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Renal -AKI Flashcards

1
Q

Most common cause of aki

A

Pre renal(55%)

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2
Q

Most common renal cause of aki

A

Tubulointerstitial disease (90%)

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3
Q

New markers of ATIN

A

Osteopontin
Ngal neutrophil gelatinase ass lipocalin
Il 18
Kidney injury molecule

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4
Q

Criterias for AKI

A

RIFLE
AKIN
KDIGO

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5
Q

KD -IGO STAGES
Q a pt has creatinine 2 times the baseline and urine output less than 0.5ml/kg/hr for more than 12 hrs
Which stage is he in

A

1
2
3
Second stage

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6
Q

Site of tubular injury in atin

A

S3 segment of PTA > ThAL

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7
Q

Causes of renal cortical necrosis which lead to ckd

A

Acute pancreatitis
Abruptio placentae
Snake bite

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8
Q

Most common pre renal cause of AKI

A 
Sepsis 
Post op sepsis
Complicated uti 
Cirrhosis
Diabetes foot
Tropical infection -lepto ans scrub typhus
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9
Q

Three phase of atin

A

Tubular injury phase 1
Tubuloglomerular feedback phase 2
Recovery phase 3

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10
Q

What happens in phase 1

A

Na K Ca P Mg levels low

Urine output increased

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11
Q

Why is there low urine output in phase 2

A

Because of increased urine excretion

Tubuloglomerular feedback is activated leading to decrease gfr

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12
Q

Complications occurring in phase 2

A

Hypervolemia leads to volume overload increased potassium in serum arrythmia
Metabolic acidosis uremia

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13
Q

Complications of atin

A

Uremia
Hypovolemia hypervolemia
Hyponatremia
Hyperkalemia

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14
Q 
A pt has non specific hyaline cast in urine 
Osmolality 800-900
Sp gravity 1.020-1.040
Fena less than 1
Aki?
A

Prerenal aki
Urine sodium less than 20 mcg/l
Urine /plasma creatinine more than 40

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15
Q

Cast seen in ischemia atin

A

Wbc cast
Eosinophilic
Muddy brown epithelial cast

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16
Q

Best parameter for Differentiating prerenal and ischemia atin

A

Fena

Normal 1-2

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17
Q

Dose dependant tubular injury causes

VACE

A

Vancomycin
Aminoglycoside (pct)amphotericin b (dct)
Cisplatin cyclophosphamide
Ethylene glycol

18
Q

Drug independent tubular injury type 4 HSN

BRAND PPI

A 
B lactam
Rifampicin 
Allopurinol 
Nsaid 
Diuretic
19
Q

Dose dependant intratubular obstruction

MITAS

A

Methotrexate
Indinavir. Triamterene
Acyclovir
Sulfonamide

20
Q

Most common mechanisn of nsaid induced kidney disease

A

Blocking of pg induced afferent arterioles vasodilation (pre renal aki)

21
Q

Features of nsaid induced kidney disease

A

Fena less than 1
Oliguria
Hyperkalemia

22
Q

What is analgesic nephropathy

Its features

A

Phenacetin aspirin caffeine
Medullary hypoxia
Calcification

23
Q

Contrast induced aki caused by

It can be prevented by

A

High volume high osmolar ionic contrast
Prevention.
Low volume low osmolar non ionic contrast like hexol
Fluids 1ml/kg/hr giver 6hrs before and 12-24 hr after procedure

24
Q

If egfr less than 30 ml/min, mri contrast gadolinum should he avoided why

A

Nephrogenic systemic fibrosis

25
Cholesterol embolism occur due to
Endovascular intervention | Heparin induced
26
Livedo reticularis skin Subacute renal failure Hollenhorst plaque in retina is seen in
Atheroembolic renal disease
27
Biopsy finding of atheroembolic renal disease
Biconvex Birefringent cholesterol crystal
28
Uric acid Nephropathy aka
``` Tumor lysis syndrome Seen in all (highest risk) Burkitt lymphoma Dlbcl Aml cml ```
29
Mechanism of uric acid Nephropathy
Uric acid crystal cause intratubular obstruction in cd and dct
30
Difference between uric acid Nephropathy and heme pigment Nephropathy on the basis of lab findings
``` Uric acid Nephropathy Oliguria K Mg P levels rise Creatinine uric acid rise Ca low Heme pigment Nephropathy High colored urine K Mg P rise Ca low CPK MM ruse High Anion gap ```
31
Treatment of uric acid Nephropathy
Hemodialysis/ Rasburicase
32
Before starting chemotherapy in pt of all preventive measure you will take place to avoid renal damage
Allopurinol 100mg OD | Vigorous hydration 4-5 L /day
33
An army personnel comes to hospital wuth muscle pain high colored urine . You will suspect
Rhabdomyolysis | Heme pigment Nephropathy
34
Renal cortical necrosis is seen in
Snakebite Acute pancreatitis Abruptio placentae
35
Reverse rim sign is seen in
Renal cortical necrosis | Non enhancing cortex
36
Renal cortical necrosis is a type of_______ necrosis
Coagulative necrosis
37
MC manifestation of myeloma kidney
Light chain cast Nephropathy
38
Mcc of renal failure in myeloma
Pre renal failure with hypercalcemia
39
Type 5 cardio renal syndrome
Diabetes and SLE
40
A pt with bone pain anemia esr elevated and dipstick negative for albumin but 24hr urine protein high Suspect and investigation to confirm
``` Myeloma kidney Inv SFLC assay serum free lt chain SPEP sr protein electrophoresis SIFE sr immuno electrophoresis ```

Medicine (11 decks)

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