Progress 20 NME (page 322-339)

mbch4kz2's version from 2016-05-13 10:58


Question Answer
What creatine levels is stage 1 AKI?1.5-1.9 x baseline or >0.3m/dl increase
What creatine level is stage 2 AKI?2-2.9 x basline
What creatine level is stake 3 AKI?3 x baseline or >4mg/dl
Name 5 pre-renal causes of AKIDehdratino, sepsis, hypotension, shock, hepatorenal syndrome, severe heart failure, intr-abdoninal hypertension (compartment syndrome)
Name 3 post-renal causes of AKIProstate enlargement, renal stones and pelvic cancer
What 5 renal causes of AKINSAIDs, ACE-i, ARBs, gentamycin, Vasculitis, Interstitial nephritis, Myeloma, Rhabdomyelosis
What are the 3 stages of AKI?Inititiation (hours to days), Maintenance (1-2 weeks)- low urine output, established renal injury, Recovery phase
When would you consider haemodialysis in a patient with AKI?1. Fluid overload (pulmonary oedema) 2. High K >5.6 with ECg changes (or K>7 with normal ECG) 3. Pericardial rub 4. Uraemia/encephalopathy 5. Metabolic acidosis
Why would diabetes cause early satiety?Damage to the autonomic supple (neuropathy) of the stomach may cause early satiety
What is a side effect of metformin?B12 malabsorption
What are 4 things that K affects?1. Action potentials 2. Cardiac muscle potential 3. Pacemaker potential 4. Acid/base balance
Name 5 causes of hypokalaemia?Vomiting (lose pool of acid in stomach), Constipation (increased HCO3 absorption in the stomach), Alkalosis (low H causes cells to take up K), Unbalanced diet, Diuretics (high GFR- not enough time to absorb K), Renal loss, Hyperaldosteronism
Name 5 causes of hyperkalaemia?Acidosis, Cellular release (burns, tissue injury, chemotherapy), Excess K intake, Kidney failure, Hypoaldosteronism (Addison's), Dibates Mellitus
Name 3 effects of hypokalaemiaHyperpolarization (neurone much less likely to fire), CNS dysfunction, cardiac dysfunction, muscle weakness, respiratory arrest
Name 3 effects of hyperkalaemiaExcess depoliarization (hyperexcitability), cardiac dysfunction (slow HR- prolonged depolarisation, wide QRS), muscle over excitability (cramping, weakness, diarrhoea- hyper motility of GI system)
Name 3 causes of hyponatraemia?Diet, water retention (dilutes), diuretics, hypoaldosteronism, excessive ADH
Name 3 causes of hypernatraemiaSweating (water loss), diet, decreased ADH (alcohol, diabetes insipdus), hyperaldosteronism
What is normal NA3.5-5
What is responsible for moving K into cells?Insulin
What is the treatment of hyperkalaemia?1. Give Ca (IV CaCl2- 1g) or (IV CaGluconate- 1g). Re-stabilises cardiac cells by making the outside of the cells more +ve- doesn't affect K directly. IV CaCl2 should be given through a central line as can cause necrosis of subcutaneous tissue 2. B-agonist (activation of B-receptors that causes K into cells 3. HCO3 4. Insulin

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