Kidney 4

Question 1

is acute kidney injury (AKI) reversible

Answer 1

often yet if treated right

Question 2

Rapid reduction in renal function (days)
Reduction of creatinine clearance by 50%
Increase of 0.5 mg/dl over baseline creatinine
Increase of 50% over baseline creatinine

Answer 2

Acute renal failure

Question 3

what stage is Acute Kidney Injury if there is an increase in SCr by 2.0-2.9 x BL
or 12 hours

Answer 3

Stage 2 AKI

Question 4

what stage is Acute Kidney Injury if there is an increase in SCr by 1.5-1.0x BL or >0.3mg/dL Or
<0.5 ml/kg/h x 6-12 hours

Answer 4

Stage 1 AKI

Question 5

what stage is Acute Kidney Injury if there is an increase in SCr by 3.0x BL or incrase SCr to 4.0 mg/dl or initiation of RRT (dialysis)
12 hours

Answer 5

Stage 3 AKI

Question 6

an increase in what for SCr is considered acute renal failure?

Answer 6

2.5

Question 7

what drugs cause decreased proximal tubular secretion. This will increase SCr because they compete w/ creatinine to get out of the body.

Answer 7

Cimetidine
Triamterene
trimethoprim

Question 8

what substances causes analytical interference w/ plasma creatinine

Answer 8

ketones
cephalosporins
methanol
isopropylalcohol

Question 9

what cause increased BUN?

Answer 9

Increased protein intake
Amino acid infusions
GI bleed
Catabolic states
Steriods
Tetracyclines

Question 10

ARF caused by sudden and severe drop in BP or interruption of blood flow

Answer 10

prerenal ARF

Question 11

what type of ARF is due to obstruction of urine flow due to englarged prostate, kidney stones, bladder tumor or injury

Answer 11

post renal ARF

Question 12

what type of ARF is due to direct damage to the kidneys by inflammation, toxins, drugs, infection or reduced blood supply

Answer 12

intrarenal ARF

Question 13

best non-invasvie test for renal anatomy

Answer 13

US

Question 14

what causes most acute kidney injury

Answer 14

prerenal injury

Question 15

what are brown casts indicative of?

Answer 15

acute kidney injury

tubular necrosis

Question 16

what is an osmotic challenge?

Answer 16

diabetes

Question 17

what causes most acute kidney injury

Answer 17

iatrogenic (something that is being done to the patient)

Question 18

what drugs can cause acute kidney injury

Answer 18

aminoglycosides
ACEI
ARB
NSAIDs
radiocontrast
cyclosporin
cisplatin
diuretics
tacrolimus
heme pigments

Question 19

what can be used to prevent acute kidney injury due to contrast?

Answer 19

fluids
diuretics (give after) 
mannitol
acetylcysteine
bicarbonate

Question 20

if some one is one what drugs should you use caution when using contrast?

Answer 20

ACEI
ARB
NSAID
diuretics 
(should be off of these meds for 24-48 hours before giving contrast if elective procedure)

Question 21

what can cause interstitial nephritis

Answer 21

allergic rxn to drugs
autoimmune dz (lupus)
infiltrative dz (sarcoidosis)
infectious process (legionaries)

Question 22

if someone presents w/ mild proteinuria, sterile pyruia (don’t grow on cultures), polyuria and nocturia, osinophiluria, RTA, fanconi-like syndrome (glycosuria, phosphaturia, aminoaciduria)

Answer 22

tubule interstitial nephritis

Question 23

what is the most common cause of post-renal acute kidney injury

Answer 23

prostatic hypertrophy

Question 24

what drugs are associated w/ stone formation

Answer 24

Sulfonamides (not as common now) 
Methotrexate
Acyclovir
Triamterene
Ethylene glycol
Protease inhibitors - indinavir

Question 25

what anti-naseau medication causes the least amount of potential outflow obstruction

Answer 25

meclizine

Question 26

what are nephrotoxic risk factors

Answer 26

``` >70 years diabetic nephropathy low CO reduced renal funciton concurrent dz/ meds electrolyte/ acid/base abnormalities dose/osmolality/ time of exposure ```

Question 27

safest and best way to assess kidneys with acute injury

Answer 27

US

Question 28

most people with pre-renal failure will generally have what type of specific gravity

Answer 28

high won't be spilling Na BUN: Cr will be >20

Question 29

if someone has an obstruction w/ a uric acid crystal what can be done?

Answer 29

Na bicarb will dissolve the stones

Question 30

what can form w/ phosphate crystals

Answer 30

staghorn calculi

Question 31

sulfa crystals are associated w/ what?

Answer 31

sniffing pain/ glue

Question 32

renal replacement therapy (dialysis) is only used for acute renal failure and what?

Answer 32

``` Uremic encephalopathy Uremic neuroirritability (asterixis) Refractory hyperkalemia Refractory acidosis Refractory volume overload Uremic pericarditis Certain ingestions ```

Question 33

what stage of CKD Is a GFR is 30-59

Answer 33

CKD stage 3

Question 34

what stage of CKD Is a GFR is 60-89

Answer 34

CKD stage 2

Question 35

what stage of CKD Is a GFR is 15-29

Answer 35

CKD stage 4

Question 36

what stage of CKD Is a GFR is >90

Answer 36

CKD stage 1

Question 37

what is CKD if GFR is <15

Answer 37

CKD stage 5

Question 38

what are common meds to use for CKD

Answer 38

``` Vit D analogues EPO phosphate binders Iron Sodium bicarb cinacalcet kayexalate ```

Question 39

what are phostphate binders

Answer 39

calcium carbonate, calcium acetate, calcium citrate, lanthanum carbonate, sevelamer

Question 40

most common cause of end-stage renal dz?

Answer 40

Diabetes melltis

Question 41

what are routes for dialysis access?

Answer 41

Internal jugular cath AV-fistula (BEST) AV-graft

Question 42

what causes most mortality in ESRD?

Answer 42

cardiac dz