Renal emergencies

Question 1

What does urinalysis look for

Answer 1

Specific gravity, pH, ketones, blood, protein, leucocytes, nitrites, glucose, bilirubin, urobilinogen

Question 2

What does specific gravity or urine measure

Answer 2

Ability of the kidney to concentrate or dilute the urine and is directly proportional to urine osmolality

Question 3

Causes of decreased urine specific gravity

Answer 3

Nephrogenic diabetes insipidus, acute glomerulonephritis, pyelonephritis, acute tubular necrosis

Question 4

What does a decreased urine specific gravity indicate

Answer 4

Inability to concentrate urine, or excessive hydration

Question 5

Causes of fixed 1.010 urine specific gravity

Answer 5

End stage renal disease, chronic renal failure, chronic glomerulonephritis

Question 6

What does an increased urine specific gravity indicate

Answer 6

Concentrated urine with large volume of dissolved solutes

Question 7

Causes of increased urine specific gravity

Answer 7

Dehydration, SIADH, adrenal insufficiency, pre-renal renal failure, hyponatraemia with oedema, liver failure, CCF, nephrotic syndrome, glycosuria, proteinuria, urine contamination, IV contrast, colloids

Question 8

Causes of alkaline urine

Answer 8

Renal tubular acidosis, fanconi syndrome, systemic alkalosis, UTIs, certain drugs

Question 9

Causes of acidic urine

Answer 9

Systemic acidosis, DM, starvation, diarrhoea, malabsorption, renal TB, alkaptonuria, phenylketonuria

Question 10

What is AKI measured with

Answer 10

Rise in creatinine and decrease of urine output

Question 11

Consequences of AKI

Answer 11

Volume overload, metabolic acidosis, increased K+ decreased Na+, uraemia, pulmonary oedema, acute lung injury, increased risk of infection and bleeding, pharmacological changes

Question 12

Reasons for dialysis (AEIOU)

Answer 12

Acidosis, electrolyte abnormalities, ingestion of toxic substances, overload fluid, uraemia symtoms