General

Question 1

Name two endocrine functions of the kidney

Answer 1

renin
EPO
1a-hydroxylation of vitamin D (controlled by PTH)

Question 2

Three renal causes of haematuria?

Answer 2

  Congenital: PCK 
  Trauma 
  Infection: pyelonephritis 
  Neoplasm 
  Immune: GN, TIN

Question 3

Three extra-renal causes of haematuria

Answer 3

 Trauma: stones, catheter
 Infection: cystitis, prostatitis, urethritis
 Neoplasm: bladder, prostate
 Bleeding diathesis
 Drugs: NSAIDs, frusemide, cipro, cephalosporins

Question 4

Name three causes of proteinuria

Answer 4

Commonest 
  DM 
  Minimal change 
  Membranous 
  Amyloidosis 
  SLE 

Other 
  HTN (inc. PET) 
  ATN 
  TIN 
  UTI 
  Fever, orthostatic

Question 5

In which condition is there a false negative proteinuria?

Answer 5

bence jones protein- myeloma

Question 6

Casts show white cells, leukocyturia. Is the cause glomerular or tubular in nature?

Answer 6

tubular

glomerular- haematuria=RBCs

Question 7

What does an isolated raised urea indicate?

Answer 7

hypoperfusion/dehydration

Question 8

What does an increased urea and creatinine imply?

Answer 8

reduced filtration- renal failure

Question 9

How is creatinine clearance determined?

Answer 9

requires urine concentration from 24hr collection

Question 10

One advantage of eGFR over CrC?

Answer 10

Simple blood test, does not need 24hr urine collection

Question 11

Name two issues with eGFR?

Answer 11

validated for CKD patient ?applicable to general population

most elderly people are in >stage 3 eGFR therefore may not impinge on health

Question 12

Three features in the presentation of patient with renal failure?

Answer 12

Uraemia
Protein loss and Na+ retention
Acidosis
Hyperkalaemia
Anaemia

Question 13

Pruritis is a feature of which presentation associated with renal failure?

Answer 13

uraemia

Question 14

Three causes of acute tubular necrosis?

Answer 14

sepsis
shock
dehydration
NSAIDs
gentamicin
heroin
radiology contrast dye

Question 15

Urinalysis shows muddy brown casts. What is the diagnosis?

Answer 15

acute tubular necrosis

Question 16

Triad of haemolytic uraemic syndrome?

Answer 16

haemolytic anaemia
AKI
thrombocytopenia

Question 17

A patient requires a renal biopsy. Provide four investigations that are essential before performing a renal biopsy and give a rationale for each

Answer 17

Renal ultrasound- to demonstrate two ‘normal’ sized kidneys

full blood count- Ensure not anaemic/platelets OK

coagulation screen- Ensure not high risk of bleeding

Urinalysis+/- culture-Ensure no evidence of UTI

Question 18

Hyaline casts observed in urine. Name one cause

Answer 18

after exercise

loop diuretics

Question 19

Brown granular casts in urine. Diagnosis?

Answer 19

acute tubular necrosis

Question 20

Red cell casts in urine. Diagnosis?

Answer 20

nephritic syndrome