chapter 42 quiz 3

Which of the following is NOT a common risk factor for acute kidney injury (AKI)?

Intravascular volume depletion
Aminoglycoside use
Radiocontrast dye exposure
Use of proton-pump inhibitors (correct)

Which of the following medications may contribute to intraoperative hypotension and exacerbate AKI in the setting of impaired hemodynamics?

Angiotensin-converting enzyme (ACE) inhibitors
Both ACE inhibitors and ARBs (correct)
Neither ACE inhibitors nor ARBs
Angiotensin II receptor blockers (ARBs)

Which of the following methods is recommended for identifying patients with preexisting renal insufficiency during the perioperative evaluation?

Measurement of serum creatinine and urinalysis (correct)
Measurement of urine output
Measurement of glomerular filtration rate (GFR)
Measurement of blood urea nitrogen (BUN)

Approximately what percentage of the United States population is affected by chronic kidney disease?

More than 10% (B) Signup and view all the answers

Which of the following is NOT mentioned as a common risk factor for chronic kidney disease?

Obesity (A) Signup and view all the answers

Which of the following genetic polymorphisms demonstrate strong associations with AKI after cardiac surgery?

IL-6 572C and angiotensinogen 842C polymorphisms (A) Signup and view all the answers

Among the following, which patient characteristic is NOT listed as a significant risk factor for AKI after cardiac surgery?

History of stroke (A) Signup and view all the answers

What did the KDIGO guidelines recommend regarding selecting off-pump CABG surgery?

Off-pump CABG should not be chosen solely to lessen AKI risk (B) Signup and view all the answers

What interaction did the CORONARY clinical trial show regarding preoperative chronic kidney disease and type of CABG surgery?

Beneficial effect of off-pump CABG in kidney disease patients (B) Signup and view all the answers

What is the primary mechanism by which anesthesia and surgery influence normal renal function?

Changes in blood pressure and cardiac output (D) Signup and view all the answers

What is the relationship between markers of abnormal central aortic compliance and postoperative AKI and dialysis?

Markers of abnormal central aortic compliance, such as preoperative isolated systolic hypertension and wide pulse pressure hypertension, are associated with an increased risk of postoperative AKI and dialysis (A) Signup and view all the answers

How does pulse pressure relate to the effects of large artery stiffness and the rate of pressure propagation and reflection within the arterial tree?

Pulse pressure is an index of the effects of large artery stiffness and the rate of pressure propagation and reflection within the arterial tree (C) Signup and view all the answers

How do patients with a predisposition to low flow attributable to abnormal central aortic compliance differ from normotensive patients in terms of perioperative renal risk?

Patients with abnormal central aortic compliance require higher perfusion pressure to maintain adequate flow and minimize renal risk compared to normotensive patients (C) Signup and view all the answers

How do epidural and spinal anesthesia affect the sympathetic innervation of the renal vasculature?

Epidural and spinal anesthesia both reduce sympathetic tone in the renal vasculature (A) Signup and view all the answers

What is the potential impact of intraoperative neuraxial blockade and postoperative epidural analgesia on the rate of postoperative acute kidney injury?

Intraoperative neuraxial blockade and postoperative epidural analgesia decrease the rate of postoperative AKI, although the evidence is controversial (B) Signup and view all the answers

What is the association between thoracic epidural anesthesia and improved surgical outcomes?

Thoracic epidural anesthesia is associated with improved surgical outcomes attributable, in part, to a reduction in perioperative morbidity, including reductions in infection, ileus, blood loss, and AKI (D) Signup and view all the answers

Which of the following inhaled anesthetics was associated with polyuric renal insufficiency when used for prolonged periods?

Enflurane (A) Signup and view all the answers

Which of the following is a potential mechanism by which propofol may have renoprotective effects?

Increasing production of bone morphogenetic protein7 (BMP-7) (C) Signup and view all the answers

According to the passage, which of the following statements is true regarding renal blood flow (RBF) during cardiopulmonary bypass (CPB) surgery?

RBF decreases to 12% to 13% of total pump flow (C) Signup and view all the answers

According to the passage, approximately what percentage of patients who undergo coronary artery bypass graft (CABG) surgery in the United States develop acute kidney injury (AKI) as defined by the need for acute dialysis or a doubling of serum creatinine from baseline?

5% (A) Signup and view all the answers

According to the passage, which of the following statements is true regarding the mechanism of perioperative acute kidney injury (AKI) during cardiac surgery?

The mechanism of perioperative AKI during cardiac surgery is multifactorial (C) Signup and view all the answers

According to the passage, which of the following statements is true regarding the use of dexmedetomidine during cardiac surgery?

A recent meta-analysis suggested a reduction in postoperative AKI with the use of dexmedetomidine (A) Signup and view all the answers

According to the passage, which of the following statements is true regarding the effects of sevoflurane, an inhaled anesthetic?

Sevoflurane generates a metabolite (compound A) that is associated with renal injury in experimental models, but there is no reported association with AKI. (C) Signup and view all the answers