Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
- 3rd side (hint)
Dx:
Rapid onet of oliguria w/ increasing BUN and creatinine; often occurs in hospitalized patients |
Acute Renal Failure
|
|
|
ARF class:
weight loss or gain, poor skin turgor, edema/ascites, renal artery bruit |
Pre-renal ARF
|
|
|
ARF class:
weight gain, obtundation, hypotension to HTN, JVD, evidence of muscle trauma, infection, contaminated IV lines |
Intrinsic ARF
|
|
|
ARF class:
weight gain, enlarged prostate, pelvic mass, bladder distension |
Post-renal ARF
|
|
|
Etiology of pre-renal ARF
(4 and example of each) |
1. Hypovolemia
(including hemorrhage and GI loss) 2. Third-spacing (including nephrotic syndrome, burns and cirrhosis) 3. Low cardiac Output (including CHF and shock) 4. Renal hypoperfusion (including renal artery stenosis, NSAIDs + ACEi) |
|
|
Etiology of Intrinsic ARF
(5) |
1. Hyperviscosity
(multiple myeloma) 2. Acute Tubular Necrosis (due to: meds or rhabdomyolysis) 3. Glomerular injury (Nephrotic syndrome, vasculitis, GN) 4. Acute Interstitial Nephritis 5. Renovascular infarction |
HAGAR
|
|
Etiology of Post-renal ARF
(3) |
1. Urinary tract obstruction
2. enlarged prostate 3. bladder dysfunction |
|
|
Define:
Oliguria |
Urine output < 400 mL/day
|
|
|
Indications for Dialysis:
(5) |
AEIOU:
Acidosis Electrolyte abnormalities Ingestions Overload Uremic symptoms (pericarditis, encephalopathy) |
|
|
Pre-renal amounts for:
1. BUN/creatinine ratio 2. Fe-Na 3. Urine Na 4. Urine Osmolality 5. Urine specific gravity |
1. > 20
2. < 1% 3. < 20 4. > 500 5. > 1.020 |
|
|
Intrinsic renal (ARF)amounts for:
1. BUN/creatinine ratio 2. Fe-Na 3. Urine Na 4. Urine Osmolality 5. Urine specific gravity |
1. < 20
2. > 1% 3. > 40 4. < 350 5. = 1.010 |
|
|
What (2) Dx test and results point to a post-renal ARF problem?
|
Fe-Ne > 4%
Urine Na > 40 |
|
|
Equation for Fractional Excretion of Sodium (Fe-Na)
|
Fe-Na = (urine Na/plasma Na) / (U-creatinine/P-creatinine) x 100%
|
|
|
MCC of intrinsic ARF
|
Tubulointerstitial diseases
(ATN and AIN) |
|
|
Dx:
Acute damage of renal tubules due to ischemic or toxic insult |
Acute Tubular Necrosis
|
|
|
Etiology of Ischemic (4) and Toxic (4) causes of ATN
|
Ischemic:
Shock; Trauma; Sepsis; Hypoxia Toxic: Rhabdomyolysis; Aminoglycosides; IV contrast; Tumor lysis |
IS TSH a TRAIT
|
|
(3) Dx findings for ATN
|
Muddy-brown granular casts;
High urine sodium; Fe-Na > 1% |
|
|
Tx for ATN
(4) |
- NS for volume replacement;
- IV diuretic in early stages; - match I and O - manage electolyte disturbance |
|
|
Dx:
Inflammation of the renal parenchyma |
Acute Interstitial Nephritis
|
|
|
(3) basic classes of etiologies of AIN
|
Systemic diseases;
Systemic infections; Medications |
|
|
(3) systemic diseases that causes AIN
|
Sarcoidosis;
Sjogren syndrome; Lymphoma |
|
|
(4) systemic infections (bugs) that cause AIN
|
Syphilis;
Toxoplasmosis; CMV; EBV |
C SET
|
|
(3) medication classes that can cause AIN
|
Beta-blockers;
Diuretics; NSAIDs |
|
|
How do NSAIDs cause AIN?
|
inhibit prostaglandin synthesis, which decreases GFR and start renal failure in pt w/ underlying renal problems
|
|
|
Dx findings of allergic AIN
(3) |
WBCs;
Eosinophils; White (or red) cell casts |
|
|
Tx of allergic AIN?
(2) |
1. stop offending agent
2. Steroids |
|
|
initial microscopic finding in ATN
|
blebbing of the PTC and loss of brush boarder
|
|
|
microscopic finding of ischemic (2) ATN versus toxic
|
Ischemic:
BM damage; skipped areas of damage Toxic: no BM damage; Uniform damage w/ sparing of DT |
|
|
Lab:
Oxalate crystal formation in kidney |
Ethylene glycol ATN
|
|