What is the cause of Acute Tubular Necrosis? (Select one or more answers)
Increased BUN/Creatinine
Ischemia
Anemia
Sepsis
Nephrotoxins
Correct Answer : B,D,E
A. Increased BUN/Creatinine: Elevated BUN and creatinine levels reflect impaired renal function and reduced glomerular filtration. These findings are laboratory consequences of acute tubular necrosis rather than initiating causes. They help confirm kidney injury but do not trigger tubular damage.
B. Ischemia: Prolonged renal hypoperfusion leads to oxygen deprivation of tubular cells, resulting in cellular injury and necrosis. Common causes include hypotension, shock, or severe blood loss. Ischemia is one of the most frequent underlying mechanisms of acute tubular necrosis.
C. Anemia: Anemia reduces oxygen-carrying capacity but does not directly cause tubular cell necrosis. While severe anemia may contribute to overall tissue hypoxia, it is not a primary or direct cause of acute tubular necrosis.
D. Sepsis: Sepsis causes systemic inflammation, hypotension, and impaired microcirculation, all of which reduce renal perfusion. Inflammatory mediators further damage renal tubular cells. This combination places patients at high risk for developing acute tubular necrosis.
E. Nephrotoxins: Exposure to nephrotoxic substances such as aminoglycosides, contrast media, or heavy metals can directly injure renal tubular cells. Toxic damage disrupts cellular metabolism and integrity, leading to necrosis. Nephrotoxins are a common non-ischemic cause of acute tubular necrosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Obstruction of urine flow: Obstruction to urine outflow causes postrenal acute kidney injury by increasing pressure within the urinary tract. This mechanism affects kidney function after urine is formed rather than blood flow to the kidneys. Examples include ureteral obstruction or prostatic enlargement.
B. Reduced perfusion: Prerenal acute kidney injury results from decreased blood flow to the kidneys, leading to reduced glomerular filtration. Causes include hypovolemia, hypotension, heart failure, or shock. Prolonged hypoperfusion can progress to intrinsic kidney damage if not corrected.
C. Damage to kidney tissue: Direct injury to renal structures such as the tubules, glomeruli, or interstitium leads to intrinsic acute kidney injury. This pathology arises from ischemia, toxins, or inflammation affecting the kidney itself. It is not classified as prerenal.
D. Chronic kidney disease: Chronic kidney disease represents long-term, progressive loss of kidney function over months to years. It is not an acute process and does not describe a prerenal mechanism. Acute kidney injury involves a sudden decline in renal function.
Correct Answer is A
Explanation
CPP (Cerebral Perfusion Pressure) is calculated as:
CPP = MAP − ICP, where MAP is mean arterial pressure.
First, calculate MAP:
MAP = (SBP + 2 × DBP) ÷ 3
= (134 + 2 × 80) ÷ 3
= (134 + 160) ÷ 3
= 294 ÷ 3
= 98 mmHg.
Then, CPP = MAP – ICP
= 98 – 18
= 80 mmHg.
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