Aquifer Internal Medicine Case 33
Questions and Answers 100% Correct
AKI definitions - ✔✔An increase in serum creatinine ≥ 0.3 mg/dl within 48 hours
Increase in serum creatinine to ≥ 1.5 times baseline, which is known or presumed to
have to have occurred within the prior
seven days
Urine volume < 0.5 ml/kg/hr for six hours
prerenal AKI pathophysiology - ✔✔decreased renal perfusion: hypovolemia or
hypotension
enhanced tubular absorption of both na and water increases passive reabsorption of
urea
prerenal AKI etiology - ✔✔hypovolemia: diarrhea, vomiting, poor fluid intake,
diuretics, fever, surgical fluid losses
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cardiorenal: decreased CO with decreased renal perfusion (CHF, MI)
systemic vasodilation with decreased renal perfusion: sepsis, cirrhosis with hepatorenal
syndrome, anesthesia
renal hypo perfusion: atherosclerosis, fibromuscular dysplasia or meds that
vasoconstrictor afferent arterial (NSAIDs)
intrinsic AKI pathophysiology - ✔✔damaged tubules, glomeruli or blood vessels
injured nephrons can't maintain homeostasis
intrinsic AKI causes - ✔✔tubules: ATN: sepsis, renal ischemia (MI or vascular surgery),
prolonger prerenal insult, hemorrhagic shock, ahminoglycosides, radiocontrast,
myoglobin, hemoglobin, chemo, myeloma light chains
AIN: allergic reaction to drug (fever, rash, eosinophilia, renal dysfunction);
fluoroquinolone, sulfa drugs, beta lactams, NSAIDs
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