Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AGACNP 2 > Renal & acid base > Flashcards

Renal & acid base Flashcards

1
Q

definitions of AKI

A

abrupt (48 hrs) reduction of kidney function defined as
-increase in serum creatinine >/= 0.3mg/dL increase
OR
-50% increase from baseline
OR
-decrease in UO < 05mL/kg/hr for > 6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oliguria criteria

A

<400 ml/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nonoliguric

A

> 400 ml/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

staging system used more for AKI

A

modified RIFLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. ↑ of sCR >/+ 0.3mg/dL or ↑ >150-200%
  2. ↑ 200-300% from baseline
  3. ↑ >300% from baseline
A

modified RIFLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

most common form of AKI

A

prerenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

prerenal is typically due to

A

decreaesd renal perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AKI type:
decreased circulation ( cardiac failure, nephrotic syndrome, cirrhosis, pancreatitis, sepsis, low BP, blood loss, trauma)
fluid loss (n/v/d, fever, increased urination, GIB

A

prerenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

AKI type:
Acute tubular necrosis
glomerular disease
interstitial disease

A

intrarenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 most common reasons for intrarenal AKI

A

Acute tubular Necrosis
Glomerular Disease
Interstitial Disease
(typically prerenal progresses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

acute tubular necrosis is caused by

A

radiographic contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

lab needed for rhabdomyolosis

A

creatinine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 main causes of acute tubular necrosis (leading to INTRARENAL AKI)

A

ischemia and nephrotoxic exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute tubular necrosis electrolyte monitoring

A

↑Mg, ↑Phos, ↑Mg, ↓Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

rhabdomyolysis
rapid hemolysis (masssive transfusion rx, hemolytic anemia)

A

Intrarenal (acute tubular necrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Strep, rocky mt spotted fever, sarcoidosis and allergic rx to PCN, sulfas, etc. are all types of

A

intra renal interstitial nephritis (inside kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

eosinophilia (↑) in blood/urine

A

intrarenal interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

immune related and inflammatory glomerular lesions account for 5% of AKI

A

intrarenal glomerular nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

granular casts may be seen in urine in which type of AKI

A

intrarenal (ATN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

red cell casts and pyuria are typically seen in what AKI

A

intrarenal: glomerular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

obstruction is the usual cause of which AKI

A

postrenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

stones
BPH
tumors
masses
clots
strictures

A

postrenal AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

muddy brown casts are seen in

A

ATN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

WBC casts are typically seen with

A

tubules infection/ pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

RBC casts are seen with

A

glomerular nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

eosinophils are seen with

A

acute interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

FeNa is only validated in what 2 patients

A

oliguria or AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

FeNa can not be used in

A

patients with diuretics, CKD, obstruction, acute glomerular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

test of choice for renal artery stenosis

A

doppler ultrasound for vascular assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cysts, stones, masses, and size of kidneys can be seen on

A

renal US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what CT is preferred for stones

A

non contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

MRI is used in place of

A

CT with contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

do not over hydrate in what AKI

A

postrenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

always consult nephrology for

A

intrarenal AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

steroids may be useful in what (2)

A

glomerural nephritis
&
interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

sepsis, ischemia, and endogenous and exogenous nephrotoxins are causes common causes of

A

AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q
A

AKI classifcation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

RIFLE criteria stands for

A

RISK
INJURY
FAILURE
LOSS
ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

diminished renal perfusion cause dfrom low blood supply to the kidneys WITHOUT nephron damage

A

prerenal AKA (60% of AKI cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

ACE, NSAIDS, diuretics may cause which AKI

A

prerenal

41
Q

patient is on max pressors and you notice a drop in UO, this could indicate

A

prerenal AKI due to vasoconstrictive state

42
Q
A

intrarenal sites

43
Q

abrupt decrease in GFR due to tubular cell damage that results from renal ischemia or nephrotoxic injury leads to

A

INTRARENAL (intrinsic) AKI

44
Q

long periods of renal azotemia lead to tubular injury resulting in

A

ATN

45
Q

*info card
ENDOGENOUSIS: hemoglobinuria (hemolysis), myoglobinuria (rhabdo), hyperuricemia, multiple myeloma

A

ATN

46
Q

*info sheet
EXOGENOUS: aminoglycosides, contrast, ethylene glycol,cyclosporin, heavy metals

A

ATN

47
Q

Contrast induced nephropathy is define das

A

rise in sCreat 25-50% within 48 hrs of IV contrast

48
Q

Sterp, CMV, rocky mt fever are forms of bacterial pyelo that lead to

A

acute tubulointerstitial nephritis (intrinsic/intrarenal)

49
Q

systemic lupus, Sjogrens, sacoidosis, cryoglobulinemia, can all cause

A

glomerulonephritis (intrinsic/intrarenal)

50
Q

greatest incidence of recovery and not progressing to ESRD

A

post renal

51
Q

conditions that cause obstruction of urinary flow and consequently a decrease in GFR

A

post renal

52
Q

never insert a foley into

A

a patietn with a positive urethrogram

53
Q

if there is trauma damage to a kidney who do you consult

A

UROLOGY (not nephro)

54
Q

3 categories of CKD incidence in USA

A

> 65 y/o
female > male
AA, hispanic, asian, caucasion (in order)

55
Q

metalic taste in the mouth, pruritus, brittle nails, SOB, ED are all s/s of

A

CKD

56
Q

your patient with CKD comes in with an acutely elevated BUN you should be suspicious of

A

1 GIB

#2 dehydration

57
Q

elevated sCreat, low GFR but BUN is really low could be related to

A

liver disease/ hepatorenal syndrome

58
Q

ACUTE elevation of creatinine could likely be

A

toxin or drug induced.

59
Q
A
60
Q

COPD, emphysema, PNA, and asthma typically cause what acid base imbalance

A

resp acidosis

61
Q

hyperventilation, fever, pain, anxiety, high altitude typically cause what acid base imbalance

A

resp alkalosis

62
Q

shock, DKA, AKI, diuretics, sepsis typically cause what acid base imbalance

A

met acidosis

63
Q

excess base, antacids, gastric suctioning, and vomiting typically cause what acid base imbalance

A

met alkalosis

64
Q

only type of hyponatermia that requires treatment

A

HYPOTONIC HYPONATERMIA

65
Q

hyperlipidemia is a common cause of what electrolyte imbalance

A

isotonic hyponatremia

66
Q

hyperglycemia, mannitol and radiocontrast is a common cause of what electrolyte imbalance

A

hypertonic hyponatermia

67
Q

what lab do you use to determine cause of hypotonic hypovolemia hyponatermia

A

urine sodium

<10: dehydration, D/V
>20: diuretics, ACE, steroid deficiency, etc

68
Q

correction dose/tx for acute hypernatremia

A

correct no faster than 1-2mEq/L/hr

(0.5 for chronic)

69
Q

beer, SIADH, diuertics, CKD are all causes of what electrolyte imbalance

A

hypotonic euvolemic hyponatermia

70
Q

what serious electrolyte abnormality must you always correct with Na if needed

A

K

71
Q

hyponatermic tx with seizures

A
  • fluid restriction <1000ml/24
  • 100 ml 3% over 10m; repeat if needed;
  • 3% @ 0.5-2ml/kg/hr
72
Q

MAX CORRECTION OF LOW NA

A

12 mEq/L/24
OR
20mEq/L/48

no more than 4-6mEq

73
Q

fluid options for mild, oder, sev volume depletion with hypernatermia

A

mild: D5W
mod: 1/2 NS, free water
sev: 9%NS then 1/2 NS

74
Q

metabolic disease, catecholamine excess, and IV insulin for DKA all cause what electrolyte disturbance

A

hypoKalemia

75
Q

Action of Glomerulus & drug at site

A

Filters plasma
Acetazolamide

76
Q

Action at proximal convoluted tube

A

bicarb, sugars, & drugs re-absorbed

77
Q

Action and drugs at ascending loop of henle

A

Site for loop diuretics

78
Q

drugs at descending loop of henle

A

Osmotic diuretics (mannitol)

79
Q

Action & drug site at Distal Convoluted tubule
(Tip ** last stop to fix everything before collecting duct)

A

Reabsorption of water, K+ acid/base balance effected by ADH and aldosterone.

Site of Action for Thiazides – HCTZ

80
Q

Action & drug site for Collecting Duct

A

Last step in water and Na+ balance.

Site of action for Potassium Sparing diuretic - Spironolactone

81
Q
A
82
Q

Acute glomerual injury, ATN, acute acute interstitial nephritis & AKI may have what in urine

A

EOSINOPHILS

83
Q

Renal epithelial cells in urine indicate what

A

Tubular injury

84
Q

If the glomerulus is not working what lab will be abnormal

A

High creatinine ( because it is the only place in the kidney where it is absorbed)

85
Q

Stage 1- kidney damage

A

GFR > 90% (normal)

86
Q

GFR 60-89

A

Stage 2 CKI

87
Q

GFR 45-59

A

Stage 3 a CKI

88
Q

GFR 30-44

A

Stage 3b CKI

89
Q

GFR 15-29

A

Stage 4 CKI

90
Q

GFR < 15

A

Stage 5/ kidney failure

91
Q

An acute increase in BUN with CKD may indicate

A

Acute GIB

92
Q

Acute decrease in BUN with CKD may indicate

A

Liver disease

93
Q

Edema/weeping, high lipids, hypoalbuminemia, proteinuria, increase bleeding/clotting all could be signs of

A

Nephrotic syndrome

94
Q

When BUN/Creat rise tighter it’s called 15:1 signifying

A

INTRA renal failure

95
Q

Nephrotic Meds “cake man c”

A

Cyclosporine - ACE - keppra - erythromycin - metformin - amphotericin - NSAIDS - contrast

96
Q

Urinary casts: red cell

A

Glomerulonephritis
Vasculitis

97
Q

Urinary casts: white cell

A

Acute interstitial nephritis

98
Q

Urinary casts: fatty

A

Nephrotic syndrome

99
Q

Urinary casts: muddy brown

A

ATN

AGACNP 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions