Effect On Kidney...

Question 1

NSAID

Answer 1

inhibit pg synthesis which means afferent arterioles is not dilated
Interstitial nephritis
Minimal change disease

Question 2

Ace and ARB

Answer 2

Block angiotensin which usually constricts efferent arterioles

Question 3

Amino glycosides

Answer 3

ATN

Question 4

Valaciclovir and aciclovir

Answer 4

Neurological reactions if used in renal imp- delusions, hallucinations, confusion, psychosis, dysarthria, ataxia

Question 5

Tenofovir

Answer 5

ATN
Low phosphate 
Low mg
Glycosuria
Avoid in diabetes, hypertension- entecavir better

Question 6

Adefovir

Answer 6

Fanconi syndrome esp in hep b …osteoporosis due to severe low phosphate in some cases
Entecavir better

Question 7

Ppi

Answer 7

Interstitial nephritis

Question 8

Cisplatin

Answer 8

Renal tubular toxin due to free radical generation and cytokines
Concentrating defect so urine output persists
Mg wasting
HUS

Avoid with hydration, forced dieresis and avoid nephrotocins

Question 9

Hydralazine

Answer 9

Drug induced lupus

Question 10

Penicillamine

Answer 10

Membranous

Question 11

VEGF inhibitors eg bevacizumab

Answer 11

Podocyte damage–> proteinuria

Thrombotic microgiopathy

Question 12

Tac

Answer 12

HUS

Question 13

Quinine

Answer 13

HUS

Question 14

Cyclosporine A

Answer 14

Constrict efferent and afferent arterioles
HUS
Path see striped fibrosis
Hyperkalaemia because decrease excretion in collecting duct
Metabolic acidosis
Low phosphate low mag
Hyperuricaemia

Question 15

Trimethoprim

Answer 15

Hyperkalaemia- Similar to K sparing diuretic even in pt with normal renal function
Inhibit tubular cr secretion

Question 16

Zoledronic acid

Answer 16

Interstitial nephritis

Question 17

Bowel prep containing sodium phosphate

Answer 17

Dehydration, hypokalaemia and ARF
HYPERPHOSPHATEMIA in crf and the elderly
Hypocalcaemia

Question 18

What are the drug causes of HUS?

Answer 18

tacrolimus/cyclosporine
Ticlopidine
Quinine
Cis platinum

Question 19

VEGF inhibitors glomerular histopathology shows:

Answer 19

Duplication of glom basement membranes
Foot process effacement
Focal endothelial swelling
Thombosis of anterior enothelial cells
Thrombocytopaenia

Question 20

SSRIs cause which electrolyte imbalance?

Answer 20

hyponatraemia

median 120 mmol/L

Question 21

Gadolinium contrast causes what feared reaction if used in renal impairment?

Answer 21

Nephrogenic systemic sclerosis
Onset 2-75 days, median 25
Dialyse soon after MRI if possible

Question 22

Use or not use warfarin in ESRF/dialysis patients who have AF?

Answer 22

Bleeding risk higher especially GI
Have to use for metallic valves etc obviously
Retrospective cohort study in Circulation in 2014- no overall benefit, higher rate haemorrhagic stroke