Flashcards in ASN QBank Pearls - AKI, ICU Nephrology, HTN, and Pharmacology Deck (108)
what filtration fraction is associated with increased clotting on CVVH?
how do you calculate filtration fraction for POSTfilter CVVH?
(QR + UF)/(QB x (1-Hct)) x 60 min/hr
how do you calculate filtration fraction for PREfilter CVVH?
(QR + UF)/((QB x (1-Hct)) x 60 min/hr) + QR
total body water (TBW)
weight x % body water
- male 0.6, elderly male 0.5
- female 0.5, elderly female 0.45
Na+ requirement formula
TBW x (desired Na+ - serum Na+)
infusion rate formula for hyponatremia
(Na+ requirement x 1000)/(infusate Na+ x time)
- Na+ requirement = TBW x (desired Na+ - serum Na+)
Na+ concentration in 3% saline
total water deficit formula
TBW x (1 - desired Na+/serum Na+)
electrolyte-free water clearance (EFWC) formula
urine volume × (1 − ((UNa+ + UK+)/SNa+))
free water clearance (FWC) formula
urine volume × (1 − (Uosm/Sosm)
indications for HD in lithium toxicity
- > 5 withOUT CKD
- > 4 WITH CKD
- > 2 with neurologic or cardiac effects and AKI
clearance rate formula
- equal to effluent rate
- (QR + UF) x 1 hr/60 min
fluid overload at time of dialysis initiation has been a/w increased risk of
have any RRT modalities shown that removal of myoglobin can shorten or prevent the course of AKI from rhabdomyolysis?
- in a patient with acute brain injury, what dialysis modality should be avoided?
- may worsen neurological status
- compromises cerebral perfusion pressure d/t hypotension and disequilibrium
- in a patient with acute brain injury, what dialysis modality should be used?
- slow removal of fluids and solutes decreases risk of worsening acute brain injury
what is the MC acid-base disturbance in the immediate postoperative period and is most prominent during the first 24-48 hours after surgery?
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
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
expected effect on systolic and diastolic BP after using CPAP
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?
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
what is an independent risk factor for AKI in a patient undergoing surgery?
what is the most important risk factor for AKI in a patient undergoing surgery?
what is the “gold standard” test to diagnose white coat HTN?
ambulatory BP monitoring
ARB exposure during the second and third trimesters has been a/w
neonatal renal failure and death
can diuretics be continued during pregnancy?
yes, especially in women with sodium-sensitive HTN or edema and when they were already on them
treatment of resistant HTN
- lifestyle modifications
- w/d of interfering meds
- correction of secondary HTN causes
- MR antagonists (spironolactone, amiloride, eplerenone)
a trial published in 2008 demonstrated that antihypertensive therapy in patients > 80 yoa is a/w
- decrease in stroke
- decrease in cardiovascular mortality