1
Q
A
3
2
Q
A
1.5x baseline
or
rise of >26 micromol/L in 48 hours
3
Q
A
6 hrs
4
Q
A
2-2.9x baseline
5
Q
A
12hrs
6
Q
A
>3x baseline or >354 micromol/L in 48 hours or RRT
7
Q
A
24 hours
or
anuric for 12 hours
8
Q
A
Pre-renal
Intrinsic
Post-renal
9
Q
A
Pre-renal - 40% - 70%
10
Q
A
renal hypoperfusion
11
Q
A
Renal artery stenosis
Hypotension
sepsis
cardiac output failure
12
Q
A
Tubular
Glomerular
Interstitial
Vascular
13
Q
A
acute tubular necrosis
14
Q
A
intrinsic
tubular
15
Q
A
intrinsic
glomerular
16
Q
A
intrinsic interstitial (i.e. infiltration)
17
Q
A
Vascular
18
Q
A
luminal
mural
extrinsic compression
19
Q
A
sloughed papillae
stones
clots
20
Q
A
strictures
malignancy
21
Q
A
BPH
retroperitoneal fibrosis
22
Q
A
post-renal
23
Q
A
BPH
24
Q
A
USS
25
[AKI]: what is hydronephrosis
distension and dilation of the renal pelvis and calyces
26
[AKI]: what is the only definite indication of CKD
previous high creatinin/low GFR Ix results
27
[AKI]: CKD would be suspected if on USS the kidneys looked ....
Small (<9cm)
28
[AKI]: what are the indications for RRT/dialysis (5)
```
Refractory pulmonary oedema
persistent hyperkalaemia
Severe metabolic acidosis
Any uraemic complication
Drug overdose
```
29
[AKI]: What is the mneumonic for drugs which can cause AKI in overdose
BLAST
30
[AKI]: What does BLAST stand for
```
Barbituates
Lithium
Alcohol
Salicylates
Theophyline
```
31
[AKI]: define severe metabolic acidosis (2 - pH and Base excess)
pH <10
32
[AKI]: Mx: what are the 3 mainstay aims of AKI Mx?
Volume status --> euvolaemia
Stop nephrotoxic drugs
nutrition
33
[AKI]: Mx: assessment of volume: give 5 signs of hypervolaemia
```
Raised JVP
Raised BP
Pulmonary crepitations
peripheral oedema
Gallop rhythm (cardiac ausculation)
```
34
[AKI]: Mx: assessment of volume: give 5 signs of hypovolaemia
```
reduced urine output
reduced JVP
Reduced BP
poor tissue turgor
Quick pulse
```
35
[AKI]: Mx: you are aiming for euvolaemia: what must you be careful of when administering fluid regimens?
K+ content
36
[AKI]: Mx: you must Tx the underlying causes: if obstructive renal what may you wish to do
catheterise
37
[AKI]: Mx: complications: what are the 4 complications of AKI
Uraemic
Pulmonary oedema
Hyperkalaemia
Acidaemia
38
[AKI]: Mx: complications: what are the 2 complications related to uraemia
uraemic encephalitis
| uraemic pericarditis
39
[AKI]: Mx: complications: Is uraemia the molecule responsible for the uraemic complications
no - just a good marker
40
[AKI]: Mx: complications: why do high levels of serum urea cause complications
reflects a reduction in the excretion of toxins
41
[AKI]: Mx: complications: why do you get pulmonary oedema?
reduction in GFR
| fluid overload
42
[AKI]: Mx: complications: Why do you get kyperkalaemia
K+ are excreted in the collecting duct
43
[AKI]: Mx: complications: define hyperkalaemia?
>5.5 mmol/L
44
[AKI]: Mx: complications: apart from renal failure give 2 examples of hyperkalaemic inducing syndromes
Rhabdomyolysis
| Hypoaldosteronism
45
[AKI]: Mx: complications: HYPERKALAEMIA: what ECG changes are seen (4)
Tall 'tented' T waves
small/absent P wave
Increased PR interval
Widened QRS complex
46
[AKI]: Mx: complications: HYPERKALAEMIA: 1st line Tx:
```
10mL 10% calcium gluconate (IV)
+
IV insulin
+
IV Glucose
```
47
[AKI]: Mx: complications: HYPERKALAEMIA: why is calcium gluconate given
cardioprotective
48
[AKI]: Mx: complications: HYPERKALAEMIA: why is insulin given
Insulin stimulates intracellular uptake of K+
49
[AKI]: Mx: complications: HYPERKALAEMIA: why is glucose given
So blood glucose is minimally affected by insulin/also facilitates process
50
[AKI]: Mx: complications: HYPERKALAEMIA: apart from the 3 mainstay drugs what else can be given
salbutamol nebulizer
51
[AKI]: Mx: complications: HYPERKALAEMIA: what could limit the use of salbutamol nebulizers?
tachycardia
52
[AKI]: Mx: complications: HYPERKALAEMIA: if the patient is acidotic what add on medication may be helpful?
NaHCO3 50mL/8.4%
53
[AKI]: Mx: complications: PULMONARY OEDEMA: 1st line Tx? (4)
```
Sit up
High flow O2
Diamorphine 2.5g IV
Cyclizine
Furosemide
```
54
[AKI]: Mx: complications: PULMONARY OEDEMA: what role does Diamorphine 2.5g IV play
Venous vasodilator
55
[AKI]: Mx: complications: PULMONARY OEDEMA: what role does Cyclizine play
anti-emitic (SE of diamorphine)
56
[AKI]: Mx: complications: PULMONARY OEDEMA: if after Tx there is no response what is indicated
RRT
57
[AKI]: Which Ix would you perform to image post-renal AKI
CTKUB
58
[AKI]: what RRT are advised in AKI
Haemodialysis
| Haemofiltration
59
[AKI]: Ix:what would C-ANCA antibodies indicate
wegeners granulomatosis
60
[AKI]: treatment in AKI is maintanence until you can treat the underlying cause T/F?
T
RENAL
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