ACUTE KIDNEY INJURY UPDATED EXAMS SCRIPT
QUESTIONS AND ANSWERS SURE A+
✔✔What BUN/creatinine ratio is seen in pre-renal failure - ✔✔A BUN/creatinine ratio
greater than 20:1 is seen in pre-renal failure.
✔✔How is urine osmolality affected in pre-renal failure - ✔✔Urine osmolality is typically
greater than 500 in pre-renal failure.
✔✔What urine specific gravity is seen in pre-renal failure - ✔✔Urine specific gravity is
typically greater than 1.018 in pre-renal failure.
✔✔What casts are commonly seen on urinalysis in pre-renal failure - ✔✔Benign or
hyaline casts are commonly seen on urinalysis in pre-renal failure.
✔✔What is FeNa used for in renal failure evaluation - ✔✔FeNa is used to help
determine the etiology of renal failure and differentiate pre-renal failure from intrinsic
renal failure.
✔✔What FeNa value suggests pre-renal failure - ✔✔A FeNa less than 1% suggests
pre-renal failure.
, ✔✔What FeNa value suggests intrinsic renal failure - ✔✔A FeNa greater than 1%
suggests intrinsic renal failure.
✔✔When can FeNa be inaccurate - ✔✔FeNa may be inaccurate after recent diuretic
use, in acute glomerulonephritis, or in non-oliguric patients.
✔✔What test should be used instead of FeNa after recent diuretic use - ✔✔FeUrea
should be used instead of FeNa after recent diuretic use.
✔✔What FeUrea value suggests pre-renal failure - ✔✔A FeUrea less than 35%
suggests pre-renal failure.
✔✔What FeUrea value suggests intrinsic renal failure - ✔✔A FeUrea greater than 35%
suggests intrinsic renal failure.
✔✔Why can FeNa be falsely low in non-oliguric patients - ✔✔FeNa can be falsely low if
urine output is good and sodium intake and excretion are relatively low.
✔✔How is decreased circulating volume treated in pre-renal failure - ✔✔Decreased
circulating volume in pre-renal failure is treated with volume repletion.
✔✔How is low cardiac output treated in pre-renal failure - ✔✔Low cardiac output in pre-
renal failure may be treated with inotropes, pericardiocentesis, or thrombolytics.
✔✔How is decreased systemic vascular resistance treated in pre-renal failure -
✔✔Decreased systemic vascular resistance in pre-renal failure is treated by repleting
vascular volume and adding vasoconstrictors.
✔✔What supportive measures are important in all cases of pre-renal failure -
✔✔Electrolytes should be monitored, euvolemia maintained, and additional
nephrotoxins avoided in pre-renal failure.
✔✔What electrolyte should be monitored closely in pre-renal failure - ✔✔Potassium
should be monitored closely in pre-renal failure.
✔✔How quickly does pre-renal failure usually improve - ✔✔Pre-renal failure usually
corrects quickly in most cases.
✔✔What is intrinsic renal failure - ✔✔Intrinsic renal failure is kidney disease in which the
renal parenchyma is damaged.
✔✔When should intrinsic renal failure be considered - ✔✔Intrinsic renal failure should
be considered after prerenal and postrenal causes have been excluded.
QUESTIONS AND ANSWERS SURE A+
✔✔What BUN/creatinine ratio is seen in pre-renal failure - ✔✔A BUN/creatinine ratio
greater than 20:1 is seen in pre-renal failure.
✔✔How is urine osmolality affected in pre-renal failure - ✔✔Urine osmolality is typically
greater than 500 in pre-renal failure.
✔✔What urine specific gravity is seen in pre-renal failure - ✔✔Urine specific gravity is
typically greater than 1.018 in pre-renal failure.
✔✔What casts are commonly seen on urinalysis in pre-renal failure - ✔✔Benign or
hyaline casts are commonly seen on urinalysis in pre-renal failure.
✔✔What is FeNa used for in renal failure evaluation - ✔✔FeNa is used to help
determine the etiology of renal failure and differentiate pre-renal failure from intrinsic
renal failure.
✔✔What FeNa value suggests pre-renal failure - ✔✔A FeNa less than 1% suggests
pre-renal failure.
, ✔✔What FeNa value suggests intrinsic renal failure - ✔✔A FeNa greater than 1%
suggests intrinsic renal failure.
✔✔When can FeNa be inaccurate - ✔✔FeNa may be inaccurate after recent diuretic
use, in acute glomerulonephritis, or in non-oliguric patients.
✔✔What test should be used instead of FeNa after recent diuretic use - ✔✔FeUrea
should be used instead of FeNa after recent diuretic use.
✔✔What FeUrea value suggests pre-renal failure - ✔✔A FeUrea less than 35%
suggests pre-renal failure.
✔✔What FeUrea value suggests intrinsic renal failure - ✔✔A FeUrea greater than 35%
suggests intrinsic renal failure.
✔✔Why can FeNa be falsely low in non-oliguric patients - ✔✔FeNa can be falsely low if
urine output is good and sodium intake and excretion are relatively low.
✔✔How is decreased circulating volume treated in pre-renal failure - ✔✔Decreased
circulating volume in pre-renal failure is treated with volume repletion.
✔✔How is low cardiac output treated in pre-renal failure - ✔✔Low cardiac output in pre-
renal failure may be treated with inotropes, pericardiocentesis, or thrombolytics.
✔✔How is decreased systemic vascular resistance treated in pre-renal failure -
✔✔Decreased systemic vascular resistance in pre-renal failure is treated by repleting
vascular volume and adding vasoconstrictors.
✔✔What supportive measures are important in all cases of pre-renal failure -
✔✔Electrolytes should be monitored, euvolemia maintained, and additional
nephrotoxins avoided in pre-renal failure.
✔✔What electrolyte should be monitored closely in pre-renal failure - ✔✔Potassium
should be monitored closely in pre-renal failure.
✔✔How quickly does pre-renal failure usually improve - ✔✔Pre-renal failure usually
corrects quickly in most cases.
✔✔What is intrinsic renal failure - ✔✔Intrinsic renal failure is kidney disease in which the
renal parenchyma is damaged.
✔✔When should intrinsic renal failure be considered - ✔✔Intrinsic renal failure should
be considered after prerenal and postrenal causes have been excluded.
