swelling and hyperkalemia (on acute dialysis) US normal, UA negative for eosinophils pre? intra? post renal?
intrarenal | no eosinophils- not acute interstitial nephritis
33
RBC casts are indicative of what
glomerulonephropathy
34
what GN involves lungs too
goodpastures and wegeners
35
final step to Dx acute renal failure if blood tests and everythin unremarkable
biopsy