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MedBridge Cambodia I create content about being a Medical Student, including the fun, and the stresses, I leave none of that out lol :) Oh, also, I like Mens Streetwear.

Drugs used in critical care (Part 9 )
17/09/2025

Drugs used in critical care (Part 9 )

Drugs used in critical care (Part 8 )
16/09/2025

Drugs used in critical care (Part 8 )

Drugs used in critical care (Part 7 )
15/09/2025

Drugs used in critical care (Part 7 )

Drugs used in critical care (Part 6 )
14/09/2025

Drugs used in critical care (Part 6 )

Drugs used in critical care (Part 5 )
13/09/2025

Drugs used in critical care (Part 5 )

Drugs used in critical care (Part 4 )
12/09/2025

Drugs used in critical care (Part 4 )

Drugs used in critical care (Part 3 )
11/09/2025

Drugs used in critical care (Part 3 )

Drugs used in critical care (Part 2 )
10/09/2025

Drugs used in critical care (Part 2 )

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10/09/2025

πŸ“Œ αž…αŸ‚αž€αžšαŸ†αž›αŸ‚αž€ αž”αž‘αž–αž·αžŸαŸ„αž’αž“αŸŒαž€αŸ’αž˜αŸαž„αž’αžΆαž™αž» 1 αžαŸ‚

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Drugs used in critical care (Part 1 )
10/09/2025

Drugs used in critical care (Part 1 )

1. Acute Kidney Injury (AKI)AKI can be divided into three main categories depending on the level of pathology:A. Pre-ren...
08/09/2025

1. Acute Kidney Injury (AKI)

AKI can be divided into three main categories depending on the level of pathology:

A. Pre-renal AKI (↓ Perfusion)

Problem is before the kidney β†’ reduced blood flow to kidneys.

Pump failure: CHF (congestive heart failure), MI (myocardial infarction).

Fluid loss: Diarrhea, dehydration, bleeding, excessive diuresis.

Pipe problems: Cirrhosis, nephrotic syndrome, gastrosis (low effective circulating volume).

Clogged vessels: Fibromuscular dysplasia (FMD), renal artery stenosis (RAS).

πŸ‘‰ Key Point: In pre-renal AKI, the kidney is structurally normal, only perfusion is reduced.

B. Intra-renal (Intrinsic) AKI (Injury inside kidney parenchyma)

Here, the kidney itself is damaged. It is further divided into 3 main patterns:

1. ATN (Acute Tubular Necrosis)

Causes: Prolonged ischemia, toxins (drugs, myoglobin, immunoglobulins), contrast-induced nephropathy.

Urine finding: Muddy brown casts

2. AIN (Acute Interstitial Nephritis)

Causes: Drugs (NSAIDs, lactams), infections (pyelonephritis), infiltrative diseases (sarcoid, amyloidosis).

Urine finding: WBCs, WBC casts

3. GN (Glomerulonephritis)

Causes: Glomerular diseases (e.g., post-strep GN, lupus nephritis).

Urine finding: RBC casts

C. Post-renal AKI (Obstruction to urine outflow)

Obstruction anywhere in urinary tract.

Ureter: Stones, cancer.

Bladder: Stones, cancer, neurogenic bladder.

Urethra: Stones, cancer, BPH, Foley catheter.

πŸ‘‰ Leads to back-pressure and hydronephrosis.

2. Diagnostic Approach (Stepwise)

When a patient presents with Acute Renal Failure, we work step by step:

Step 1: Rule out Pre-renal

Labs:

BUN:Cr > 20

Urine Na < 10

FENa < 1%

If positive β†’ Pre-renal AKI β†’ treat with IV fluids or diuresis (depending on volume status).

Step 2: Rule out Post-renal

Imaging: Renal ultrasound / sonogram.

Findings:

Hydroureter

Hydronephrosis

If positive β†’ Post-renal AKI β†’ treat by stent placement or obstruction removal.

Step 3: If both are negative β†’ Intra-renal

Do Urinalysis (U/A):

Muddy casts β†’ ATN

WBC casts β†’ AIN

RBC casts β†’ GN

If U/A unclear β†’ Kidney Biopsy (Bx) β†’ confirms diagnosis.

3. Management Summary

Pre-renal: Restore perfusion (IVF, treat heart failure, control bleeding).

Intra-renal: Depends on the exact cause (stop offending drug, treat infection, manage GN with immunosuppressants).

Post-renal: Relieve obstruction (catheter, stent, surgery).

βœ… This flowchart basically teaches:

Think of AKI in 3 categories (Pre-renal, Intrinsic, Post-renal).

Use labs and imaging step-by-step to find the cause.

Treatment is based on underlying category.

Paediatric Medicine Guidelines
07/09/2025

Paediatric Medicine Guidelines

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