week 12

Question 1

RIFLE is the widely accepted approach to dx and classifying AKI. What does RIFLE stand for?

Answer 1

R- risk
I- injury 
F-failure, and outcome criteria of 
L-loss and
E-end-stage disease

Question 2

Define Anuria?

Answer 2

when the kidneys are not producing urine

Question 3

the conventional classification of ARF is based on the perceived causative mechanisms. What are they?

Answer 3

• prerenal
• intrarenal (intrinsic)
• postrenal

Question 4

what is acute renal failure (ARF)?

Answer 4

sudden deterioration of kidney function as a result of physiological injury, to the point where there is retention of nitrogenous waste.

Question 5

what is acute kidney injury (AKI)?

Answer 5

rapid deterioration in renal function (hrs to days).

Question 6

List the key assessments used in monitoring renal functions

Answer 6

-urine output
-serum creatinine and urea levels
-HR + BP
fluid balance and daily weights

Question 7

A common concern in AKI is fluid overload. What can this cause?

Answer 7

it can cause heart failure and pulmonary oedema.

Question 8

what is renal replacement therapy?

Answer 8

any treatment that replaces renal function including intermittent haemodialysis and peritoneal dialysis.

Question 9

What 2 organs are important to check after trauma in relation to internal bleeding?

Answer 9

The liver and spleen

Question 10

List at least 4 hollow viscera

Answer 10

• stomach
• spleen
• gallbladder
• small intestine
• colon
• bladder

Question 11

List at least 4 solid viscera

Answer 11

• liver
• pancreas
• spleen
• adrenal glands
• kidneys
• ovaries
• uterus

Question 12

The abdominal walls is divided into 4 quadrants. List them.

Answer 12

• right upper quadrant
• left upper quadrant
• right lower quadrant
• left lower quadrant

Question 13

List at least 4 causes of abdominal complications.

Answer 13

• infections
• trauma (blunt/penetrating)
• inflammation
• pre-existing conditions
• cancers
• organ failure

Question 14

What is Blumberg’s sign?

Answer 14

It is when we choose a site away from tender area, pain on release of pressure.
-rebound tenderness

Question 15

What is Murphy’s sign?

Answer 15

It indicates an inflamed gall bladder.
Pain on deep breath when palpating liver.
-inspiratory arrest

Question 16

Each nephron contains?

Answer 16

• glomerulus
• bowmans capsule
• loop of Henle

Question 17

Define Glomerulonephritis

Answer 17

infective/inflammatory process damaging glomerular membrane or a systematic autoimmune illness attacking the membrane

Question 18

Define Nephrotoxicity

Answer 18

Damage to nephron from causative agent.

Question 19

what can cause nephrotoxicity? (list 3)

Answer 19

• drugs
• antibiotics
• anti-inflammatory
• cancer drugs

Question 20

Clinical management of ARF is

Answer 20

-reducing further damage
=IV fluid resuscitation
=assessment of renal output
=cease or modify any nephrotoxic drugs
=treat infection with alternate less toxic antibiotics
-nutrition
=enteral or parenternal
-renal replacement therapy (RRT)
=dialysis

Question 21

Renal replacement therapy is required to?

Answer 21

• control blood biochemistry
• prevent toxin accumulation
• allow removal of fluids to allow adequate nutrition

Question 22

There are 2 types of liver failure. What are they?

Answer 22

• acute

- chronic

Question 23

define liver failure

Answer 23

the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology.

Question 24

Renal therapy options consist of?

Answer 24

• peritoneal dialysis
• Haemodialysis
• renal transplant

Question 25

who are most at risk of trauma to the kidneys?

Answer 25

- elderly - athletes/sports players - children - motor bike riders

Question 26

what is a possible complication of a broken pelvis due to trauma?

Answer 26

transection of femoral arteries

Question 27

define pre-renal kidney failure?

Answer 27

affected by things that are outside of the kidneys such as blood flow

Question 28

Define Intra-renal kidney failure

Answer 28

things that are affected by a mechanism within the kidney

Question 29

Define post-renal failure

Answer 29

affected by mechanisms that are below the kidneys such as the bladder.

Question 30

List some possible causes of pre-renal failure

Answer 30

- hypovolaemia | - decreased cardiac function

Question 31

what is Acute tubular Neurosis (ATN)?

Answer 31

damage to the tubular portion of the nephron

Question 32

what is the criteria for renal replacement therapy?

Answer 32

- RRT may be commenced if the pt has 1 of the select criteria - mandatory/urgent RRT for a pt that has 2 or more of the selection criteria

Question 33

what is acute liver failure?

Answer 33

-it is the rapid development of hepatocellular dysfunction in a pt without known prior liver disease

Question 34

what is chronic liver failure?

Answer 34

-liver failure that developed over time due to conditions such as: Hep B and C, alcohol, metabolic or immune diseases