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Medicine > Renal -AKI > Flashcards

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
Q

Cholesterol embolism occur due to

A

Endovascular intervention

Heparin induced

26
Q

Livedo reticularis skin
Subacute renal failure
Hollenhorst plaque in retina is seen in

A

Atheroembolic renal disease

27
Q

Biopsy finding of atheroembolic renal disease

A

Biconvex Birefringent cholesterol crystal

28
Q

Uric acid Nephropathy aka

A 
Tumor lysis syndrome 
Seen in all (highest risk)
Burkitt lymphoma
Dlbcl
Aml cml
29
Q

Mechanism of uric acid Nephropathy

A

Uric acid crystal cause intratubular obstruction in cd and dct

30
Q

Difference between uric acid Nephropathy and heme pigment Nephropathy on the basis of lab findings

A 
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
Q

Treatment of uric acid Nephropathy

A

Hemodialysis/ Rasburicase

32
Q

Before starting chemotherapy in pt of all preventive measure you will take place to avoid renal damage

A

Allopurinol 100mg OD

Vigorous hydration 4-5 L /day

33
Q

An army personnel comes to hospital wuth muscle pain high colored urine . You will suspect

A

Rhabdomyolysis

Heme pigment Nephropathy

34
Q

Renal cortical necrosis is seen in

A

Snakebite
Acute pancreatitis
Abruptio placentae

35
Q

Reverse rim sign is seen in

A

Renal cortical necrosis

Non enhancing cortex

36
Q

Renal cortical necrosis is a type of_______ necrosis

A

Coagulative necrosis

37
Q

MC manifestation of myeloma kidney

A

Light chain cast Nephropathy

38
Q

Mcc of renal failure in myeloma

A

Pre renal failure with hypercalcemia

39
Q

Type 5 cardio renal syndrome

A

Diabetes and SLE

40
Q

A pt with bone pain anemia esr elevated and dipstick negative for albumin but 24hr urine protein high
Suspect and investigation to confirm

A 
Myeloma kidney 
Inv 
SFLC assay serum free lt chain
SPEP sr protein electrophoresis
SIFE sr immuno electrophoresis

Medicine (11 decks)

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