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Renal / Urology > Kidney in Systemic Disease > Flashcards

Kidney in Systemic Disease Flashcards

1
Q

What is the commonest cause of ESRF

A

Diabetic Nephropathy

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2
Q

What can infective endocarditis cause and how

A

GN
Small vessel vasculitis
Due to immune comple formation

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3
Q

What causes infective endocarditis

A

S.Aureus
Strep viridans
ENterococci

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4
Q

What are the symptoms of infective endocarditis in relation to the kidney

A

Haematruia
Abnormal u+e
Low complement
Plus standard symptoms

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5
Q

What systemic disease, autoimmune disease and infections can cause kidney issues

A 
MM
Amyloidosis
HUS / TTP = AKI
Sickle cell 
Pregnancy - PET / obstruct 
Autoimmune 
SLE
ANCA vasculitis
HSP
Systemic sclerosis 
Scleroderma
Sarcoid
Sjogren
Infection 
TB
Malaria
Hepatitis
HIV
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6
Q

What is vasculitis

A

Inflammatory reaction in any blood vessel

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7
Q

What type of vasculitis affects large arteries

A

Takayasu

Giant cell

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8
Q

What type of vasculitis affects small arteries

A

Granulomatois poly
Microscopic poly
Curg-Strauss

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9
Q

What does granulomatous polyarteritis present with

A 
URT- epistaxis / sinusitis / deaf
LRT - cough / SOB / haemoptysis 
Renal - FOCAL NECROTISING GN WITH CRESCENTS 
Other 
Scleritis
Pericarditis 
Fever
Weight loss
Rash
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10
Q

What Ab in granulomatous

A

C-ANCA Ab against proteinase-3

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11
Q

How does microscopic present

A

Similar presentation

More common renal

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12
Q

What Ab in microscopic

A

P-ANCA Ab against myeloperoxidase

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13
Q

How do you Dx vasculitis

A

Urinanalysis
Bloods - FBC, U+E, LFT
Ab
Renal biopsy

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14
Q

What is gold standard

A

+ve ANCA

Renal biopsy

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15
Q

What does urine show

A

Blood

Protein

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16
Q

What do bloods show

A

Abnormal U+E
Increased CRP
Increased ALP

17
Q

What is show on FBC

A

Anaemia
Thrombocytopenia
Leucocytosis
Hyperglobuliaemia

18
Q

How do you treat vasculitis

A

Steroid - pred
Immunosuppression - Cyclophosphamide
Biologics
Plasma exchange if renal failure / anti-GBM

19
Q

What risks of cyclophosphamide

A

Bladder TCC

20
Q

What do you do if symptomatic on cyclophosphamide

A

Refer to urology if haematuria / cystitis

21
Q

Complications of vasculitis

A

Progress to ESRF

22
Q

What is MM

A

Monoclonal proliferation of plasma cell

Produce excess of Ig and light chains

23
Q

What are the symptoms of MM

A 
Anaemia
Back pain
Weight loss
Fractures
Infection
Cord compression
Elevated ESR
Hypercalcaemia 
Renal failure
24
Q

How do you Dx MM

A 
Bone marrow aspirate = diagnostic 
Serum paraprotein / light chain
Electrophoresis + immunofixation 
Urinary bench jones protein
Skeletal survey
25
Q

What does aspiration show

A

> 10% clonal plasma cells

26
Q

How do you treat

A

Fluid + biphosphonate for hypercalcaemia
Plasma exchange to remove light chains
Myeloma Rx

27
Q

Why should you be careful with biphosphonates

A

if eGFR <30

28
Q

What causes renal failure in MM

A 
Cast nephropathy - Ig gets stuck in tubules
Light chain nephropathy
Amyloidosis
Hypercalcaemia
Hyperuricaemia
29
Q

What is amyloidosis

A

Deposits of amyloid

Affects any organ

30
Q

What causes

A

Idiopathic
2d to infection / solid organ tumour / lymhpoma
MGUS

31
Q

How do you Dx amyloidosis

A

Biopsy of area affected

32
Q

How does kidney affect CVS

A

Hypertension
Fluid overload
Calcification of vessel

33
Q

How does CVS disease affect kidney

A 
Hypertension = CKD
Atheroembolism 
Warfarin
Vascular procedures
Nephrotoxic drugs
34
Q

When would you use diuretics in kidney disease

A

If HF is the reason for the kidney issue

35
Q

How should you investigate systemic disease

A 
Urinanalysis
Urine culture
Bloods 
Specific - ANA/ ANCA / complement
Blood culture
CXR / USS / CT / ECHO
Biopsy

Renal / Urology (16 decks)

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