Intrinsic acute kidney injury (AKI) (Smarty PANCE) Test Questions and
Answers Rated A
What is intrinsic AKI?- Renal injury causing
impaired filtration, reabsorption, or excretion What drugs commonly cause acute interstitial
nephritis (AIN)?- NSAIDs, penicillins,
What are the FOUR major categories of intrinsic sulfonamides
AKI based on the location of the injury- 1.
Tubular (e.g., ATN) What clinical features are suggestive of AIN?-
2. Glomerular (e.g., glomerulonephritis) Fever, rash, eosinophilia, eosinophiluria
3. Interstitial (e.g., AIN)
4. Vascular (e.g., thrombotic microangiopathy) How is drug-induced AIN treated?-
Discontinue the offending drug; consider
What is the most common cause of intrinsic corticosteroids
AKI?- Acute tubular necrosis (ATN)
Urinalysis findings in glomerulonephritis (GN)?-
What are the main causes of acute tubular Dysmorphic red blood cells and RBC casts
necrosis (ATN)?- ischemia (e.g.,
hypotension, sepsis) or nephrotoxins (e.g., Urinalysis findings in AIN?- WBC casts and
aminoglycosides, contrast media, myoglobin in eosinophiluria (Hansel stain)
rhabdomyolysis)
What urinalysis finding is characteristic of ATN?-
What are common exogenous nephrotoxins in Muddy brown granular casts , epithelial
ATN?- Aminoglycosides, radiographic cells
contrast agents
What is the best initial diagnostic test for AKI?-
What endogenous substances can cause ATN?- Renal ultrasound to rule out obstruction
Myoglobin (rhabdomyolysis), hemoglobin
(hemolysis) What are the common complications of intrinsic
AKI?- Hyperkalemia, metabolic acidosis,
What is the BUN:creatinine ratio in intrinsic AKI?- uremia
<15:1
What electrolyte disturbance is common in
What is the fractional excretion of sodium (FeNa) intrinsic AKI?- Hyperkalemia
in intrinsic AKI?- FeNa is typically >2% in In intrinsic AKI, impaired tubular function reduces
acute tubular necrosis (ATN) due to impaired potassium excretion, causing it to accumulate in
sodium reabsorption (indicates tubular damage). the blood. Additionally, cell damage and
However, it may be <2% in other forms of breakdown (e.g., in acute tubular necrosis or
intrinsic AKI like glomerulonephritis, where rhabdomyolysis) release intracellular potassium,
tubular function may remain intact. further raising serum levels.
What differentiates ATN from prerenal AKI using What metabolic disturbance is common in
urine sodium?- In ATN, urine sodium is >40 intrinsic AKI?- Metabolic acidosis with an
mEq/L due to impaired reabsorption by damaged elevated anion gap
tubules, whereas in prerenal AKI, it is <20 mEq/L In intrinsic AKI, the kidneys cannot excrete
because the kidneys conserve sodium in hydrogen ions or regenerate bicarbonate
response to hypoperfusion effectively, leading to a buildup of acids.
1/2
Answers Rated A
What is intrinsic AKI?- Renal injury causing
impaired filtration, reabsorption, or excretion What drugs commonly cause acute interstitial
nephritis (AIN)?- NSAIDs, penicillins,
What are the FOUR major categories of intrinsic sulfonamides
AKI based on the location of the injury- 1.
Tubular (e.g., ATN) What clinical features are suggestive of AIN?-
2. Glomerular (e.g., glomerulonephritis) Fever, rash, eosinophilia, eosinophiluria
3. Interstitial (e.g., AIN)
4. Vascular (e.g., thrombotic microangiopathy) How is drug-induced AIN treated?-
Discontinue the offending drug; consider
What is the most common cause of intrinsic corticosteroids
AKI?- Acute tubular necrosis (ATN)
Urinalysis findings in glomerulonephritis (GN)?-
What are the main causes of acute tubular Dysmorphic red blood cells and RBC casts
necrosis (ATN)?- ischemia (e.g.,
hypotension, sepsis) or nephrotoxins (e.g., Urinalysis findings in AIN?- WBC casts and
aminoglycosides, contrast media, myoglobin in eosinophiluria (Hansel stain)
rhabdomyolysis)
What urinalysis finding is characteristic of ATN?-
What are common exogenous nephrotoxins in Muddy brown granular casts , epithelial
ATN?- Aminoglycosides, radiographic cells
contrast agents
What is the best initial diagnostic test for AKI?-
What endogenous substances can cause ATN?- Renal ultrasound to rule out obstruction
Myoglobin (rhabdomyolysis), hemoglobin
(hemolysis) What are the common complications of intrinsic
AKI?- Hyperkalemia, metabolic acidosis,
What is the BUN:creatinine ratio in intrinsic AKI?- uremia
<15:1
What electrolyte disturbance is common in
What is the fractional excretion of sodium (FeNa) intrinsic AKI?- Hyperkalemia
in intrinsic AKI?- FeNa is typically >2% in In intrinsic AKI, impaired tubular function reduces
acute tubular necrosis (ATN) due to impaired potassium excretion, causing it to accumulate in
sodium reabsorption (indicates tubular damage). the blood. Additionally, cell damage and
However, it may be <2% in other forms of breakdown (e.g., in acute tubular necrosis or
intrinsic AKI like glomerulonephritis, where rhabdomyolysis) release intracellular potassium,
tubular function may remain intact. further raising serum levels.
What differentiates ATN from prerenal AKI using What metabolic disturbance is common in
urine sodium?- In ATN, urine sodium is >40 intrinsic AKI?- Metabolic acidosis with an
mEq/L due to impaired reabsorption by damaged elevated anion gap
tubules, whereas in prerenal AKI, it is <20 mEq/L In intrinsic AKI, the kidneys cannot excrete
because the kidneys conserve sodium in hydrogen ions or regenerate bicarbonate
response to hypoperfusion effectively, leading to a buildup of acids.
1/2
