Acute Renal Failure CIS Flashcards Preview

RENAL II Exam 3 > Acute Renal Failure CIS > Flashcards

Flashcards in Acute Renal Failure CIS Deck (48):
1

aleve

NSAID

2

elevated creatinine

represent renal failure**

3

creatinine represents

GFR

4

acute kidney injury

acute renal failure
-50% increased in serum Cr
-increase in serum Cr - 0.3
-reduction in urine output less than 0.5 longer than 6 hours

5

acute or chronic kidney problem?

-sediment
-kidney size
-compare previous Cr

6

acute sediment

active - casts

7

chronic sediment

bland

8

acute kidney size

normal

9

chronic kidney size

small and scarred

10

stigmata for chronic renal failure

-anemia
-hyperPTH
-A/V fistula
-hyperP

11

acute kidney injury

prerenal
renal
post renal

12

renal causes of acute kidney

ischemia
toxic
glomerulonephritis
acute interstitial nephritis
renovascular obstruction

13

endogenous toxins

cause AKI > renal > toxic
-Mg, Hg, light chain, calcium, uric acid

14

hyaline casts

prerenal AKI**

15

muddy brown casts

intrarenal tubular cell injury
-ATN** - acute tubular necrosis

epithelial casts

16

eosinophils

intrarenal - interstitial nephritis

17

RBC casts

glomerularnephritis AKI

18

FeNa

urine Na x plasma Cr x 100 / plasma Na x Urine Cr

19

pre-renal FeNa

<10

20

urine Na

usually looked a for AKI work up

low in pre-renal
high in renal - can't reabsorb

21

prerenal urine Na

<10

22

ATN urine Na

>20

23

toxic injury urine Na

>20

24

renal ultrasound

hydronephrosis
kidney size
cysts
stones
tumors

25

prerenal azotemia

no change to kidney
-hypoperfusion will recover normally

26

causes of prerenal azotemia

shock , dehydration, hemorrhage, sepsis, vomiting, diarrhea, sweating, diuretics, DM, cirrhosis, CHF, hepatorenal syndrome, peritonitis, hepatorenal syndrome, renal a stenosis, embolism

27

meds make prerenal azotemia worse

NSAIDs
ACE (-)
diuretics
contrast dye
tacrolimus
cyclosporine
ARBs

28

urinary sodium >20

think acute tubular necrosis

29

acute interstitial nephritis

with NSAIDs

30

upper GI bleed

can result in very high BUN

31

muddy brown casts

ATN
-acute tubular necrosis

32

stages of ATN

initiation - polarized cell
extension - depolarized cell
maintenance - dedifferentiated cell
recovery - polarized again

usually takes 1 week to recover**

33

initation of ATN

falling GFR
polarized cell

34

extension of ATN

depolarized cell
-apoptosic/necrosis/lumen obstruction
-GFR falling

35

maintenance of ATN

dedifferentiated cells are reestablishing as tubular epithelium

36

recovery of ATN

cell repolarization
-GRF rising

37

neurogenic bladder

can be due to multiple sclerosis
-Tx catheter

38

unilateral ureter obstruction

causes postrenal azotemia if they have one kidney or chronic kidney disease

39

majority of postrenal azotemia

from bilateral ureter obstruction

40

nephrotoxic meds

aminoglycosides
contrast
acyclovir
cisplatin
sulfa
methotrexate
cyclosporine
tacrolimus
amphotericin B
foscarnet
pentamidine
ethylene glycol
toluene
cocaine
HMG-CoA recuctase (-)

41

legs petechia, lung consolidations, RBC casts in urine,

wegeners granulomatosis

42

causes of acute interstitial nephritis

beta-lactam antibiotics
diuretics
other antibiotics
NSAIDs

**eosiniphils in urine, rash, and elevated Cr

43

RBC casts

something wrong with glomerulus

44

wegeners

kidney, lung, sinus

45

goodpasture

anti-GBM antibodies

46

wegeners

c-ANCAs

47

polyareritis nodosa

p-ANCAs

48

final step if nothing else works

urinalysis, ultrasound, antibody check

*do biopsy*