renal and urology

Question 1

what causes AKI?

Answer 1

a rapid deterioration in kidney function

when there is a sudden decrease in glomerular filtration rate

Question 2

what are the 3 groups causes of AKI?

Answer 2

pre renal
renal
post renal

Question 3

what causes a pre renal cause of AKI?

Answer 3

when there is reduced perfusion to the kidneys

Question 4

what are the causes of pre renal AKI?

Answer 4

absolute hypovolaemia
low effective arterial blood volume
anatomical
drug induced

Question 5

give 3 causes of absolute hypovolaemia

Answer 5

haemorrhage
over diuresis
vomiting and diarrhoea

Question 6

give 4 causes of low effective arterial blood volume

Answer 6

heart failure
sepsis
cirrhosis
3rd spacing of fluid

Question 7

give 1 cause of anatomical causes of pre renal AKI

Answer 7

renal artery stenosis

Question 8

give 3 drugs that can cause pre renal AKI

Answer 8

NSAIDs
ACE inhibitors
diuretics

Question 9

what causes intra renal AKI?

Answer 9

structural or functional change at the level of the nephron

Question 10

what are the 2 ways in which intra renal AKI can occur?

Answer 10

independently or as a transformation of pre renal AKI

Question 11

what is the most common cause of AKI?

Answer 11

acute tubular necrosis

Question 12

why does acute tubular necrosis occur?

Answer 12

due to iscaemic or toxic injury to cells in the proximal convoluted tubule

Question 13

what are the 3 things that can cause acute interstitial nephritis?

Answer 13

drug induced
infection induced
immune mediated

Question 14

what is a nephrotic syndrome?

Answer 14

a non proliferative process affecting podocytes

Question 15

how does nephrotic syndrome present?

Answer 15

proteinuria >3g / day
oedema
hypoalbuminaemia <30

Question 16

what is the most common cause of nephrotic syndrome in children?

Answer 16

minimal change disease

Question 17

what is the most common cause of nephrotic syndrome in adults?

Answer 17

focal segmental glomerulonephritis

Question 18

what is nephritic syndrome?

Answer 18

a proliferative process affecting endothelial cells

Question 19

how does nephritic syndrome present?

Answer 19

haematuria
oliguria
hypertension

Question 20

which 2 things can cause intra-tubular obstruction that can cause intra-renal AKI?

Answer 20

multiple myeloma w/ paraprotein
pigment e.g. rhabdomyolysis

Question 21

what causes post renal AKI?

Answer 21

obstructive pathology leading to congestion of the kidneys

Question 22

where can pathology cause post renal AKI?

Answer 22

ureters
bladder
prostate
urethra
external

Question 23

what can cause a post renal AKI in both kidneys?

Answer 23

obstruction at the level or distal to the bladder

Question 24

based on the KDIGO criteria what confirms a diagnosis of AKI?

Answer 24

any of the following:

• urine output <0.5ml / kg / hr for 6hrs
• serum creatinine increase 1.5x baseline for 7 days
• serum creatinine increase by 0.3mg / dL in 48hrs

Question 25

what are the indications for dialysis in AKI?

Answer 25

A - acidosis (pH <7.15)

E - electrolyte imbalance (hyperkalaemia >6.5 mmol)

I - ingested toxins

O - fluid overload

U - uraemia

Question 26

what are the renal complications of systemic sclerosis treated w/?

Answer 26

ACEi