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Flashcards in Renal function test Deck (23):
1

Ratio BUN: Cr > 20 vs <20 suggest what?*******

can this be used as a dx?

>20: pre renal injury (dehydration, volume depletion)

<20: intra-renal injury (something actually happening inside kidney)

should not rely soley for dx, but can be helpful in directing work-up

2

what does muddy brown cast indicate in microscopy*******

its granular: Acute Tubular Necrosis

3

RBC cast

glomerulonephritis

4

WBC cast

pyelonephritis, interstitial nephritis, post-strep glomerular nephritis

5

Eosinophils in microscopy

AIN (acute/allergic interstitial nephritis), contrast

6

what will you see in Multiple myloma microscopy

sometimes light chains will not be picked up on urinalysis.

No protein on dipstick, proteinuria on UPC ratio

7

Rhabdomyolysis microscopy

Rhabdomyolysis: + blood, but NO RBC

Myoglobin, not hemoglobin in blood

8

If you suspect kidney stones, what type of test would you want? **

CT scan

9

Benefits of using CT scan over ultrasound****

to dx kidney stones, nephro or urolithiasis

better quality use for obese patients

Can delineation of lesion better than ultrasound

necessary for angiography (to see blood vessels)

10

what are the 3 categories for Acute kidney injury? main causes?******

Pre-renal: dehydration, volume depletion

post-renal: (obstruction)

intra-renal (glomerulonephritis, ATN, acute interstitial nephritis(AIN))

you need to figure out where the injury is coming from

11

what is the NSAID effect on kidneys?

NSAID can constrict afferent arteriole of glomerulus -->decrease hydrostatic pressure in glomerulus

12

what is the most common cause of Acute kidney injury in ambulatory patient is what? other indications? ************

pre-renal injury

causes:
-Dehydration/volum depletion***
-heart failure/shock
-renal artery stenosis
-meds:diuretic, NSAIDs, ACEI,ARB

13

patient that comes in dehydrated with kidney injury, what should you immediately ask about and immediately stop?

NSAID med

14

what happens when you are taking NSAID + ARB/ACEI with renal injury?***********

Decreased hydrostatic pressure I. Glomerulus--->Decrease in GFR.

15

what is the common treatment for post-renal AKI? *******

foley catheter--relief obstruction

-when someone pees a lot immediately, make sure they dont get volume depleted.
****only replace 1/2 the liquid they peed out/output
**watch electrolytes

16

what is the most common cause of AKI in hospitalized patient?********

acute tubular necrosis

17

RBC cast and dysmorphic RBC indicates what******

glomerulonephritis

18

which patients is most likely in need of kidney biopsy

glomerulonephritis

19

what are the two major causes of ATN?******

ischemia: not delivering blood correctly (low perfusion to kidneys)

toxins: some sort of medication (antibiotics: Aminoglycosides)

20

Features of ATN****

Muddy brown casts***

history of precipitating event

FeNa >2%

21

which disease have WBC casts?****** what is the most common cause for this?

Acute interstitial nephritis (AIN)--usually due to rxn to medication (Naficillin)

22

what are some diagnostic clues for AIN

-eosinophils on urine microscopy
-exposure to new medication
-WBC cast
-rash, fever

23

Indications of Acute hemodialysis

what is NOT an indication of dialysis

A: uncorrectable acidosis
E; electrolytes (hyperkalemia**)--resistant to tx and still hyperkalemia

I: intoxication (meds)
O: overload (volume overload**, pulmonary edema-respiratory distress)

U: uremia


**=most common

HIGH creatinine is NOT an indication for dialysis***