Term
| top causes of AKI in ICU-3 |
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Definition
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Term
| pts with underlying risk for AKI-3 |
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Definition
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Term
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Definition
NSAIDS
chemo
penicillins
acyclovir
ampho B
aminoglycosides |
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Term
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Definition
| inc of Sr Cr 0.3 in 48 hrs increa SCr 1.5x w/i 7 days urine volume .5mL/kg/hr for 6 hrs |
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Term
| AKIN criteria says SrCr rise within 48 hrs |
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Definition
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Term
| RIFLE crterisa says SrCr rise in 1-7 days and sustained for 24 hrs |
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Definition
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Term
| look at slide 18 for staging in AKI right before test |
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Definition
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Term
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Definition
| drop in BP stops flow to kidneys |
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Term
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Definition
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Term
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Definition
| obstruction of urine flow |
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Term
| pre-renal repsonse to treatment is? |
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Definition
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Term
| lab signs of pre-renal AKI-4 |
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Definition
BUN>20
decreased BP
increased HR
Na<40 |
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Term
| causes of pre-renal AKI-4 |
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Definition
diuretics
vasoconsticiotn form cyclosporin/ampho B
Heart failure
imapried renal autoregulation from ACEi/ARB/NSAIDS |
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Term
| treatment for pre-renal AKI |
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Definition
treat underlying cuase
replace fluids (mild bleed=.9% Ns, renal/gi losses= .45%) |
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Term
| types of damage leading to intrrenal AKI-4 |
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Definition
acute tubular (ATN)
acute interstitial (AIN)
glomerluonephritis
vascular damage |
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Term
| most intra renal AKI will return to nromal espeically if caused by? |
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Definition
| drugs (may take days tho!) |
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Term
| signs of intra renal AKI-4 |
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Definition
elevated temp
BUN<15
NA>40
protein in urine |
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Term
| causes of acute tubular necorsis-3 |
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Definition
| cyclosporin, aminoglycoside, cocaine |
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Term
| causes of Acute interstitial necorsis-3 |
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Definition
| penicillin, cipro, sulfonamide |
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Term
| treatment for vascualr or glomerluonephritis for intra renal AKI-2 |
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Definition
corticosteroids
cyclophosphamide |
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Term
| treatment for AIN in intrrenal AKI-2 |
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Definition
corticosteroids
remove cuase |
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Term
| treatment for ATN in intrrenal AKI |
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Definition
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Term
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Definition
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Term
| signs of post renal AKI-4 |
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Definition
BUN<15
Na>40
urine is normal
obstrucution on ultrasound |
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Term
| what drugs cna cause kidney stones-3 |
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Definition
indinavir
acyclovir
sulfanomides |
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Term
| treatment for psot renal AKI-3 |
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Definition
remove cause
catheter for bladder obsturuction
surgery for kidney stones |
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Term
| 2 most common cuases of AKI in ICU |
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Definition
rhabdo
contrast nephropathy |
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Term
| treatment for contrast nephropahty? |
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Definition
| no good ones, so do prophyalxis |
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Term
| risk factros for contrast nephro-3 |
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Definition
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Term
| look on slide 38 for contrast enphro risk score, aks someon if need ot know! |
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Definition
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Term
what volume of contrast dye has high risk for CN?
which test has this? |
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Definition
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Term
| which types of contrast are better?-2 |
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Definition
low osmolar 600-800
iso-osmolar- 290 |
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Term
| what is the best dye to use? |
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Definition
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Term
| use non ionic or ionic contrast dye? |
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Definition
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Term
| gold standard for preventing CN?> |
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Definition
| hydraiton therapy (esp oral) |
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Term
| how does hydraiton therapy help prevent CN? |
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Definition
flushes radicals
counteract vasoconstriciton |
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Term
| which fluid types shoudl be used for CN prevention?-2 |
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Definition
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Term
| urien flow rate for hydraiton therapy in CN should be wht? |
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Definition
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Term
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Definition
| 2 ml/kg/hr 12 hrs before and after contrast |
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Term
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Definition
3 ml/kg/hr 1 hr before
1 ml/kg for 6 hrs after |
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Term
| in emergency situaitons can give bicarb bolus of- |
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Definition
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Term
is n acytlycystien recocmend for CN prophylaxis?
if you did which formulation would you sue nad why? |
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Definition
not really-
oral, less expesnive an dADEs |
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Term
| n acytlcysteine PO dosing |
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Definition
| 600 bID day before and day of |
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Term
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Definition
| 600 mg bolus before and 1200 q 12 hrs x 4 after |
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Term
| asocrobic acid and fenoldopam are sometimes reccomedned for- |
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Definition
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Term
| if pt on statin and goingt o get contrast dye, what shoud be done? |
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Definition
| keep on it, may have antioxidant properties to prevent CN |
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Term
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Definition
| breakdown of skeletal muscle causing protein in circ |
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Term
| risk of AKI devloping form rhabdo inceases with increased conc of? |
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Definition
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Term
| look at slide 52 for pahtiphys of rhabdo |
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Definition
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Term
| what drugs cna cause rhabdo-7 |
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Definition
alcohol
cocoaine
hypntocs
statins
fibrates
TCa/SSRI
antipsychotics |
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Term
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Definition
increase CK MB
hyperK
tea colored urine |
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Term
| rhabdo complicaitons that cause AKI-3 |
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Definition
hypovolemia
acid urine <5.6
ferriheaemate has direct nephrotox->aTN |
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Term
Rhabdo treatment 1st thing
when shoud it be started?
what type? |
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Definition
hydraiton
w/i 6 hrs
9% (dont do lactated ringers->hyperK) |
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Term
what should be fluid rate used for rhabdo?
what is it adjusted to? |
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Definition
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Term
| contiue hydraiton for rhabdo until? |
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Definition
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Term
what is given to rhabdo pts with acidosis?
dose? -2 |
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Definition
sodium bicarb
1 amp in 1L NS
2-3 amps in 1 L dextorse |
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Term
| if pt doesnt respond to sodium bicarb can give? |
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Definition
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Term
when do you give pt mannitol in rhabdo?
what does i do |
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Definition
if cant get 300 mL/hr urine putput
promotes diuresis |
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Term
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Definition
20% sol with .5 g/kg over 15 min then
.1 g/kg/hr |
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Term
treatment options AKI:
crystalloids vs colloid? |
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Definition
| crystalloids, less epxensive and fewer ADEs |
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Term
| when do you use diuretics in AKI? |
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Definition
| only if pt has volume overload |
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Term
| what 3 drugs not reccomedned for AKI? |
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Definition
| fenoldapam, atrial naturietic, dopamine |
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