Trigger - AKI part 1 Flashcards
this finding can indicate Acute obstruction, cortical necrosis, aortic dissection
anuria
this finding is indicative of poor prognosis in AKI
oliguria
s/s include encephalopathy, dry skin, HTN and tachypnea.
uremia
also:
General - weakness, fatigue
Neuro - tremors, seizures, encephalopathy, confusion, coma
Skin - itching, dryness
Cardiovascular - pericardial effusion, pericarditis, HTN
GI - anorexia, nausea, vomiting
Other - shallow breaths/tachypnea, metabolic acidosis
s/s include weakness, tremors, confusion, pericarditis, metabolic acidosis
uremia
also:
General - weakness, fatigue
Neuro - tremors, seizures, encephalopathy, confusion, coma
Skin - itching, dryness
Cardiovascular - pericardial effusion, pericarditis, HTN
GI - anorexia, nausea, vomiting
Other - shallow breaths/tachypnea, metabolic acidosis
low FENa+ (<1%)
prerenal azotemia
also see decreased GFR and BUN:Cr as well as hyaline casts on urine sediment
hyaline casts on urine sediment
prerenal azotemia
s/s include uremia, diffuse abdominal pain, ileus and decreased urine output
prerenal azotemia
tamm-horsfall mucoprotein is associated with what
forms the hyaline casts found in prerenal azotemia
etiology of retroperitoneal fibrosis and neurogenic bladder
etiologies of postrenal obstruction. i keep forgetting these two specifically
s/s include anuria or polyuria with lower abdominal pain
postrenal obstruction
s/s include distended bladder, enlarged prostate or pelvic/abdominal mass
postrenal obstruction
urine osmolality of 400 or less
postrenal obstruction
urine sediment that is normal but may have RBC, WBC and crystals
postrenal obstruction
CK > 20,000-50,000
myoglobinuria
false + hemoglobin on urine dipstick
myoglobinuria
dark brown urine with no presence of RBC
myoglobinuria
complications include hypocalcemia, hyperkalemia, hyperphosphatemia, hyperuricemia
myoglobinuria
etiology includes transfusion reaction and hemolytic anemia
hemoglobinuria (seen in acute tubular necrosis)
etiology includes rapid cell turnover and lysis such as during chemo
hyperuricemia
s/s include arrhythmias, abdominal pain and uremia
ATN
hyperkalemia, hyperphosphatemia and elevated urine sodium
ATN
urinary sediment shows pigmented granular casts or “muddy brown” casts, renal tubular cells and epithelial cell casts
ATN
protein restriction to avoid metabolic acidosis is part of treatment for what diagnosis
ATN
cresent lesions and inflammatory lesions
acute glomerulonephritis
HTN and edema as classic presentation
acurte glomerulonephritis
urine containing protein, WBCs, RBCs and RBC casts.
acute glomerulonephritis
when antigen excess over antibody production occurs and antigen-antibody complexes get lodged in glomerular basement membrane.
immune complex deposition type acute glomerulonephritis
caused by bergers, lupus, endocarditis and strep
immune complex deposition type acute glomerulonephritis
caused by Membranoproliferative disease and cryoglobulinemic disease
immune complex deposition type acute glomerulonephritis
autoantibodies against glomerular basement membrane (GBM). This can be confined to the kidney or involve lungs as well
Anti-GBM-associated acute glomerulonephritis
Anti-GBM-associated acute glomerulonephritis with pulmonary involvement
goodpastures syndrome
abnormalities in the alternative complement pathway
C3 glomerulopathy
Monoclonal Ig deposited in GBM and/or tubular basement membrane.
no excess antigens
monoclonal Ig-Mediated Glomerulonephritis
identified with serum protein electrophoresis
monoclonal Ig-Mediated Glomerulonephritis
can also use immunofixation and free light chain analysis
identified with free light chain analysis and immunofixation
monoclonal Ig-Mediated Glomerulonephritis
can also use electrophoresis
small-vessel vasculitis associated with Antineutrophil cytoplasmic antibodies (ANCAs)
Pauci-Immune Glomerulonephritis
etiologies include hypertensive emergencies or thrombotic microangiopathies
possible causes of acute glomerulonephritis
RBC casts on urine sediment
acute glomerulonephritis
hematuria and moderate proteinuria with increased serum creatine
acute glomerulonephritis
treated with cytotoxic agents and high dose corticosteroids
acute glomerulonephritis
PCN rifampin sulfonamides
acute interstitial nephritis
eosinophilia
acute interstitial nephritis
only AKI presenting with enlarged kidneys on US
acute interstitial nephritis
symptoms include rash
acute interstitial nephritis
WBC casts
acute interstitial nephritis
treat with plasma exchange
pauci immune or good pastures
renal tubular cells and epithelial cell casts on urine sediment
acute tubular necrosis
AVOID ACE/ARB
prerenal azotemia
BUN>20:1
prerenal azotemia
postrenal obstruction
BUN<20:1
acute tubular necrosis.
(i think this represents instrinsic kidney injuries in general)
can be caused by bacteria such as strep, staph, diptheria, legionella and ricketssia
acute interstitial nephritisa
can be caused by allergies and collagen vascular disease
acute interstitial nephritis
what lab value can be seen in a patient who’s symtpoms are caused by overuse of NSAIDS
proteinuria
proteinuria is not super high in acute interstitial nephritis unless it is caused by the use of NSAIDS.
assocaited with hemolytic uremic syndrome
pauci immune GN
assocaited with thrombotic thrombocytic purpura
pauci-immune GN