Acute kidney injury workup, electrolyte disorder management, and dialysis indications tested on USMLE Step 2 CK.
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- What formula calculates the fractional excretion of sodium (FENa)?
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(Urine Na x Plasma Cr) / (Plasma Na x Urine Cr) x 100- A FENa below 1% suggests which category of acute kidney injury?
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Prerenal azotemia- A FENa above 2% suggests which category of acute kidney injury?
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Intrinsic AKI (e.g., acute tubular necrosis)- In prerenal azotemia, the BUN to creatinine ratio is typically ____.
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greater than 20:1- Which urine sediment finding is classic for acute tubular necrosis?
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Muddy brown granular casts- Which urine sediment findings suggest acute interstitial nephritis?
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White blood cell casts and urine eosinophils- Which urine sediment findings suggest glomerulonephritis?
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Red blood cell casts and dysmorphic red blood cells- Name two drug classes that commonly cause acute interstitial nephritis.
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NSAIDs and beta-lactam antibiotics (e.g., penicillins)- What is the initial imaging study of choice for suspected postrenal AKI?
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Renal ultrasound (looking for hydronephrosis)- When does serum creatinine typically peak after contrast-induced nephropathy?
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About 3 to 5 days after contrast exposure- What is the best strategy to prevent contrast-induced nephropathy in at-risk patients?
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IV isotonic fluids given before and after the procedure- What urine sediment finding is characteristic of rhabdomyolysis-induced AKI?
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Pigmented muddy brown granular casts, with a urine dipstick positive for blood but no RBCs on microscopy- Which lab is markedly elevated in rhabdomyolysis and correlates with AKI risk?
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Creatine kinase (CK)- What does the mnemonic AEIOU represent in nephrology?
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The indications for emergent (urgent) dialysis- In the AEIOU dialysis mnemonic, what does A stand for?
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Severe metabolic acidosis refractory to medical therapy
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