PCCN Renal/Electrolytes/Fluids Exam questions with
accurate answers.
BUN/Crt Ratio - accurate answers-10-15mg/dl to 1mg/dl
Reasons BUN is elevated disproportionally to crt - accurate answers-
dehydration, hypovolemia
catabolism, rhabdo
blood in the gut
AKI labs - accurate answers-BUN elevation and CRT normal/pt baseline
AKI causes: pre-renal - accurate answers-disrupted blood flow to kidneys dt
- decreased intravascular volume ex. burns
- hypotension
- vasodilation
- renovascular disease
- mechanical block
AKI causes: post-renal - accurate answers-caused by issue/disease
downstream of kidneys
- UTI
- BPH
- Neurogenic bladder
- Kidney stones
- obstructed stents or foley
- tumor
AKI causes: intrinsic - accurate answers-kidney itself is damaged
- Glomerulonephritis
- Acute tubular nephrosis or nephritis
- Rhabdo
- Tumor lysis syndrome
- Nephrotoxic meds
Oliguria - accurate answers-urine output less than 400 ml/day
, MAP and kidney relationship - accurate answers-Map >65 for adequate renal
perfusion
Urine output and GFR will decline when BP decreases
AKI Onset (Phase 1) - accurate answers-duration of time from precipitating
event to the beginning of oliguria
can be hours to days
AKI oliguric phase (Phase 2) - accurate answers-when urine output <400ml in
24 hours
↑ BUN/crt rise proportionally
↑ K+ hyperkalemia
↓ Na, water gain w dilutional hyponatremia
↓ decreased osmolality
↑ hyperphosphatemia
↓ hypocalcemia
metabolic acidosis
duration 1-2 weeks
mortality rate is at highest (50-60%)
AKI diuretic phase (Phase 3) - accurate answers-when urine output > 400ml
in 24hours; can be as high as 3L
metabolic acidosis
↑ K+ hyperkalemia
sodium depends on volume status
duration 1-2 weeks
AKI recovery phase (Phase 4) - accurate answers-period between when labs
stabilize until return to normal
duration 3-12 months
BUN/Crt normalizes
acid base and electrolyte imbalances gradually resolve
AKI treatment - accurate answers-Pre-renal: fluids
accurate answers.
BUN/Crt Ratio - accurate answers-10-15mg/dl to 1mg/dl
Reasons BUN is elevated disproportionally to crt - accurate answers-
dehydration, hypovolemia
catabolism, rhabdo
blood in the gut
AKI labs - accurate answers-BUN elevation and CRT normal/pt baseline
AKI causes: pre-renal - accurate answers-disrupted blood flow to kidneys dt
- decreased intravascular volume ex. burns
- hypotension
- vasodilation
- renovascular disease
- mechanical block
AKI causes: post-renal - accurate answers-caused by issue/disease
downstream of kidneys
- UTI
- BPH
- Neurogenic bladder
- Kidney stones
- obstructed stents or foley
- tumor
AKI causes: intrinsic - accurate answers-kidney itself is damaged
- Glomerulonephritis
- Acute tubular nephrosis or nephritis
- Rhabdo
- Tumor lysis syndrome
- Nephrotoxic meds
Oliguria - accurate answers-urine output less than 400 ml/day
, MAP and kidney relationship - accurate answers-Map >65 for adequate renal
perfusion
Urine output and GFR will decline when BP decreases
AKI Onset (Phase 1) - accurate answers-duration of time from precipitating
event to the beginning of oliguria
can be hours to days
AKI oliguric phase (Phase 2) - accurate answers-when urine output <400ml in
24 hours
↑ BUN/crt rise proportionally
↑ K+ hyperkalemia
↓ Na, water gain w dilutional hyponatremia
↓ decreased osmolality
↑ hyperphosphatemia
↓ hypocalcemia
metabolic acidosis
duration 1-2 weeks
mortality rate is at highest (50-60%)
AKI diuretic phase (Phase 3) - accurate answers-when urine output > 400ml
in 24hours; can be as high as 3L
metabolic acidosis
↑ K+ hyperkalemia
sodium depends on volume status
duration 1-2 weeks
AKI recovery phase (Phase 4) - accurate answers-period between when labs
stabilize until return to normal
duration 3-12 months
BUN/Crt normalizes
acid base and electrolyte imbalances gradually resolve
AKI treatment - accurate answers-Pre-renal: fluids
