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FRACP questions Flashcards

1
Q

Which immune cell population is the primary mediator of cellular rejection? (in acute + chronic rejection)

A
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2
Q

Infections post renal transplant

A
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3
Q

Sensitivity of renal US in detection of ADPKD in patients > 30 years old

A
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4
Q

Renovaszularization strategy in renal artery stenosis, is it a thing?

A

Noo, not even - futile!

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5
Q

Clues to diagnosis to this nephropathy - chornic inflammatory disorder plus proteinuria?

A

Amyloid nephropathy

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6
Q

Sirolimius (rapamycin)

A

mTOR of rapamycin used in IS regimen in kdiney transplants.

Inhibits IL-2 mediated signal transduction which results in cell0cycle arrest in the G1-S phase.

Well known side effect = hyperlipidemia - dose related effect of sirolimus therapy that occur via the inhibition of lipoprotein lipase

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7
Q

Glomerulonephritis’s most likely to recur post transplant

A
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8
Q

Mesangial hypercellularity seen in what?

A

IgA nephropathy!

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9
Q

Therapeutic options to preserve RRF (residual renal function)

A
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10
Q

Nephritic or nephrotic in lupus nephritis

A

Nephrotic syndrome!

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11
Q

Lupus nephritis stages

A
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12
Q

Lupus nephritis histological features

A
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13
Q

Treatment options in lupus nephritis

A
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14
Q

Cyclophosphammide side effects

A
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15
Q

MMF side effects

A
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16
Q

Treatment for RPGN

17
Q

When does microalbuminuria occur in DM?

A

5-15 years of disease in T1DM

~10 years of disease in T2DM

18
Q

In presence of overt nephropathy in T1DM, usually associated with which complication?

A

Diabetic retinopathy!

19
Q

Definition of macroalbuminuria in diabetic nephropathy

20
Q

Which interventions slows the progression of diabetic nephropathy?

A
  • BP control
  • ACE inhibitors
  • Glycaemic control
  • smoking cessation
  • lipid control
21
Q

Which medication has been proven to slow the progression of diabetic nephropathy in both T1DM and T2DM?

A

ACEi!

Also slows the progression of overt nephropathy to ESRF

22
Q

In a diabetic patient with NO evidence of albuminuria, which feature would support the use of ACEi in delaying the progression of microalbuminuria?

A

Presence of concurrent hypertension

23
Q

The use of ACEi/ARB in diabetic patients who are normotensive and normoalbuminemic is protective against what?

A

Retinopathy!!

Nothing else

24
Q

Opportunistic infection post renal transplant - what is the most common? how to treat?

25
Q

Goodpastures syndrome

A

Anti-GBM disease

Dehydration may decrease the likelihood of a pulmonary haemorrhage. Pulmonary oedema is associated with an increased risk. Goodpastures syndrome is rare condition associated with both pulmonary haemorrhages and rapidly progressive GN. It is causes by anto-glomerular basement mebrane (anti-GBM) antibodies against type IV collagen.

Goodpastures syndrome is more common in men (2:1) and has a bimodal age distribution. Is assoc with HLA DR2

Features:

    • pulmonary haemorrhage
  • followed by RPGN

Factors which increase likelihood of pulmonary haemorrhage

  • smoking
  • LRTI
  • pulmonary oedema
  • ihalation of hydrocarbons
  • young males

Investigations

  • renal biopsy: linear IgG depositis along basement membrane
  • raised transfer factor secondary to pulmonary haemorrhages

​Management

  • plasma exchange
  • steroids
  • cyclophosphamide
26
Q

Glucose reabsorpiton?

A

PROXIMAL TUBULE 100%

27
Q

Sodium reabsorption

A

65% in proximal tubule,

25% thick ascending limb

5% in distal tubule and 5% collecting duct

28
Q

Potassium reabsoprtion?

A

65% in proximal convultued tubule

20% in thick ascening loop

29
Q

HCO3 reabsoprtion in kidney?

A

80-90% reabsorbed in proximal tubule

30
Q

Anion gap

A

Na - (Cl+ HCO3)

Normal anion gap = 12

31
Q

Causes for a NAGMA?

A

HARDUPS

  • Hyperalimenation
  • Acetazolamide
  • Renal Tubular Acidosis
  • Diarrhoea
  • Uretero-Pelvic shunt
  • Post-hypocapnia
  • Spironolactone
32
Q

Causes for a HAGMA?

A

MUDPILERS

  • Methanol
  • Uraemia
  • DKA/alcoholic KA
  • Paraldehyde
  • Isoniazid
  • Lactic Acidosis
  • etoh
  • Rhabdo/renal failure
  • Salicylates
33
Q

As GFR declines, urinary creatine clearance overestimates eGFR because?

A

Creatinine is secreted by tubules

34
Q

Which medication can be cleared by haemodialysis?

A

BLAST

  • Barbiturate
  • Lithium
  • Alcohol (methanol. ethylene glycol)
  • Salicylates (aspirin)
  • Theophyllines
35
Q

Diagnosis of Conns syndrome - primary hyperaldosteronism

A
  • Diagnostic confirmation –seated saline suppression test, renin suppressed by saline, not aldosterone in PA

Renal (3 decks)

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