13 - AKI Flashcards Preview

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Flashcards in 13 - AKI Deck (40):
1

ECG:

 

QRS > 0.12 

No disernable waves 

Peaked T waves

 

Q image thumb

Hyperkalaemia 

2

ECG: 

Prolonged PR 
Prominant U waves 

ST depression 


 

Hypokalaemia 

3

What is SALFORD used for?

Used for treatment of AKI

4

What does SALFORD  stand for?

Sepsis 

Ace-i and NSAIDS 

Labs and leaflets 

Fliud assesment 

Obstruction 

Renal and critical care referral 

Dip urine and document it.

5

Treatment of hyperkalaemia?

IV Calcium gluconate 

IV insulin + glucose 

Salbutamol nebulised 

IV bicabonate 

6

What is the treatment of non urgent hyperkalaemia?

PO Polystyrene sulfonate resin 

7

Risk factors for AKI?

 

>65

history of AKI 

CKD

obstruction 

CCF

liver disease 

DM 

neurological disability 

sepsis 

hypovolaemia 

oliguria < 0.5 mL/Kg/hour 

nephritexic drugs

8

What drugs are nephrotoxic?

ACE-i 

ARBs 

diuretics 

NSAIDS

9

How is eGFR calculated?

eGFR =  1/ creatinine 

 

10

What does a protienuria > 3 from a urine dipstick indicate?

renal disease 

11

What does blood with positive protien in dipstick indicate?

Glomulonephritis 

12

Urea is a broken down from what?

Amino acids and ammonia 

13

What is ATN?

Acute tubular necrosis 

14

What are the 3 phases of ATN?

Oliguric 

Maintenance 

Polyuric recovery 

15

What happens to creatin in the Oliguric phase of ATN?

rises quickly 

 

16

What happens to creatin in the maintenance phase of ATN

rises slowly or remains the same 

17

What happens to creatin in the polyuric recovery phase of ATN?

Decreases 

18

What is the urine output for the oliguric phase of ATN?

<500 ml

19

What phase of ATN has a risk of hyperkalaemia?

Oliguric due to renal impairment 

20

What phase of ATN is at risk of hypokalaemia?

Polyuric recovery phase - lots of water and electrolyte loss 

21

What is urea recycling?

Urea can be excreted via the kidneys or the GI system. In the GI system microbes produce ammonia which is reabsorbed from the urea.

 

This means that urea is not a reliable indicator kidney function 

22

What medicine should be stopped in AKI due to toxicity?

Digoxin 

Lithium 

Metformin 

23

Should ACEi or ARB be continued or stopped during ATI?

Thye should be stopped

24

Should warfarin be continued during AKI?

Yes, warfarin should be continued 

25

Should clopidogrel and asprin be stopped during AKI?

No, continue use of clopidogrel and aspirin

26

What are the criteria for AKI stage 1 

 

< 0.5 ml per Kg for > 6 hours 

 

50% increase serum creatinine 

27

Definition of AKI?

increase of serum creatinine by 50% 

< 0.5 ml/Kg of urine 

-25% eGFR 

28

Loop diuretics are not recommended in AKI excpet when?

Fliud overloaded 

 

+ recovering renal function/ renal replacement therapy 

29

Indications for renal replacment therapy?

Hyperkalaemia 

Pulmonary oedema 

Fluid overload

Metabolic acidosis

Ureamic complactions - pericarditis and encephalopathy  

 

30

What is the intial fluid delivery in resuscitation? 

500ml crystaloid in < 15 mins 

31

What is a side effect of omeprazole?

Hyponatraemia 

32

What is ACR?

Albumin creatinine ratio

33

What does ACR show?

Shows proteinurea

 

Clinically significant > 3mg/mmol

34

What is the most common intrinsic renal cause of AKI?

ATN - acute tubular necrosis

35

What are the pre renal cuases of AKI?

Hypoperfusion - spesis, hypovolaemia

Renal artery stenosis +/- ACEi

36

How much K+ is needed for fluid maintence?

1 mmol/kg/24hr 

 

37

How much Na+ is needed for fliud maintenance?

2 mmol/kg/24 hr

38

NICE risk stratisification tool for sepsis

PLEASE LOOK UP YOU LAZY BASTARD 

39

What affect does IV insulin and dextrose have on during hyperkalaemia?

A) Remove K+ from the body 

B) Short-term shift in potassium from extracellular to intracellular fluid compartment

C) Stabilise cardiac membrane potential 

B - Short-term shift in potassium from extracellular to intracellular fluid compartment

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