Kidney in Trouble
What are the types of AKI?
Renal, pre renal, post renal
What is the cutoff to define acute liver failure.
less than 26 weeks
List 2 Causes of Isotonic hyponatremia
Hyperlipidemia – very high levels of triglycerides
Hyperproteinemia – e.g., multiple myeloma, paraproteinemia
SPO2 target In COPD patient
88% to 92%
What is the cut off value of Normal Blood pressure?
<120/80 mmHg
List three complications of acute kidney injury.
Hypervolemia, Hyperkalemia, Metabolic acidosis, Uremia, platelet dysfunction, progression to CKD
List three causes of AST and ALT elevation above 1000 U/L.
DILI, Auto immune, Shock liver, Budd–Chiari syndrome ,viral hepatitis, Acute biliary obstruction
List 1 cause of hypertonic hyponatremia
Hyperglycemia, Mannitol use, radiocontrast agent.
List 4 method or devices used to administer oxygen?
Nasal cannulas, simple face masks,
face tents, nonrebreather masks, Venturi
masks, high flow nasal cannulas, noninvasive
positive-pressure ventilation.
List 5 causes of secondary hypertension
CKD, RAS, Thyroid dysfunction, hyperaldosteronism, cushings syndrome, pheochromocytoma, COA, OSA, Substance, raised ICP, pre eclampsia.
List 4 Indication for Dialysis
Uremia, Hyperkalemia, Hypervolemia, Acidosis, Toxins.
List 3 complication of acute liver failure
Encephalopathy, Coagulopathy, Hypoglycemia, Infection, HRS
List 4 parameters used to check volume status
BP, Pulse, JVP, skin turgor, peripheral edema, mucous membrane, lung auscultation, BUN, urine output.
What is the reason of using humidifier with oxygen?
Humidifier help prevent dryness and irritation by
adding moisture to the oxygen, improving
patient comfort, and protecting the airways
from potential injury.
5 Complication of Hypertension
MI, Stroke, Peripheral arterial disease, sub arachnoid hemorrhage, CKD, HTN Retinopathy, HF, Aortic dissection, Aortic aneurysm.
According to KDIGO, what are the criteria for acute kidney injury?
a) an increase in serum creatinine (SCr) to ≥1.5 times the baseline within 7 days or b) an increase in SCr by ≥0.3 mg/dL within 48 hours, or c) urine volume <0.5 mL/kg/h for at least 6 hours.
List the medications used for hepatic encephalopathy.
Lactulose
Rifaximin
Why over correction of sodium causes ODS?
If serum sodium is raised too quickly the extracellular fluid becomes hypertonic relative to the brain cells. Water moves out of brain cells, causing them to shrink. The sudden shrinkage damages oligodendrocytes, leading to central pontine and extrapontine demyelination.
List 4 contraindication of use of NIPPV
Coma, Cardiac arrest, Respiratory arrest, GI bleeding Intractable emesis and/or uncontrollable bleeding altered level of consciousness, status epilepticus.
Definition of Hypertensive emergency?
BP>180/120, with End Organ Damage.
List three treatment options for HRS.
Albumin, Octreotide and Midodrine
List the stages of hepatic encephalopathy along with clinical features of each stage.
Stage I – mild confusion, Stage II – disorientation + asterixis, Stage III – somnolence/stupor, Stage IV – coma.
List 4 Features of Osmotic Demyelination syndrome?
Quadriplegia, Diplopia, Dysarthria, Dysphagia, movement disorders, and altered consciousness.
5 indication of Intubation
GCS ≤ 8, coma, seizures, Loss of gag or cough reflex, massive hematemesis, GI bleed, vomiting with altered sensorium, Persistent PaO₂ < 60 mmHg on high FiO₂ or noninvasive support, PaCO₂ > 50 mmHg with acidosis (pH < 7.25), Impending or established respiratory muscle fatigue, Severe work of breathing, tachypnea > 35/min
What are the recommended BP reduction targets during a hypertensive emergency?
Lower BP 15-20% within 1-2 hours and 5% by next 23 hours.