Genitourinary

Question 1

What is a normal BUN?

Answer 1

10-23

Question 2

What is the normal serum creatinine for males and females?

Answer 2

males 0.8-1.4mg/dL

females 0.6-1.1 mg/dL

Question 3

What is a normal GFR?

Answer 3

125ml/minute

Question 4

What 2 types of medications can lead to pre-renal failure?

Answer 4

NSAIDs, and ACE Inhibitors

NSAIDs block the production of prostaglandins in the afferent arteriole resulting in afferent arteriole constriction, decrease inflow of blood into the glomerulus leading to a decrease in the GFR (Even at normal doses failure can occur when other renal risks are present - HF, sepsis, pre-exist renal insufficiency)

ACE inhibitors prevent the production of angiotensin II, the efferent arteriole will remain dilated preventing the maintenance of adequate glomeruli pressure

Question 5

Who is most likely a candidate for dialysis?

AEIOU

Answer 5

Acidemia
Electrolyte disorders
Intoxication (methanol, ethylene glycol, aspirin OD, lithium, theophylline)
Overload (HF)
Uremia (elevated BUN with associated mental status changes)

Question 6

How can you differentiate pre renal from intra renal via BUN:CR ratio?

Answer 6

A wide ratio (20-40:1) is usually associated with pre renal failure

A narrower ratio (10-15:1) is usually associated with intra renal failure

Question 7

A 35 year old man developed an AKI after upper GI bleeding secondary to esophageal varices, in which he lost a great deal of blood. Which of the following lab results would he be expected to have?

A. low urine osmo, high urine sodium concentration
B. high urine osmo, high urine sodium concentration
C. low urine osmo, low urine sodium concentration
D. high urine osmo, low urine sodium concentration

Answer 7

D
Volume depletion will result in pre renal failure. In the presence of pre renal failure, the renal tubules can still concentrate urine and hold onto sodium.