Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

(67 cards)

Start Studying
1
Q

What is the relationship between AKI and CKD?

A

Any AKI, no matter how severe, will increase the risk of CKD in the future

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The definition of AKI is an abrupt (< 48 hours) reduction in kidney function. How can this be identified?

A

An absolute increase in serum creatinine by > 26.4µmol/l // An increase in creatinine by > 50% // A reduction in urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

You can only diagnose a patient with AKI following what?

A

Adequate fluid resuscitation and exclusion of obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What defines stage 1 AKI in terms of creatinine?

A

A > 26.4µmol/l increase in creatinine, or 1.5-1.9 x baseline creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What defines stage 1 AKI in terms of urine output?

A

< 0.5 mL/kg/hour for > 6 consecutive hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What defines stage 2 AKI?

A

Increased creatinine 2-2.9 x baseline // Urine output < 0.5mL/kg/hour for > 12 consecutive hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What defines stage 3 AKI in terms of creatinine?

A

Increased creatinine > 3 x baseline // Increase to 354 or more // Need for renal replacement therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What defines stage 3 AKI in terms of urine output?

A

< 0.3mL/kg/hour for > 24 hours // 12 hours of anuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some risk factors which a patient may have for AKI?

A

Old, CKD, diabetes, cardiac failure, liver disease, PVD, previous AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medical investigation may predispose a patient to getting AKI?

A

Contrast radiography (causes contrast nephropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 3 major causes of pre-renal AKI?

A

Hypotension, hypovolaemia, renal hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can cause hypovolaemia leading to AKI?

A

Haemorrhage, volume depletion from vomiting, burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can cause hypotension leading to AKI?

A

Cardiogenic shock, septic shock, anaphylactic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can cause renal hypoperfusion leading to AKI?

A

NSAIDs/COX2 inhibitors, ACEIs/ARBs, hepatorenal syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drugs should be stopped in AKI?

A

Drugs to lower BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the definition of pre-renal AKI?

A

Reversible volume depletion leading to oliguria and increase in creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In pre-renal AKI, which will occur first: oliguria or raised creatinine?

A

Oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What defines oliguria?

A

< 0.5mls/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is anuria?

A

Passing no urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you are ill, what medication must be stopped?

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What effect do ACE inhibitors have on GFR? How?

A

Decreased GFR by causing efferent arteriolar vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Untreated pre-renal AKI leads to what?

A

Acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What causes acute tubular necrosis?

A

A combination of factors causing decreased renal perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some causes of acute tubular necrosis?

A

Sepsis, severe dehydration, rhabdomyolysis, drug toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the two major steps in the treatment of pre-renal AKI?
Assess for hydration and fluid challenge for hypovolaemia
26
What fluid should be used for pre-renal AKI?
Crystalloid (0.9% NaCl) or colloid (gelofusin)
27
How should fluid be given in pre-renal AKI?
Give bolus and then reassess and repeat as necessary
28
When should you seek help for a pre-renal AKI?
If you've given over 1l of fluid and there has been no improvement
29
What is the definition of renal AKI?
Diseases causing inflammation or damage to cells causing AKI
30
What are the 4 broad causes of renal AKI?
Vascular, glomerular, interstitial, tubular
31
What are some vascular causes of AKI?
Vasculitis, renovascular disease
32
What is the glomerular cause of AKI?
Glomerulonephritis
33
What are some causes of interstitial nephritis causing renal AKI?
Drugs, infection (TB), systemic disease (sarcoidosis)
34
What are some causes of tubular injury causing renal AKI?
Ichaemia, drugs, contrast, rhabdomyolysis
35
What drugs are the commonest causes of interstitial nephritis?
Antibiotics (particularly gentamicin) and PPIs
36
What are some symptoms of AKI?
Constitutional symptoms (anorexia, weight loss, fatigue), N+V, itch, fluid overload (oedema, SOB)
37
What are some signs of AKI?
Fluid overload e.g. oedema, effusions // uraemia e.g. itch, pericarditis // oliguria
38
If there is haematuria, where is the most likely place of AKI?
Renal
39
Recent contrast indicates which type of AKI?
Renal
40
What blood tests should be done to assess renal AKI?
Us and Es, FBC and coagulation screen, immunology,
41
What are some investigations which should be used in renal AKI?
Urinalysis, USS
42
What investigations are used for myeloma?
Protein electrophoresis and BJP
43
If a patient with AKI is anaemic, what are some more likely causes?
CKD or haemorrhage
44
What do small kidneys suggest?
Chronic kidney problems
45
Anti-GBM antibodies are suggestive of what disease?
Goodpasture's syndrome
46
What are some indicators of myeloma as a cause for AKI?
High Ca++ and low haemoglobin
47
What are urgent indications for renal biopsy?
Suspected rapidly progressive GN, positive immunology
48
What are semi-urgent indications for renal biopsy?
Unexplained AKI, rule out obstruction, volume depletion and ATN
49
When should you not do a renal biopsy?
If the patient is on warfarin, aspirin etc // The patient is not normotensive // The patient has hydronephrosis
50
Which kidney should you biopsy? What test should you check it with?
Left kidney, use ultrasound
51
What should happen if patients with AKI remain anuric with uraemia?
Dialysis
52
What are some life threatening complications of AKI?
Hyperkalaemia, fluid overload (pulmonary oedema), severe acidosis (< 7.15) uraemia pericardial effusion, severe uraemia (> 40)
53
What is the definition of a post-renal AKI?
AKI due to obstruction of urine flow leading to back pressure (hydronephrosis) and loss of concentrating ability
54
What are some causes of post renal AKI?
Stones, cancers, strictures, extrinsic pressure
55
What is the first step in management of a post renal AKI? Why?
Put in a catheter- sometimes it is only retention and this will relieve the obstruction
56
After insertion of a catheter, what are the next steps in the management of a post-renal AKI?
Nephrostomy, referral to urology for uretering stenting
57
Hyperkalaemia is associated with what life threatening complication?
Cardiac arrhythmias
58
A potassium of what is classed as hyperkalaemia? What is life threatening hyperkalaemia?
> 5.5, life threatening is > 6.5
59
How do you assess for hyperkalaemia?
ECG and muscle weakness
60
What are the major ECG changes which are seen in hyperkalaemia?
Tall T waves, broad QRS, no P wave
61
What will happen to the heart rate in hyperkalaemia?
Bradycardic
62
What is the 1st step in the management of hyperkalaemia?
Cardiac monitor and IV access
63
What medication is given in hyperkalaemia to protect the myocardium?
10mls 10% calcium gluconate (within 2-3 mins)
64
What medication is given in hyperkalaemia to move K+ back into cells?
Insulin (act rapid 10 units), with 50mls 50% dextrose // nebulised salbutamol
65
What medication is given in hyperkalaemia to prevent K+ absorption from the GI tract? Is this given acutely?
Calcium resonium, don't give acutely
66
What can be given in hyperkalaemia to control the acidosis?
Sodium bicarbonate
67
What are some urgent indications for haemodialysis in AKI?
Hyperkalaemia, severe acidosis, fluid overload, urea > 40, pericardial rub/effusion

Renal (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions