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Renal Final > My Version of Pathoma Renal Failure > Flashcards

My Version of Pathoma Renal Failure Flashcards

1
Q

hallmark of acute renal failure is

A
  • azotemia
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2
Q

what is azotemia

A
  • increased BUN and creatinine
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3
Q

what often accompanies azotemia in acute renal failure

A
  • oliguria - low urine production
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4
Q

what is prerenal azotemia due to

common cause

A
  • decreased blood flow to the kidneys

- heart failure

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5
Q

what is the GFR in prerenal azotemia

A
  • low GFR
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6
Q

BUN/Creat raio in prerenal azotemia

A

> 15

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7
Q

tubular function in prerenal azotemia

A
  • remains intact
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8
Q

fractional excretion of Na in prerenal azotemia

A

< 1%

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9
Q

urine osmolality in prerenal azotemia

A

> 500

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10
Q

post renal azotemia due to

A
  • obstruction of urinary tract downstream from kidney
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11
Q

GFR in post renal azotemia

A
  • decreased
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12
Q

BUN/Creat in early stage of obstruction of post renal azotemia

why

A

> 15

  • increased tubular pressure forces BUN into the blood
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13
Q

tubular function in early post renal azotemia

A
  • remains intact
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14
Q

FENa in early post renal azotemia

A

< 1%

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15
Q

urine Osm in early post renal azotemia

A

> 500

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16
Q

tubular function in long standing obstruction post renal azotemia

A
  • tubular damage ensues
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17
Q

BUN/Creat ratio in long standing obstruction post renal azotemia

why

A

< 15

  • tubular damage results in decreased reabsorption of BUN
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18
Q

FeNa in long standing obstruction post renal azotemia

why

A

> 2%

  • decreased reabsorption of sodium
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19
Q

urine osmolarity in long standing obstruction post renal azotemia

why

A

< 500

  • inability to concentrate urine
20
Q

acute tubular necrosis definition

A
  • injury and necrosis of tubular epithelial cells
21
Q

what is the most common cause of acute renal failure (infrarenal azotemia)

A
  • acute tubular necrosis
22
Q

what happens in acute tubular necrosis

A
  • necrotic cells plug tubules

- obstruction

23
Q

GFR in acute tubular necrosis

A
  • decreased GFR
24
Q

what is seen in the urine of acute tubular necrosis

A
  • brown, granular casts
25
Q

BUN/Creat ratio in acute tubular necrosis

why

A

< 15

  • dysfunctional tubular epithelium results in decreased reabsorption of BUN
26
Q

FENa in acute tubular necrosis

27
Q

urine osm in acute tubular necrosis

A

< 500 mOsm

28
Q

etiology of acute tubular necrosis

A
  • ischemic

- nephrotoxic

29
Q

ischemic causes of acute tubular necrosis

A
  • decreased blood supply resulting in necrosis of tubules
30
Q

ischemic causes of acute tubular necrosis preceded by

A
  • prerenal azotemia
31
Q

what is particularly susceptible to ischemic damage in acute tubular necrosis

A
  • proximal tubule

- medullary segment of thick ascending limb

32
Q

nephrotoxic causes of acute tubular necrosis

A
  • toxic agents result in necrosis of tubules
33
Q

causes of nephrotoxic acute tubular necrosis

A
  • aminoglycosides
  • heavy metals (lead)
  • myoglobinuria
  • ethylene glycol
  • radiocontrast dye
  • urate
34
Q

myoglobinura is due to

A
  • crush injury to muscle
35
Q

ethylene glycol is associated with what in the urine

A
  • oxalate crystals
36
Q

urate is associated with

A
  • tumor lysis syndrome
37
Q

what is used prior to initiation of chemotherapy to decrease risk of urate induced acute tubular necrosis

A
  • hydration

- allopurinol

38
Q

potassium levels of acute tubular necrosis

also associated with

A
  • hyperkalemic

- metabolic acidosis

39
Q

reversibility of acute tubular necrosis

requires

A
  • reversible

- supportive dialysis

40
Q

acute interstitial nephritis definition

results in

A
  • drug-induced hypersensitivity involving the interstitium and tubules
  • results in acute renal failure (intrarenal azotemia)
41
Q

causes of acute interstitial nephritis

A
  • NSAIDS
  • penicillin
  • diuretics
42
Q

presentation of acute interstitial nephritis

A
  • oliguria
  • fever
  • rash
  • eosinophils in urine
43
Q

treatment of acute interstitial nephritis

A
  • resolves with cessation of drug
44
Q

acute interstitial nephritis may progress to

A
  • renal papillary necrosis
45
Q

renal papillary necrosis presents with

A
  • hematuria

- flank pain

46
Q

causes of renal papillary necrosis

A
  • chronic analgesic abuse
  • diabetes mellitus
  • sickle cell trait or disease
  • severe acute pyelonephritis

Renal Final (13 decks)

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