17/02

Question 1

What is a complication of high phosphate in CKD?

Answer 1

Leads to calcium being dragged from the bones causing osteomalacia

Treat with alendronic acid to reduce turnover rate and increase strength of the bone

Question 2

What is a sign of acute graft failure?

Answer 2

Asymptomatic finding within a few months of renal transplant

Will have proteinuria, leucocytes in urine and raised creatinine

Question 3

How is anaemia managed in CKD?

Answer 3

Restoration of iron supplies first
-if on haemodialysis normally done via IV iron

Then give Erythropoietin stimulating agents e.g. erythropoietin

Question 4

What can cause hyaline casts on urine MCS?

Answer 4

Furosemide

Question 5

What is the treatment of Rhabdomyolysis?

Answer 5

IV fluid resus

Often with 0.9% saline as AKI can occur which causes derangement of K+ levels

Question 6

How is anion gap calculated?

Answer 6

Sodium- bicarbonate + chloride

Normal anion gap is 8-16

Question 7

When should a referral to nephrologist occur in patients with CKD?

Answer 7

If eGFR drops below 30 or if decrease >15 each year

Question 8

What diuretics should be used in ascites?

Answer 8

Spironolactone
Amiloride
Chlortalidone