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**Old DOOS > Kidney 4 > Flashcards

Kidney 4 Flashcards

1
Q

is acute kidney injury (AKI) reversible

A

often yet if treated right

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2
Q

Rapid reduction in renal function (days)
Reduction of creatinine clearance by 50%
Increase of 0.5 mg/dl over baseline creatinine
Increase of 50% over baseline creatinine

A

Acute renal failure

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3
Q

what stage is Acute Kidney Injury if there is an increase in SCr by 2.0-2.9 x BL
or 12 hours

A

Stage 2 AKI

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4
Q

what stage is Acute Kidney Injury if there is an increase in SCr by 1.5-1.0x BL or >0.3mg/dL Or
<0.5 ml/kg/h x 6-12 hours

A

Stage 1 AKI

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5
Q

what stage is Acute Kidney Injury if there is an increase in SCr by 3.0x BL or incrase SCr to 4.0 mg/dl or initiation of RRT (dialysis)
12 hours

A

Stage 3 AKI

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6
Q

an increase in what for SCr is considered acute renal failure?

A

2.5

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7
Q

what drugs cause decreased proximal tubular secretion. This will increase SCr because they compete w/ creatinine to get out of the body.

A

Cimetidine
Triamterene
trimethoprim

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8
Q

what substances causes analytical interference w/ plasma creatinine

A

ketones
cephalosporins
methanol
isopropylalcohol

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9
Q

what cause increased BUN?

A 
Increased protein intake
Amino acid infusions
GI bleed
Catabolic states
Steriods
Tetracyclines
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10
Q

ARF caused by sudden and severe drop in BP or interruption of blood flow

A

prerenal ARF

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11
Q

what type of ARF is due to obstruction of urine flow due to englarged prostate, kidney stones, bladder tumor or injury

A

post renal ARF

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12
Q

what type of ARF is due to direct damage to the kidneys by inflammation, toxins, drugs, infection or reduced blood supply

A

intrarenal ARF

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13
Q

best non-invasvie test for renal anatomy

A

US

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14
Q

what causes most acute kidney injury

A

prerenal injury

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15
Q

what are brown casts indicative of?

A

acute kidney injury

tubular necrosis

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16
Q

what is an osmotic challenge?

A

diabetes

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17
Q

what causes most acute kidney injury

A

iatrogenic (something that is being done to the patient)

18
Q

what drugs can cause acute kidney injury

A 
aminoglycosides
ACEI
ARB
NSAIDs
radiocontrast
cyclosporin
cisplatin
diuretics
tacrolimus
heme pigments
19
Q

what can be used to prevent acute kidney injury due to contrast?

A 
fluids
diuretics (give after) 
mannitol
acetylcysteine
bicarbonate
20
Q

if some one is one what drugs should you use caution when using contrast?

A 
ACEI
ARB
NSAID
diuretics 
(should be off of these meds for 24-48 hours before giving contrast if elective procedure)
21
Q

what can cause interstitial nephritis

A 
allergic rxn to drugs
autoimmune dz (lupus)
infiltrative dz (sarcoidosis)
infectious process (legionaries)
22
Q

if someone presents w/ mild proteinuria, sterile pyruia (don’t grow on cultures), polyuria and nocturia, osinophiluria, RTA, fanconi-like syndrome (glycosuria, phosphaturia, aminoaciduria)

A

tubule interstitial nephritis

23
Q

what is the most common cause of post-renal acute kidney injury

A

prostatic hypertrophy

24
Q

what drugs are associated w/ stone formation

A 
Sulfonamides (not as common now) 
Methotrexate
Acyclovir
Triamterene
Ethylene glycol
Protease inhibitors - indinavir
25
Q

what anti-naseau medication causes the least amount of potential outflow obstruction

A

meclizine

26
Q

what are nephrotoxic risk factors

A 
>70 years
diabetic nephropathy
low CO
reduced renal funciton
concurrent dz/ meds
electrolyte/ acid/base abnormalities
dose/osmolality/ time of exposure
27
Q

safest and best way to assess kidneys with acute injury

A

US

28
Q

most people with pre-renal failure will generally have what type of specific gravity

A

high
won’t be spilling Na
BUN: Cr will be >20

29
Q

if someone has an obstruction w/ a uric acid crystal what can be done?

A

Na bicarb will dissolve the stones

30
Q

what can form w/ phosphate crystals

A

staghorn calculi

31
Q

sulfa crystals are associated w/ what?

A

sniffing pain/ glue

32
Q

renal replacement therapy (dialysis) is only used for acute renal failure and what?

A 
Uremic encephalopathy
Uremic neuroirritability (asterixis) 
Refractory hyperkalemia
Refractory acidosis
Refractory volume overload
Uremic pericarditis
Certain ingestions
33
Q

what stage of CKD Is a GFR is 30-59

A

CKD stage 3

34
Q

what stage of CKD Is a GFR is 60-89

A

CKD stage 2

35
Q

what stage of CKD Is a GFR is 15-29

A

CKD stage 4

36
Q

what stage of CKD Is a GFR is >90

A

CKD stage 1

37
Q

what is CKD if GFR is <15

A

CKD stage 5

38
Q

what are common meds to use for CKD

A 
Vit D analogues
EPO
phosphate binders
Iron
Sodium bicarb
cinacalcet
kayexalate
39
Q

what are phostphate binders

A

calcium carbonate, calcium acetate, calcium citrate, lanthanum carbonate, sevelamer

40
Q

most common cause of end-stage renal dz?

A

Diabetes melltis

41
Q

what are routes for dialysis access?

A

Internal jugular cath
AV-fistula (BEST)
AV-graft

42
Q

what causes most mortality in ESRD?

A

cardiac dz

**Old DOOS (11 decks)

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