ASN QBank Pearls - AKI, ICU Nephrology, HTN, and Pharmacology Flashcards Preview

Nephrology Board Review Pearls > ASN QBank Pearls - AKI, ICU Nephrology, HTN, and Pharmacology > Flashcards

Flashcards in ASN QBank Pearls - AKI, ICU Nephrology, HTN, and Pharmacology Deck (108)
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1

what filtration fraction is associated with increased clotting on CVVH?

> 25-30%

2

how do you calculate filtration fraction for POSTfilter CVVH?

(QR + UF)/(QB x (1-Hct)) x 60 min/hr

3

how do you calculate filtration fraction for PREfilter CVVH?

(QR + UF)/((QB x (1-Hct)) x 60 min/hr) + QR

4

total body water (TBW)

weight x % body water

- male 0.6, elderly male 0.5
- female 0.5, elderly female 0.45

5

Na+ requirement formula

TBW x (desired Na+ - serum Na+)

6

infusion rate formula for hyponatremia

(Na+ requirement x 1000)/(infusate Na+ x time)

- Na+ requirement = TBW x (desired Na+ - serum Na+)

7

Na+ concentration in 3% saline

513 meq/l

8

total water deficit formula

TBW x (1 - desired Na+/serum Na+)

9

electrolyte-free water clearance (EFWC) formula

urine volume × (1 − ((UNa+ + UK+)/SNa+))

10

free water clearance (FWC) formula

urine volume × (1 − (Uosm/Sosm)

11

indications for HD in lithium toxicity

- > 5 withOUT CKD
- > 4 WITH CKD
- > 2 with neurologic or cardiac effects and AKI

12

clearance rate formula

- equal to effluent rate
- (QR + UF) x 1 hr/60 min

13

fluid overload at time of dialysis initiation has been a/w increased risk of

mortality

14

have any RRT modalities shown that removal of myoglobin can shorten or prevent the course of AKI from rhabdomyolysis?

no

15

- in a patient with acute brain injury, what dialysis modality should be avoided?
- why?
- how?

- iHD
- may worsen neurological status
- compromises cerebral perfusion pressure d/t hypotension and disequilibrium

16

- in a patient with acute brain injury, what dialysis modality should be used?
- why?

- CRRT
- slow removal of fluids and solutes decreases risk of worsening acute brain injury

17

what is the MC acid-base disturbance in the immediate postoperative period and is most prominent during the first 24-48 hours after surgery?

metabolic alkalosis

18

why is metabolic alkalosis the MC acid-base disturbance immediately post-op?

large citrate load from stored PRBC and FFP that's metabolized to bicarbonate

19

what are the benefits of using bicarbonate as a buffer in the dialysate or replacement fluid of AKI patients with circulatory problems or liver dysfunction?

- better correction of acidosis
- lower lactate levels
- improved hemodynamic tolerance

20

expected effect on systolic and diastolic BP after using CPAP

-3/-2 mmHg

21

what is the likelihood of identifying adrenal cancer or a hyperfunctioning lesion (pheochromocytoma, primary aldosteronism, Cushing’s) in the setting of discovering an adrenal “incidentaloma” mass?

10-20%

22

what is the BEST way to dose antibiotics for a patient on CRRT at 25 ml/kg/hr?

measure effluent UF and dialysate and calculate a CrCl

23

what is an independent risk factor for AKI in a patient undergoing surgery?

obesity

24

what is the most important risk factor for AKI in a patient undergoing surgery?

CKD

25

what is the “gold standard” test to diagnose white coat HTN?

ambulatory BP monitoring

26

ARB exposure during the second and third trimesters has been a/w

neonatal renal failure and death

27

can diuretics be continued during pregnancy?

yes, especially in women with sodium-sensitive HTN or edema and when they were already on them

28

treatment of resistant HTN

- lifestyle modifications
- w/d of interfering meds
- correction of secondary HTN causes
- MR antagonists (spironolactone, amiloride, eplerenone)

29

a trial published in 2008 demonstrated that antihypertensive therapy in patients > 80 yoa is a/w

- decrease in stroke
- decrease in cardiovascular mortality

30

older patients with HTN are more likely to be salt-sensitive and responsive to what therapy?

diuretics