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Renal (Zoe's cards) > Clinical questions > Flashcards

Clinical questions Flashcards

1
Q

Ab 8 year old girl present with leg swelling, pre orbital oedema and frothy urine

A

Minimal change disease

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2
Q

What is the initial treatment for minimal change disease?

A

Steroids

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3
Q

What is the treatment for minimal change disease which is resistant to steroids?

A

Cyclophosphamide

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4
Q

A 26 year old male who is on treatment for rheumatoid arthritis shows ++ protein and +blood.

A

Membranous nephropathy due to penicllamine or gold

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5
Q

What is the treatment for membrabous nephropathy?

A

Cyclophosphamide

Rituximab

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6
Q

What kidney disease are you most likely to get if you suffer from HIV?

A

Focal segmental glomerulosclerosis

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7
Q

An obese man present with frothy urine, haemature and hypertension.

A

Focal segmental glomerulosclerois

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8
Q

How do you treat focal segmantal glomerulosclerosis?

A

Prednisolone
Ciclosporin
Cyclophosphamide
Aziothioprine

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9
Q

A teenage boy presents with haematuria> he says he notices blood in his urine the last time he had a cold. On dipstick he has +blood and +protein.

A

IgA nephropathy

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10
Q

Which kidney disease is henoch schonlein purpura associated with?

A

IgA nephropathy

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11
Q

HHow do you treat IgA nephropathy?

A

Tight BP control with ACE

ARB

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12
Q

Which renal condition is most associated with red cell casts?

A

Rapidly progressive glomerulonephritis

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13
Q

What do you see on biopsy with rapidly progressive glomerulonephritis?

A

Crescents on biopsy

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14
Q

Give three ANCA +ve causes of RPGN?

A

Wegners granulomatosis
Microscopic polyangiitis
Systemic vasculitis

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15
Q

Give three ANCA -ve causes of PRGN

A

Goodpastures
Henoch schonlein
SLE

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16
Q

How do you treat goodpastures disease?

A

Steroids
Cyclophosphamide
Aziothioprine
Plasmapherisis

17
Q

In what kidney disease do you get deposition of protein fragments and eosonophillic depositis in the mesangium?

A

Amyloidosis

18
Q

What is the diagnositic criteria for overt diabetic nephropathy?

A

Persistent albuminuria (300mg/24h on at least 2 occasions separated by 3 - 6 months.

19
Q

Describe the pathogenesis of diabetic nephropathy?

A
  1. Haemodynamic changes cause an increase in GFR.
  2. Glomerular basement membrane thickening.
  3. mesangial expansion
  4. proteinuria due to break down of podocytes.
  5. Glomerulosclerosis with nodules
20
Q

In which renal disease would you expect to see kimmelstiel wilson lesions (glomerulosclerosis with nodules)

A

Diabetic nephropathy

21
Q

What is the treatment for diabetic nephropathy?

A

Glycaemic control
Anti hypertensives (ACE and ARB)
Lipid control

22
Q

what is the blood pressure target for a patient with diabetes?

A

Under 130mmHg sysstolic

23
Q

Small vessel vasculitis
Characterised by chronic rhinosinusitis, asthma, and prominent peripheral blood eosinophilia
Lung most commonly involved (asthma in > 95%)
2/3 have skin involvement (palpable purpura to subcutaneous nodules)

A

Churg strauss

24
Q

Nasal crusting, sinusitis, persistent rhinorrhea, otitis media, oral/nasal ulcers, bloody nasal discharge
WG-evidence of bony/cartilage destruction (saddle nose)

A

Wegners granulomatosis

25
Q

List the classes of renal disease seen in SLE

A

Class I: Minimal mesangial
Class II: Mesangial Proliferative

Class III: Focal Proliferative
Class IV: Diffuse Proliferative

Class V: Membranous

Class VI: Advanced sclerosing

26
Q

How does SLE kidney disease commonyl present?

A

Proteinura

27
Q

What do you aim for the blood pressure to be in patients with proliferative SLE?

A

130/80

28
Q

What is the treatment for proliferative SLE?

A

ACEI
ARB
Cyclophasphamide
Prednisolone

29
Q

When are ACE inhibitors contraindicated?

A

Bilateral renal artery stenosis

Renal (Zoe's cards) (21 decks)

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