Renal

Question 1

abrupt loss of kidney function resulting in retentino of urea and other nitrogenous wastes and in dysregulation of extracellular volume and electrolytes

Answer 1

acute renal failure

Question 2

loss of kidney function is most easily detected by

Answer 2

serum creatinine which is used to estimate GFR

Question 3

urine output < 400 ml/24 hours or a urine output < 5 ml/kg/hr

Answer 3

oliguria

Question 4

BUN creatinine ratio of 10:1 suggests

Answer 4

intrinsic renal pathology

Question 5

BUN creatinine ratio of 20:1 suggests

Answer 5

pre or post renal cause

Question 6

RIFLE criteria for acute kidney injury

Answer 6

increase in creatinine of >50% developing over <7 days

Question 7

RIFLE criteria for acute renal failure

Answer 7

Risk-increased creatinine 1.5x or GFR decrease of 25%
Injury-increased creatinine 2x or GFR decrease of 50%
Failure-increased creatinine 3x or GFR decrease of 75%
Loss-persistent acute renal failure, complete loss of renal function >4 weeks

Question 8

common causes of prerenal failure

Answer 8

hypovolemia

drugs

Question 9

acute interstitial nephritis shows these casts

Answer 9

white cell

Question 10

acute tubular necrosis shows these casts

Answer 10

epitheleal

Question 11

myoglobinuria shows these casts

Answer 11

pigmented

Question 12

a urine Na of <20 meq/L is this type of renal failure

Answer 12

prerenal

Question 13

one of the most reliable parameters for distinguishing prerenal from renal causes of oliguria

Answer 13

FENA (fractional excretion of Na, fraction of Na filtered at the glomerulus that is excreted in urine)

Question 14

renal injury will show

Answer 14

serum creatinine increase 2x and 50% decrease in Cr clearance

Question 15

renal failure will show

Answer 15

serum creatinine increase 3x or acute rise 0.5 mg/dl to 4 with decrease in creatinine clearance >75%

Question 16

how to manage oliguria and acute renal failure

Answer 16

fluid challenge-500 to 1000 cc of fluid over 30 min until a response is seen

Question 17

can be used as a renal dilator

Answer 17

dopamine

Question 18

oxidative injury to the renal tubular cells with sloughing of cells into renal tubules. This creates an obstruction that increases pressure which in turn reduces GFR

Answer 18

acute tubular necrosis

Question 19

inflammatory condition MCC by drug rxns

Answer 19

acute interstitial nephritis

Question 20

how to tx/prevent contrast induced nephropathy

Answer 20

combo of IV fluids and n-acetylcysteine

mucomyst

Question 21

hemofiltration uses

Answer 21

convection (solute containing fluid is driven across a permeable membrane)

Question 22

locked in state

Answer 22

mimics vegetative state, but awareness is intact

Question 23

MC mental disorder in ICU

Answer 23

delirium

MC symptom is visual hallucinations

Question 24

Confusion assessment method for delirium

Answer 24

score of 0 is alert and calm
neg is sedated
pos is agitated

Question 25

best tx for delirium

Answer 25

atpyical antipsychotics

Question 26

3 essentials of brain death

Answer 26

coma
absence of brain stem reflexes
apnea

Question 27

+ apnea test

Answer 27

PCO2 >60 after preoxygenating and turn off ventilator