Finals

Question 1

how much urine does the kidney filter a day

Answer 1

150 litres a day!!!!!!!!!!

Question 2

What makes creatinine

Answer 2

muscle

Question 3

How will you assess for pre-renal AKI

Answer 3

Check for shock/hypotension
Dehydration
Heart failure
Acute blood loss

Question 4

How will you assess for renal AKI/other causes of AKI

Answer 4

ATN from contrast / drugs - stop these drugs
Glomerulonephritis/acute interstitial nephritis
Rhabdomyolysis

Question 5

Post-renal causes of AKI

Answer 5

Stones
Cancer - bladder, prostate, retroperitoneal
BPH
Neurogenic bladder

Question 6

Invx for AKI

Answer 6

Urinalysis
Infection - leucocytes and nitrites
Acute nephritis - protein and blood

Na level excreted in kidney - less excretion in post renal

Question 7

AKI prevention

Answer 7

Avoid nephrotoxic meds
Ensure adequate fluid intake - oral or IV
Additional fluids before and after radiocontrast agents but there’s no

Question 8

AKI management

Answer 8

NSAIDS
ACEi

Withhold/adjust meds that may accumulate with reduced renal function
Relieve obstruction with catheter
Dialysis

Question 9

Heart failure + AKI is called

Answer 9

Cardiorenal syndrome

Vasodilatory drugs - GTN, IV abx
ITU / HDU

Question 10

Dialysis indications (AEIOU)

Answer 10

A - acidosis
E - electrolyte disturbance
I - intoxication
O - oedema
U - symptomatic uremia - encephalopathy and pericarditis

Answer 11

Colchicine and analgesia
Dialysis

Question 12

How long can it take to

Answer 12

6 weeks

Question 13

What’s the dose of

Question 14

Causes of hyperkalemia

Answer 14

AKI, CKD
Rhabdomyolysis
Adrenal insufficiency
Tumour lysis syndrome

Question 15

Severe hyperkalemia

Answer 15

Over 6.5

Answer 16

Tall tented T waves
Flattening of absence of P waves
Prolonged PR interval
Broad QRS complex

Question 17

Hyperkalemia management

Answer 17

Cardiac monitoring
A to E approach
Senior help

50ml 20 percent glucose
6-8 units actrapid
IV calcium gluconate 10ml 10percent - protects for about 6 hours

Question 18

Hyperkalemia other options

Answer 18

Neb salbutamol
Calcium resonium
Sodium ciruconium

Question 19

Hyperkalemia goes with which ABG picture?

Answer 19

Metabolic acidosis

Question 20

Oedema differentials

Answer 20

RHF
CHF
Liver failure

Question 21

Someone has oedema and

Answer 21

Dipstick urine for blood and protein
Urine for ACR ratio
14 hr collection for protein

Question 22

Causes of CKD

Answer 22

Diabetes
HTN
Medications
Glomerulonephritis
PKD

Question 23

Investigation for CKD

Answer 23

eGFR/creatinine

ACR/PCR to quantify proteinuria

haematuria with urine dip/micrsoppcy

USS

BP, HBA1c, Lipid profile, nephritis screen

Question 24

Mx of CKD

Answer 24

Control underlying disease e.g. diabetes
BP control
Minimise proteinuria

ACEi/ARB
SGLT2
Exercise

Question 25

Problems due to CKD

Answer 25

Anaemia - loss of EPO - give erythropoetin/iron

Acidosis

Bones - give Vit D

Clearance

Drugs

Electrolytes

Fluid balance

Question 26

AV Fistula auscultation signs

Answer 26

machinery murmur
thrill

Question 27

AV fistula complications

Answer 27

Hand ischemia - STEAL syndrome
High output failure

Question 28

Tunnelled dialysis lines

Answer 28

Over clavicle

Tunnelled dialysis lines / tesio lines for haemodialysis

Question 29

Tenckhoff catheter use vs tesio line

Answer 29

For peritoneal dialysis - tenkckhoff catheter

tesio line = haemodialysis

Question 30

Why are ACE inhibitors differentially preferred in AKI vs CKD

Answer 30

Efferent arteriole vasodilation, less glomerular flow - bad in AKI

But this is protective in CKD

Question 31

When do you give ACEi in chronic kidney disease?

Answer 31

Anyone with proteinuria should be on an ACEi

Question 32

How long does it take EPO to work?

Answer 32

6-8 weeks

but remember to give iron first

Answer 33

PKD 1 - chromosome 16
PkD2 - chromosome 4

Autosomal dominant

Question 34

PDK drugs

Answer 34

tolvaptan to

antihypertensives
Abx for infection preventions
genetic counselling for family