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Year2 Renal > Exam 3- Acute Renal Failure Pales > Flashcards

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

A

pre-renal

17
Q

what damage do kidneys get from pre-renal damage

A

none

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
Q

Why would creatinine go up after a surgery for GI ulcer and dehydrated man suffering from acute interstitial nephritis that was just reperfused

A

part of the maintenance phase of kidney recovery from AKI

26
Q

what are the phases of recovery in AKI

A

initiation, extension, maintenance, recovery

27
Q

how do you Tx post renal ARF from obstruction

A

remove obstruction

28
Q

What is DIC

A

increased coagulopaty

more Hb etc..

29
Q

When giving fluids over period of time and shows worsening renal conditions what must you look at

A

intake and output of fluids each day

30
Q

what are some nephrotoxic medications

A 
radiocontrast dye
acyclovir
sulfonamides
methotrexate
cyclosprine
tacrolimus
amphotericin B
aminoglycosides
cisplatin
pentamidine
ethylene glycol
toluene
cocaine
HMG-CoA reductase inhibirors
31
Q

what is prognosis of radiocontrast related nephropathy

A

gets better with time

32
Q

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?

A

intrarenal

no eosinophils- not acute interstitial nephritis

33
Q

RBC casts are indicative of what

A

glomerulonephropathy

34
Q

what GN involves lungs too

A

goodpastures and wegeners

35
Q

final step to Dx acute renal failure if blood tests and everythin unremarkable

A

biopsy

Year2 Renal (20 decks)

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