Renal

Question 1

Definition

Acute Kidney Injury

Answer 1

Any of the following:
- SCr increases by 0.3mg/dL or more within 48 hours
- SCr rises to at least 1.5-fold from baseline within 7 days
- Urine volume < 0.5mL/kg/hr for more than 6 consecutive hours

norm creatinine is ~1

Question 2

if your kidneys tank today, it would take ___hrs for it to be reflected in your serum creatinine labs

Answer 2

48-72 hrs
lags

Question 3

AKI Staging

Answer 3

Question 4

AKI Classification

Answer 4

Question 5

The majority of AKI cases in the hospital are what classification(s)

Pre-renal, intrinsic, post-renal

Answer 5

combined incidence = Pre-renal + Intrinsic acute tubular necrosis

Question 6

Pre-Renal Acute Kidney Injury Medication Causes

Answer 6

Question 7

Intrinsic AKI (Acute Tubular NECROSIS) Medication Causes

Answer 7

Aminoglycosides
Vanco
Amphotericin B
IV Contrast

Question 8

Intrinsic AKI (Acute Interstitial NEPRHITIS) Medication Causes

Answer 8

Delayed hypersensitivity rxn to:
- Beta lactams
- NSAIDs
- Loop diuretics

Question 9

Post-renal AKI causes

Answer 9

Obstruction

Question 10

hemorrhagic or cardiogenic shock may cause what type of acute kidney injury classifcation?

Answer 10

Pre-Renal
(low-flow state to kidneys)

not enough to filter out

Question 11

AKI Management overview

Answer 11

Identify and treat the underlying cause
- Pre-renal, intrinsic, post-renal AKI
- Evaluate the need for renal replacement therapy

Manage complications
- Electrolyte abnormalities
- Fluid status changes
- Acid/base abnormalities

Question 12

Which e- abnormality is MC in chronic kidney disease?

Answer 12

High Phosphate

Question 13

low magnesium = increased risk for ____

Answer 13

cardiac arrhythmia

Question 14

Hypomagnesia Trmnt

Answer 14

IV replacement (0.5-1g /Hr)
PO replacement -> diarrhea

Question 15

Hyperkalemia Trmnt

Answer 15

• Calcium Gluconate
• Bicarbonate & Inhaled B2 agonists
• Insulin & Glucose
• Na Zirconium Cyclosilicate
• Dialysis

Question 16

What meds can cause hyperkalemia?

Answer 16

ACE-I/ARB/ARNI
Spironolactone
K+ Supplements

Question 17

Hypokalemia Trmnt

Answer 17

Question 18

Which Diuretics can cause hypokalemia?

Answer 18

Thiazides
Loop Diuretics

Question 19

IV K+ Replacement Rates for Hypokalemia

Max _____ mEq per hour peripherally
Max ____mEq per hour centrally + continous EKG monitoring

Answer 19

10 peripherally
20 centrally

Question 20

Hyperphosphatemia Trmnt

Answer 20

Phosphate binders (Ca+ acetate/carbonate, Sevelamer, Lanthanum carbonate)
Monitor Ca+ levels

Question 21

Hypophosphatemia Trmnt

Answer 21

IV rate 7-8mmol / Hr
PO tablets or powder

phosphate replacement is bound with Na+ or K+

Question 22

Hypercalcemia is MC associated with _____

Answer 22

malignancy

Question 23

Hypocalcemia Trmnt

Answer 23

• Ca+ correction for albumin = Serum Ca + 0.8 (4.0 - albumin)
• IV replacement (Calcium chloride is more concentrated than Calcium gluconate)

Question 24

1st thing you do if serum Ca+ is low

Answer 24

correct for albumin
Corrected Ca+ = CMP Ca + 0.8 (4.0 - albumin)

Question 25

PO Calcium supplements are often combined with ____

Answer 25

Vit D

Question 26

Which two electrolytes should you think of when you hear cardiac arrhythmia

Answer 26

K+ (Low or High) Mg+ (Low)