Acute Renal Failure

Question 1

Mild damage not causing azotemia –> severe damage associated with complete anuria

Answer 1

Acute kidney injury

Question 2

Decreased GFR leading to the retention of nitrogenous wastes

Answer 2

Acute renal failure

Question 3

Anuria

Answer 3

no urine production

Question 4

Polyuria

Answer 4

excessive urine production

Question 5

polykuria

Answer 5

increased frequency of urine

Question 6

stranguira

Answer 6

straining to urinate

Question 7

Oliguria

Answer 7

Decreased amount of urine production

Question 8

What are the 4 phases of acute renal failure?

Answer 8

Initial phase
Extension phase
Maintenance phase
Recovery phase

Question 9

This phase of acute renal failure has absence of CS and a decreased urine output or increased CREA. Best time to treat in this stage.

Answer 9

Initial phase

Question 10

This phase of acute renal failure is due to continued hypoxia and inflammation, compromised Na/K pumps, increased cystosolic calcium and loss of brush border.

Answer 10

Extension phase

Question 11

In this phase of acute renal failure the urine is considered ultrafiltrate- no longer concentrating urine.

Answer 11

Maintenance phase

Question 12

This phase of acute renal failure is characterized by polyuria and extreme Na loss

Answer 12

Recovery phase

Question 13

What is the number one treatment choice for acute renal injury/failure?

Answer 13

FLUIDS

Question 14

What is the shock dose for k9/feline?

Answer 14

K9: 60-90 ml/kg/hr
Cat: 45 ml/kg/hr

Question 15

What is the standard amount of insensible fluid loss?

Answer 15

22 ml/kg/day

Question 16

What is the maintenance rate?

Answer 16

60 ml/kg/day

Question 17

Urine production < 0.5 ml/kg/hr is classified as what?

Answer 17

Oliguria

Question 18

What is measured to determine if there is enough fluids in the patient?

Answer 18

Central venous pressure

Question 19

What is the name of the osmotic diuretic?

Answer 19

Mannitol

Question 20

What is the name of the loop diuretic?

Answer 20

Furosemide

Question 21

When is the use of dopamine only effective?

Answer 21

when acute renal failure is secondary to CO or severe hypotension

Question 22

What are the two definitive treatments for ARF?

Answer 22

Extracorporeal renal replacement therapy and peritoneal dialysis

Question 23

What is the indicated therapy for ethylene glycol toxicity?

Answer 23

4-MP w/in 8 hrs. of digestion

Question 24

What is the indicated therapy for NSAID induced ARF?

Answer 24

Misoprostal (PGE analog)

Question 25

What is the indicated therapy for leptospirosis induced ARF?

Answer 25

Penicillins and doxycycline

Question 26

What is the indicated therapy for pylonephritis?

Answer 26

fluoroquinolones or TMS

Question 27

What can be used to treat hyperkalemia secondary to ARF?

Answer 27

Insulin followed by dextrose. K will follow glucose into the cell

Question 28

What is used to correct metabolic acidosis?

Answer 28

HCO3 administration IV

Question 29

Why should ACEi be avoided with hypertension in ARF?

Answer 29

decrease the GFR in the kidney and that will become a problem

Question 30

What should be used to tx hypertension in renal failure patients?

Answer 30

Amlodipine and hydralazine

Question 31

Na-fractional excretion differentiates what?

Answer 31

<1%= pre-renal disease
>1%= renal disease

Question 32

What are the two causes of insensible fluid losses?

Answer 32

Sweat and Respiration