Reading...
Play button
Play button
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;
17 Cards in this Set
- Front
- Back
|
What are some of the causes of prerenal azotemia?
|
hypovovolemia (dehydration, burns, diuretics, vomiting, hemorrhage)
Hypotension (shock, renal artery stenosis) third spacing fluids ( intravascular volume depletion decreased CO (CHF, Low albumin (nephrotic syndrome) |
|
|
What are the lab values consistent with prerenal azotemia?
Bun:creatinine ratio urine Na FeNa urine osmolality urine specific gravity |
Bun:creatinine ratio: 20:1
urine Na: low FeNa: < 1% urine osmolality: high urine specific gravity: high (> 1.010 |
|
|
What effects does ACE inhibitors have on the renal system.
What pt are prone to having this problem |
-can cause a prerenal failure due to dilation of efferent arterioles
-pt at risk: elderly, diabetics, hypertensive |
|
|
T or F
You cannot get renal failure by the obstruction of only a single kidney if pt has both kidneys in place |
TRUE
|
|
|
What are some of the causes of postrenal azotemia?
|
bladder cancer
prostate hypertrophy (most common) bilateral renal disease neurogenic bladder |
|
|
What are the 2 major causes of ATN
|
Ischemic
Toxic injury |
|
|
What are the 3 phases of ATN?
|
Prodrome: acute injury
Oliguric (<400ml/hr) or Anuric (<100ml/hr) Postoliguric- diuretic phase |
|
|
What are values consistent with ATN?
BUN:creatinin ratio urine Na urine osmolality |
BUN:creatinin ratio: 10:1
urine Na: high urine osmolality: < 350 |
|
|
How can you tell the difference between prerenal and ATN on lab values?
Urine osmolarity: Urine Na FeNa Urine sediment |
Prerenal:
Urine osmolarity: > 500 Urine Na: < 20 FeNa: < 1% Urine sediment: scant ATN Urine osmolarity: < 350 Urine Na: > 40 FeNa: > 1% Urine sediment: brown pigmented granular cast |
|
|
What are the symptoms ass. with allergic interstitial nephritis?
What are the drugs? |
-fever
-rash -eosinophile in urine Drugs: penicillins, NSAIDS, PPI, sulfa drugs, diuretics |
|
|
What test is important to order when a pt presents with rhabdomyolysis?
|
EKG or potassium level (peaked T waves)
-Acidosis and hyperkalemia can lead to arrhythmia |
|
|
What is the tx for hyperkalemia?
|
calcium chloride
calcium gluconate |
|
|
What are the metabolic disturbances that can occur in rabdomyolysis?
|
hyperphosphatemia
hyperkalemia hypocalcemia hyperuricemia |
|
|
What is an important disease that can occur after angioplasty?
What are some of the physical findings? |
Atheroembolic disease
-esinophilia -low complement levels -bluish discoloration of fingers and toes -livedo reticularis |
|
|
Can NSAIDS cause renal failure and if so by what mechanism?
|
YES
-interstitial nephritis -direct toxic effect on tubules -papillary necrosis -glomerulonephritis (most pt will have underling renal problems) |
|
|
A pt presents with very acute flank pain, hematuria, pyuria and fever. Cultures grew no organism
What could be the cause? |
Papillary necrosis
-seen in: sickle cell, DM, chronic phyelo, NSAID use Best test: CT scan |
|
|
If a pt with underlying renal disease and needs a CT scan what can you do?
|
Hydration 1-2 liters of normal saline over 12 hrs
Bicarbonate or N acetyl cystine |
