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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
BUN/Creat ratio in acute tubular necrosis why
< 15 - dysfunctional tubular epithelium results in decreased reabsorption of BUN
26
FENa in acute tubular necrosis
> 2%
27
urine osm in acute tubular necrosis
< 500 mOsm
28
etiology of acute tubular necrosis
- ischemic | - nephrotoxic
29
ischemic causes of acute tubular necrosis
- decreased blood supply resulting in necrosis of tubules
30
ischemic causes of acute tubular necrosis preceded by
- prerenal azotemia
31
what is particularly susceptible to ischemic damage in acute tubular necrosis
- proximal tubule | - medullary segment of thick ascending limb
32
nephrotoxic causes of acute tubular necrosis
- toxic agents result in necrosis of tubules
33
causes of nephrotoxic acute tubular necrosis
- aminoglycosides - heavy metals (lead) - myoglobinuria - ethylene glycol - radiocontrast dye - urate
34
myoglobinura is due to
- crush injury to muscle
35
ethylene glycol is associated with what in the urine
- oxalate crystals
36
urate is associated with
- tumor lysis syndrome
37
what is used prior to initiation of chemotherapy to decrease risk of urate induced acute tubular necrosis
- hydration | - allopurinol
38
potassium levels of acute tubular necrosis also associated with
- hyperkalemic | - metabolic acidosis
39
reversibility of acute tubular necrosis requires
- reversible | - supportive dialysis
40
acute interstitial nephritis definition results in
- drug-induced hypersensitivity involving the interstitium and tubules - results in acute renal failure (intrarenal azotemia)
41
causes of acute interstitial nephritis
- NSAIDS - penicillin - diuretics
42
presentation of acute interstitial nephritis
- oliguria - fever - rash - eosinophils in urine
43
treatment of acute interstitial nephritis
- resolves with cessation of drug
44
acute interstitial nephritis may progress to
- renal papillary necrosis
45
renal papillary necrosis presents with
- hematuria | - flank pain
46
causes of renal papillary necrosis
- chronic analgesic abuse - diabetes mellitus - sickle cell trait or disease - severe acute pyelonephritis

Renal Final (13 decks)

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