CS: AKI

5 Written Questions

1. a/w renal failure, nephrolithiasis, nephrogenic DI
2. cause: impaired concentration ability, impaired Na reabsorption, type 1 RTA
3. muscle pain/weakness, elevated CK, elevated ALT/AST, renal failure: myoglobinuria, increased K, PO4, uric acid, decreased Ca
4. subacute renal failure. skin: cyanotic digits, livido reticularis; GI: ischemic bowel; eosinophilia. renal biopsy: biconvex cholesterol clefts.
5. PE: dehydration. Lab: FENA <1%, hemoconcentration, BUN/Cr > 20

5 Matching Questions

1. hepatorenal syndrome
2. multiple myeloma: LCDD
3. acute GN
4. acute tubular apoptosis
5. acute tubular necrosis

1. a cause: ischemia, sepsis, nephrotoxicity (drug-induced)
2. b cause: post-infectious, vasculitis
3. c a/w ischemic renal injury
4. d tx: midodrine (selective vasoconstrictor), octreotide (inhibits vasodilator release), albumin, vasopressin, possibly liver transplant
5. e presents as nephrotic syndrome. light chains metabolized by macrophages, secrete congo red negative LC fragment deposits

5 Multiple Choice Questions

1. a/w post-infectious GN, cryoglobulinemia, SLE, membranoproliferative GN, hep C
   1. tumor lysis syndrome
   2. pre-renal azotemia
   3. multiple myeloma: LCDD
   4. low levels of complement
2. hepatorenal syndrome, hypercalcemia
   1. hypercalcemia
   2. postrenal AKI
   3. hepatorenal syndrome
   4. pre-renal azotemia
3. low GFR d/t renal vasoconstriction. unresponsive to volume expansion
   1. tumor lysis syndrome
   2. postrenal AKI
   3. hepatorenal syndrome
   4. uremic syndrome
4. tx: IV hydration, diuretics, rasburicase, hemodialysis, CRRT
   1. uremic syndrome
   2. hepatorenal syndrome
   3. rhabdomyolysis
   4. tumor lysis syndrome
5. tx: isotonic saline, loop diuretics, calcitonin, bisphosphonates
   1. hypercalcemia
   2. pre-renal azotemia
   3. acute GN
   4. postrenal AKI

5 True/False Questions

1. acute interstitial nephritis → Lab: BUN/Cr <10, FENA >2, UA: tubular epithelium

   True        False

2. multiple myeloma: amyloidosis → presents as nephrotic syndrome. light chains metabolized by macrophages, secrete LC fragments => Congo red positive B-pleated fibrils

   True        False

3. TTP-HUS → cause: post-infectious, vasculitis

   True        False

4. acute interstitial nephritis → Lab: BUN/Cr <10, FENA >2, UA: tubular epithelium

   True        False

5. goodpasture's → cause: obstruction d/t tubular defects

   True        False