Renal for mock OSCE Flashcards
causes of prerenal injury
hypovolemia sepsis ccf renal artery stenosis ACE inhibitors
causes of renal injury
Ischemia toxins glomeruloneprhitis interstitial nephritis hepatorenal syndrome HUS/TTP
causes of post-renal injury
stone tumour prostate blocked catheter vesicoutereral reflex
what is an acute kidney injury
an acute decline in renal function leading to a rise in serum creatinine and or a fall in urine output
which bloods to get for AKI?
ABG - lactate, pH FBC - platelets, WCC U & E - creatinine, potassium Osmolality Glomerulonephritis screen - C3/C4 levels, electrophoresis, antibodies, ASOT
Which investigations in the urine, for AKI ?
nitrites, leukocytes, proteinuria, heamaturia, osmolality,
Imaging for AKI
renal US - hydronephrosis
why might you get an ECG in the setting of AKI?
a fib - > increased risk of ischemia
indications for starting renal replacement therapy?
- pH < 7.1
- electrolyte imbalance with K > 7 or intractable hyperkalemia with ECG changes
- Intoxication - poisons
- Overload (fluid)
- Ureamia symptoms - encephalopathy or pericarditis
kidney transplant requires lifelong therapy with…
calcineurin inhibitors
antimetabolites
steroids
whats an uncomplicated UTI ?
absence of flank pain
systemically well
cystitis
whats a complicated UTI?
- systemically unwell/signs of SIRS
- catheter associated
- long-term care residency
- Urinary tract abnormalities
- immunosuppressed
advice to prevent UTIs?
- adequate hydration
- avoid constipation
- practice good hygeine
- voiding after sexual intercourse
indications for hospitalization in complication UTI
- inability to intake adequate fluids or oral antibiotics
- pregnant or pyrexial
- signs of sepsis
- immunocompromised
inpatient anitbiotics for UTI?
IV- co amoxiclav + IV gentamicin
