Concepts Unit 3 EXAM

What is the definition of Acute Kidney Injury (AKI)?

The abrupt deterioration of renal function with fluid, electrolyte, and waste accumulation.

What are the three criteria for diagnosing AKI?

Serum creatinine increase, urine volume decrease, or creatinine rise to 1.5x baseline.

What are the three classifications of AKI?

Pre-renal, Intra-renal, and Post-renal.

What is the primary cause of pre-renal AKI?

Reduced kidney perfusion.

What causes intra-renal AKI?

Damage to kidney tissue.

What causes post-renal AKI?

Obstruction of urine outflow.

What are common pre-renal AKI etiologies?

Hypotension, hypovolemia, myocardial infarction (MI), and thrombosis.

What are common intra-renal AKI etiologies?

Glomerulonephritis, acute tubular necrosis (ATN), and nephrotoxins.

What are common post-renal AKI etiologies?

Cancer, kidney stones, clots, and strictures.

What urine output indicates Stage 1 AKI?

Less than 0.5 mL/kg/hr for over 6 hours.

What urine output indicates Stage 2 AKI?

Less than 0.5 mL/kg/hr for over 12 hours.

What urine output indicates Stage 3 AKI?

Less than 0.3 mL/kg/hr for over 12 hours or anuria.

What lab value increases with Stage 1 AKI?

Serum creatinine 1.5-1.9 times baseline or more than 0.3 mg/dL.

What lab value increases with Stage 2 AKI?

Serum creatinine 2-2.9 times baseline or more than 0.3 mg/dL.

What lab value increases with Stage 3 AKI?

Serum creatinine 3 times baseline or more than 4 mg/dL.

What are signs of fluid volume excess in Stage 3 AKI?

Hypertension and encephalopathy.

What hormone systems are activated in Stage 1 AKI?

RAAS (Renin-Angiotensin-Aldosterone System) and ADH.

What are common physical manifestations of AKI?

Neuromuscular, cardiovascular, hematological, integumentary, gastrointestinal, renal, metabolic, and respiratory symptoms.

What diagnostic tests are used for AKI?

History, physical exam, imaging, ultrasound, BMP, CBC, urinalysis, CT/MRI, biopsy.

What is the goal of medical management in pre-renal AKI?

Identify risk factors, monitor urine output, and maintain MAP >65.

What is the role of dopamine in pre-renal AKI?

Increases renal blood flow and urine output.

What dietary restrictions are recommended for Stage 2-3 AKI?

High carb, low protein, sodium, and potassium restriction.

What therapy is used for waste removal in AKI?

Dialysis, specifically CRRT.

What is the purpose of Foley catheters in AKI management?

Monitor hourly urine output.

What is the main focus of post-renal AKI treatment?

Remove obstruction (e.g., stents, surgery).

What patient education is important for those with AKI?

Fluid restriction, daily weights, blood pressure management, medication, and dialysis adherence.

What is the difference between nephritic and nephrotic syndrome?

Nephritic involves blood loss in urine, while nephrotic involves protein loss in urine.

What causes acute glomerulonephritis (GN)?

An excessive immune response causing damage and inflammation to the glomeruli.

What are the effects of chronic glomerulonephritis on kidney tissue?

Kidney tissue atrophies, with reduced nephron function and glomerular filtration rate (GFR).

What is a primary manifestation of acute glomerulonephritis?

Hematuria (tea or rust-colored urine).

What are common systemic manifestations of acute glomerulonephritis?

Hypertension, edema, fatigue, and uremia.

What diagnostics are used to confirm acute glomerulonephritis?

BMP, urinalysis, ASO titers, and kidney biopsy.

What is the medical management approach for nephrotic syndrome?

Fluid restriction, diuretics, prednisone, and anticoagulation therapy.

What is the key manifestation of nephrotic syndrome?

Proteinuria greater than 3.5g/24hr urine.

What dietary restrictions are recommended for nephrotic syndrome?

Sodium restriction and increased protein intake if no renal insufficiency.

What are common causes of chronic kidney disease (CKD)?

Diabetes mellitus, hypertension, and nephrotoxic medications.

What defines Stage 1 of CKD?

GFR greater than 90 mL/min with no visible kidney damage.

What defines Stage 3 CKD?

GFR 30-59 mL/min with azotemia and albuminuria.

What medical intervention is typically anticipated by Stage 5 CKD?

Dialysis or kidney transplant.

What is the purpose of fluid management in CKD?

To attain fluid balance and prevent fluid overload.

What dietary restrictions are important for CKD patients?

Protein, sodium, potassium, and phosphorus restriction based on kidney function.

What is the purpose of a kidney-friendly diet?

To limit waste and fluid buildup in the body.

Which nutrients are typically restricted in a kidney-friendly diet?

Potassium, phosphorus, and fluids.

Why should potassium be limited in kidney disease?

High potassium can cause muscle cramps, heart issues, and weakness.

What are some low-potassium food options for CKD patients?

Apples, grapes, cauliflower, and white bread.

What are some high-potassium foods CKD patients should avoid?

Bananas, potatoes, and tomatoes.

Why is phosphorus limited in CKD?

High phosphorus weakens bones by building up in the blood.

What are some low-phosphorus food options for CKD patients?

Corn cereal, sourdough bread, and unsalted popcorn.

What is the effect of too much fluid in CKD patients?

Fluid overload can lead to high blood pressure, swelling, and heart failure.

What can CKD patients do to reduce thirst when on fluid restrictions?

Chew gum, rinse mouth, or suck on ice or sugar-free candy.

Why may CKD patients need special vitamin supplements?

Kidney-friendly diets can lack essential vitamins and minerals.

What are the common diagnostics for AKI?

BMP, CBC, urinalysis, and 24-hour urine collection.

What imaging techniques are used in AKI diagnosis?

Ultrasound, CT, MRI, X-ray, and cystoscopy.

What are key manifestations of AKI?

Oliguria, metabolic acidosis, hyperkalemia, and pruritus.

What are the neurological manifestations of AKI?

Headache, confusion, seizures, and coma.

What are potential treatments for AKI?

Diuretics, dopamine, ACE inhibitors, and dialysis.

What causes pulmonary edema in AKI?

Fluid volume excess (FVE) due to decreased kidney function.

What dietary restrictions are recommended for AKI patients?

Sodium, potassium, and protein restrictions.

What interventions are recommended for AKI?

Seizure precautions, dialysis, I/O monitoring, and medication adjustment.

What can AKI lead to if not treated promptly?

Chronic kidney disease or irreversible kidney damage.

What are the causes of CKD?

Repeated kidney insults, congenital issues, and intra-renal damage.

What are common manifestations of CKD?

Edema, anemia, neuropathy, and bone pain.

What causes anemia in CKD?

Reduced erythropoietin production and low red blood cell count.

What dietary restrictions are important for CKD patients?

Low phosphorus, sodium, and potassium intake.

What is the role of vitamin D in CKD?

To maintain bone health by regulating calcium and phosphorus.

What are common lab findings in nephritic syndrome?

Elevated BUN/creatinine, hematuria, and reduced GFR.

What are the immune markers associated with nephritic syndrome?

IgG immune complexes, positive ANA, and elevated ASO titers.

What are common symptoms of nephritic syndrome?

Hematuria, edema, oliguria, and hypertension.

What is the main difference between nephritic and nephrotic syndrome?

Nephritic has hematuria; nephrotic has proteinuria.

What are the common causes of nephritic syndrome?

Recent infections, autoimmune diseases, and immune complex deposition.

What is the treatment focus for nephritic syndrome?

Managing fluid overload, infection, and hypertension.

What lab values are indicative of nephrotic syndrome?

Hypoalbuminemia, hyperlipidemia, and elevated BUN/creatinine.

What are the key manifestations of nephrotic syndrome?

Proteinuria, ascites, edema, and clotting issues.

Why do patients with nephrotic syndrome have an increased risk of blood clots?

Loss of antithrombotic factors and production of prothrombotic factors.

What is the recommended dietary approach for nephrotic syndrome?

Low sodium, low fat, and moderate protein intake.

What are common complications of nephrotic syndrome?

Pulmonary embolism, deep vein thrombosis, and renal vein thrombosis.

What is the role of steroids in nephrotic syndrome treatment?

To reduce glomerular inflammation and protein leakage.

What are the typical lab findings in nephrotic syndrome?

Lipiduria, proteinuria, and hypoalbuminemia.

What causes ascites in nephrotic syndrome?

Fluid accumulation due to reduced oncotic pressure from protein loss.

What symptoms are associated with fluid overload in nephritic syndrome?

Periorbital edema, hypertension, and weight gain.

What is the cause of hematuria in nephritic syndrome?

Inflammation of the glomeruli allowing blood to enter the urine.

What immune complexes are commonly found in nephritic syndrome?

IgG immune complexes trapped in the glomeruli.

What triggers the inflammatory response in nephritic syndrome?

Recent infections, such as strep throat or impetigo.

What is the effect of hypertension in nephritic syndrome?

Can lead to hypertensive encephalopathy and other complications.

What is the role of plasmapheresis in nephritic syndrome treatment?

To remove antibodies causing glomerular inflammation.

What are the signs of uremia in CKD patients?

Metallic taste, itchy skin, and uremic frost.

What electrolyte abnormalities are common in CKD?

Hyperkalemia, hyperphosphatemia, and hypocalcemia.

What medications are commonly used in CKD management?

ACE inhibitors, diuretics, and phosphate binders.

What interventions help manage fluid overload in CKD?

Fluid restriction, diuretics, and dialysis.

What are the risks associated with untreated hyperkalemia in CKD?

Cardiac arrhythmias, muscle weakness, and paralysis.

What dietary recommendations help manage CKD?

Low potassium, low sodium, and protein moderation.

What is dialysis disequilibrium syndrome?

Cerebral swelling due to intravascular hypotonicity during dialysis.

What are common symptoms of dialysis disequilibrium syndrome?

Headache, nausea, blurred vision, and confusion.

How can dialysis disequilibrium syndrome be prevented?

Slow, gentle initial dialysis and limited urea clearance.

What is the purpose of phosphate binders in CKD treatment?

To prevent phosphorus buildup and protect bone health.

What is the role of protein restriction in CKD management?

To reduce kidney workload and prevent further damage.

What are common manifestations of fluid overload in CKD?

Hypertension, pulmonary edema, and weight gain.

What are the neurological effects of CKD?

Confusion, seizures, and neuropathy.

What are the effects of CKD on bone health?

Bone pain, fractures, and alterations in vitamin D metabolism.

What are common causes of AKI?

Pre-renal, intra-renal, and post-renal etiologies.