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Management of Acute Kidney Injury

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Objectives 1. Clinical diagnosis of acute kidney injury. 2. Identifying the aetiology of acute kidney injury. 3. Learn the complications of acute kidney injury. 4. Management of complications of acute kidney injury. 5. Basics of renal replacement therapy in acute kidney injury. 1.  Clinical diagnosis of acute kidney injury. Usual manifestations of acute kidney injury is oliguria (Reduced urine output). With the progression of renal impairment, patients develop various complications such as acidosis/ uremia which give rise to other manifestations. There are various criterions to diagnose AKI, you don't have to memorise those. Increase in S.Cr by >0.3 mg/dl (>26.5 umol/l) within 48 hours; or Increase in S.Cr to >1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or  Urine volume < 0.5 ml/kg/h for 6 hours. 2. Identifying the aetiology of acute kidney injury. You must be already knowing that acute kidney ...

COPD exacerbation

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Objectives 1. Clinical diagnosis of COPD exacerbation 2. Principles of initial management 3. Assessing the clinical response 4. Principles of managing refractory exacerbation 1. Clinical diagnosis of COPD exacerbation Patients usually present with increasing SOB. If the precipitant is an infection, they may also have productive cough with yellowish sputum, fever, anorexia, pleuritic chest pain In patients with advanced COPD there will be Features of hyperinflation - Barrel shape, impaired cardiac and liver dullness Features of Cor-pulmonale - Elevated JVP, Edema, Tender hepatomegaly Generalized wasting Look for features of hypoxia - Cyanosis Look for features of CO2 retention - Flapping tremors, Bounding pulses 2. Principles of initial management These patients need HDU care. Patient should be propped up and attached to a monitor. Oxygen therapy Should be administered cautiously. In patients with long standing COPD, especially if they have fea...