Hyperkalemia And Acute Kidney Injury Flashcards
(77 cards)
1
Q
What is Dilutional Hyponatremia?
A
A condition characterized by renal dysfunction with increased intake of hypotonic fluids, excessive sweating, and impaired renal excretion of water.
2
Q
List some causes of Dilutional Hyponatremia.
A
- Syndrome of Inappropriate ADH (SIADH)
- Oliguric renal failure
- Severe congestive heart failure
- Cirrhosis
3
Q
What is Hyperkalaemia?
A
A condition where serum potassium (K+) levels exceed 5.5 mEq/L.
4
Q
What are the early clinical manifestations of Hyperkalemia?
A
- Hyperactive muscles
- Paraesthesia
5
Q
What are the late clinical manifestations of Hyperkalemia?
A
- Muscle weakness
- Flaccid paralysis
- Change in ECG pattern
- Dysrhythmias
- Bradycardia
- Cardiac arrest
6
Q
What is the initial treatment for Hyperkalemia?
A
- Find cause & treat
- Calcium gluconate IV
- Soluble insulin with 50% glucose IV
- Ion exchange resin
- Bicarbonate IV
7
Q
What is the long-term treatment for Hyperkalemia?
A
Dialysis.
8
Q
What are the clinical manifestations of Hypokalaemia?
A
- Weakness
- Flaccid paralysis
- Respiratory arrest
- Constipation
- Dysrhythmias
- Postural hypotension
- Cardiac arrest
9
Q
What is the treatment for Hypokalaemia?
A
Increase K+ intake, preferably by foods, but slowly.
10
Q
What is the etiology of Hyperkalemia?
A
- Renal disease
- Massive cellular trauma
- Insulin deficiency
- Addison’s disease
- Potassium-sparing diuretics
- Decreased blood pH
11
Q
True or False: Peritoneal dialysis is as effective as hemodialysis for treating Hyperkalemia.
A
False.
12
Q
What are some causes of Hypernatremia?
A
- Hypertonic IV solution
- Oversecretion of aldosterone
- Loss of pure water
- Long-term sweating with chronic fever
- Respiratory infection
- Diabetes
- Insufficient intake of water
13
Q
What is the treatment for Hyponatremia?
A
- Water restriction
- Sodium chloride administration
- Hypertonic saline for severe cases
- Vaptan
- Treat underlying aetiology
14
Q
What are the clinical manifestations of Hyponatremia?
A
- Neurological symptoms: lethargy, headache, confusion, seizures
- Muscle symptoms: cramps, weakness
- Gastrointestinal symptoms: nausea, vomiting, abdominal cramps
15
Q
What is the treatment for Hypernatremia?
A
- Desmopressin for DI
- Volume status assessment
- Salt restriction
- Loop diuretics with water
16
Q
What are the aetiologies of calcium imbalance?
A
- Hypocalcemia: post thyroid surgery, renal failure, hyperphosphatemia
- Hypercalcemia: renal dysfunction, malignant disease, nutritional disorders
17
Q
What are the clinical features of Hypocalcaemia?
A
- Tetany
- Depression
- Perioral paraesthesiae
- Carpopedal spasm
- Neuromuscular excitability
18
Q
What is the treatment for Hypercalcemia?
A
- Treat the etiology
- Saline diuresis with furosemide
- Inhibit bone resorption
- Hemodialysis
19
Q
What is the normal serum level of potassium?
A
3.5-5.0 mmol/L.
20
Q
What is the primary intracellular ion?
A
Potassium.
21
Q
Fill in the blank: An electrolyte is a substance whose components dissociate in solution into positively charged _______ and negatively charged _______.
A
[cations], [anions]
22
Q
What regulates sodium balance in the body?
A
ADH.
23
Q
What is the RDA for sodium?
A
2400 mg (1-2 mEq/kg/day).
24
Q
What is the RDA for potassium?
A
4700 mg (0.6-0.8 mEq/kg/day).
25
What is the significance of serum osmolality?
It helps assess the concentration of solutes in the serum.
26
Reference interval for hyperkalemia
3.5-5.0mmol/l
27
The most important intracellular cation Is?
Potassium
28
Which of the concentration of potassium (extracellular or intracellular ) is of clinical significance
Extracellular concentration
29
When does potassium arrest the heart
Diastole
30
When does calcium cause cardiac arrrest
In systole
31
What does AKI stand for?
Acute Kidney Injury
32
What is the primary clinical measurement used to diagnose AKI?
A rise in serum creatinine and a decrease in urinary output
33
According to KDIGO guidelines, what is one criterion for diagnosing AKI?
A rise from baseline of at least 0.3 mg/dL (26µmol/L) within 48 h
34
What is the KDIGO definition for a reduction in urine output indicative of AKI?
A reduction in urine output to <0.5 mL/kg per hour for >6 consecutive hours
35
What are common findings associated with AKI?
* Increased plasma urea
* Hyperkalemia
* Increased anion gap
36
What is the role of intravenous crystalloid solutions in AKI?
They may prevent further deterioration of AKI in many cases
37
What percentage of hospital patients experience AKI?
About 18%
38
What are some risk factors for developing AKI?
* Older age
* Pre-existing CKD
* Male gender
* Co-morbidities (e.g., diabetes, heart disease)
39
What are the three categories of AKI precipitating factors?
* Pre-renal
* Renal
* Post-renal
40
What is the most common cause of AKI?
Pre-renal AKI
41
What characterizes pre-renal azotemia?
Diminished renal function due to poor renal perfusion
42
What urine sodium concentration is typically seen in pre-renal azotemia?
Typically <20 mmol/L
43
What is the first urgent requirement in treating pre-renal AKI?
Restoration of extracellular volume
44
What is intrinsic AKI caused by?
Primary vascular, glomerular, or interstitial disorders
45
What is the most common kidney lesion seen in intrinsic AKI?
Acute tubular necrosis (ATN)
46
What are some nephrotoxins that can cause intrinsic AKI?
* Contrast agents
* Aminoglycoside antibiotics
* Hemoglobin
* Myoglobin
47
What is a common finding in urine for intrinsic renal azotemia?
Isosthenuric urine
48
What does the fractional excretion of sodium (FeNa) indicate?
The kidney's ability to reabsorb sodium
49
What is a typical serum urea to creatinine ratio in prerenal azotemia?
Above 40:1
50
What type of AKI occurs when urine flow is obstructed?
Post-renal AKI
51
What is one common urinalysis finding in prerenal azotemia?
Unremarkable or hyaline casts
52
What tests are crucial in the investigation of AKI?
* Blood tests
* Urinalysis
* Imaging (ultrasound)
53
What is the typical duration for renal tubular epithelial cell regeneration after injury?
3–4 weeks
54
What is a key feature of urine in intrinsic renal disease?
Urine sodium concentration >20 mmol/L
55
True or False: AKI is a disease entity.
False
56
What is the NEWS score derived from?
Seven physiological variables or vital signs
57
What can increased urinary output indicate in the context of AKI?
A normal kidney function
58
What type of obstruction may lead to post-renal azotemia?
Functional or structural obstruction
59
What is the significance of urinalysis in patients with AKI?
To test for infection, hematuria, and proteinuria
60
What is the primary characteristic of acute kidney injury (AKI) due to intrinsic renal pathology?
Typical features of AKI due to intrinsic renal pathology.
61
What laboratory finding indicates a patient has hyperkalemia?
Potassium level above 5.0 mmol/L.
62
What is the significance of a urea:creatinine ratio less than 40:1 in renal dysfunction?
It favors the diagnosis of intrinsic renal disease.
63
What are the four key components defining nephrotic syndrome?
* Massive proteinuria
* Hypoalbuminemia
* Peripheral edema
* Hyperlipidemia
64
Fill in the blank: Nephrosis is a clinical disorder defined by massive _______.
[proteinuria]
65
What laboratory tests are performed in nephrotic patients?
* Establish the clinical syndrome
* Evaluate renal function
* Define the underlying etiological process
* Monitor the effects of therapy
66
What is the typical urine sodium level in pre-renal AKI?
Less than 1%.
67
What is the most likely diagnosis for a patient with azotemia and a short duration of illness?
Acute kidney injury (pre-renal).
68
True or False: The fractional excretion of sodium is typically above 1% in intrinsic acute kidney injury.
True.
69
What are the laboratory findings of a patient with severe dyspnea and acute renal failure after drug withdrawal?
* Hypertension
* Elevated creatinine
* Elevated urea
* Altered sodium and potassium levels
70
What does a urine osmolality of 298 mosm/Kg suggest in the context of renal disease?
It is typical of intrinsic renal disease.
71
What is the expected change in urine output for a patient recovering from acute tubular necrosis (ATN)?
Urine output increases to >1500 mL/day.
72
What can happen if a patient's serum potassium falls to 3.1 mmol/L?
Oral potassium supplementation may be initiated.
73
What is the reference interval for plasma sodium levels?
132-144 mmol/L.
74
What laboratory value indicates metabolic acidosis in a patient?
Bicarbonate levels below the reference interval.
75
Fill in the blank: A plasma creatinine level of _______ mg/dL indicates severe renal impairment.
[greater than 5.0]
76
What are the typical laboratory findings for a patient undergoing acute renal failure?
* Elevated creatinine
* Elevated urea
* Variable sodium and potassium levels
77
What does a urine osmolality of 325 mosm/Kg indicate?
It suggests concentrated urine, possibly due to dehydration.
