Kidney disease

Question 1

causes of renal failure

Answer 1

gentamycin - IV antibiotic

x-ray contrast

sepsis

diabetes
high bp
aki

Question 2

signs of renal failure

Answer 2

low urea, pH, potassium levels

pulmonary and peripheral edema because of low water excretion

chronic kidney disease: low haemoglobin

Question 3

managing renal failure

Answer 3

diuretics if no urinary failure
catheter in patients to monitor urine output, exclude obstruction of bladder to urethra
dialysis to remove fluid and K
IV to increase bicarbonate levels to reduce acidosis

kidney transplant for compliant patients

Question 4

diagnose crepitations

Answer 4

sign of water in lungs / infection

could be sepsis

Question 5

orthopnoea

Answer 5

shortness of breath when lying flat

Question 6

neuropathy

Answer 6

disease of peripheral nerves causing numbness

poor sensation in hands/feet

Question 7

JVP
jugular venous pressure

Answer 7

if raised, problem w right heart

fluid overload
needs diuresis

Question 8

nephrotic syndrome

Answer 8

Nephrotic syndrome is a group of symptoms that indicate your kidneys are not working properly.

Amyloid in the kidney can cause leakage of protein in the urine resulting in a low blood protein level and swelling of legs or face.

These symptoms include. too much protein in your urine, called proteinuria.

low levels of a protein called albumin in your blood, called hypoalbuminemia.

edema.

Question 9

bence jones protein
paraproteins in urine

Answer 9

sign of multiple myeloma

Question 10

treating nephrotic syndrome

Answer 10

ace inhibitors to lower bp and proteins released in urine

diuretics

statins to reduce cholesterol

anticoagulants

fill catheter bag w whats needed (albumin…)

Question 11

diagnosing nephrotic syndrome

Answer 11

dipstick for protein
check albumin

Question 12

pulmonary renal syndrome

Answer 12

life threatening
usually caused by autoimmune disorder
small vessel vascularitis resulting in inflammation of kidney

Question 13

Wegener’s

Answer 13

Granulomatosis with polyangiitis (Wegener’s), also known as GPA, is a rare blood vessel disease. It can cause symptoms in the sinuses, lungs, and kidneys as well as other organs. It is a potentially serious disease.

Question 14

anca associated vascularitis

Answer 14

ANCA associated vasculitis (AAV) is an umbrella term for a group of multi-system autoimmune small vessel vasculitides that can present at any age

AAV diseases include microscopic polyangiitis, granulomatosis with polyangiitis (GPA, previously “Wegener’s granulomatosis”),

vascularitis- inflammation of vessels

Question 15

haemoptysis

Answer 15

coughing up blood
main cause infection leading to mucosal inflammation and edema
rupture of blood vessels

Question 16

symptoms of pulmonary renal syndrome

Answer 16

Cough
Dyspnea (laboured breathing)
Fever
Hematuria (blood in urine)
Hemoptysis
Peripheral edema

stiffness typical for vascularitis

Question 17

diagnosing pulmonary renal syndrome

Answer 17

Serologic testing (blood serum)

Sometimes lung and kidney biopsies

hemoptysis not obviously attributable to other causes

Initial testing includes urinalysis for evidence of hematuria and red cell casts (suggesting glomerulonephritis), serum creatinine for renal function assessment, and CBC for evidence of anemia. Chest x-ray is done if not yet obtained.

Serum antibody testing may help distinguish some causes, eg. ANCA

Definitive diagnosis requires lung biopsy with findings of small-vessel vasculitis or renal biopsy with findings of glomerulonephritis with or without antibody deposition.

Question 18

treating pulmonary renal syndrome

Answer 18

immunosuppressants and high dose steroids
corticosteroids
plasma exchange for pulmonary haemorrhage
cytotoxic chemotherapy

Question 19

nephritic syndrome

Answer 19

Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.

inflammation of glomerulus

presents as hematuria, elevated blood pressure, decreased urine output, and edema

Question 20

rhabdomyolysis induced renal failure

Answer 20

trauma

Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the kidneys and cause permanent disability or even death.