Kidneys in Systemic Disease

Question 1

Diabetic nephropathy will develop quickly. True/false?

Answer 1

False - takes decades

Question 2

Diabetic nephropathy causes constriction/dilatation of the efferent arteriole?

Answer 2

Constriction

Question 3

What is the earliest sign of diabetic nephropathy?

Answer 3

Microalbuminuria

Question 4

How is diabetic nephropathy managed?

Answer 4

Glycaemic control
Anti-hypertensives (ACEIs/ARBs)
Lipid control

Question 5

What is the gold standard treatment for diabetic nephropathy?

Answer 5

Kidney-pancreas transplant

Question 6

What occurs in ischaemic nephropathy?

Answer 6

Reduced GFR with reduced renal blood flow

Question 7

Give some causes of ischaemic nephropathy

Answer 7

Essential hypertension
Renal artery stenosis
Fibromuscular dysplasia

Question 8

How can renal artery stenosis present?

Answer 8

AKI after treatment of hypertension
Abdominal bruit
Atherosclerotic disease
Different sized kidneys

Question 9

What imaging is used for renal artery stenosis?

Answer 9

Renal ultrasound

Renal artery duplex studies

Question 10

What is the medical treatment of renal artery stenosis?

Answer 10

Statin
Anti-platelet
ACE inhibitor

Question 11

When are ACE inhibitors contra-indicated in renal artery stenosis?

Answer 11

When it is bilateral

Question 12

What is fibromuscular dysplasia?

Answer 12

A narrowing of both renal arteries

Question 13

What occurs in cardiorenal syndrome?

Answer 13

Decreased CO leads to decreased renal perfusion, impairing renal function and increasing Na and H2O retention decreasing cardiac performance

Question 14

What is myeloma?

Answer 14

A cancer of the plasma cells

Question 15

How can myeloma cause renal dysfunction?

Answer 15

As there is production of abnormal antibodies

Question 16

What is the classic presentation of myeloma?

Answer 16

Back pain and renal failure

Question 17

Give some other signs and symptoms of myeloma?

Answer 17

Anaemia
Hypercalcaemia
Weakness
Fatigue
Weight loss

Question 18

What structures in the kidney are affected by myeloma?

Answer 18

Glomerulus

Tubule

Question 19

How is myeloma diagnosed?

Answer 19

Serum protein electrophoresis (bloods)

Bence Jones protein (urine)

Question 20

How is myeloma managed?

Answer 20

Chemotherapy

Stem cell transplant

Question 21

What antibodies can be found in ANCA+ve vasculitis?

Answer 21

ANCA
Anti-MPO
Anti-PR3

Question 22

Anti-PR3 antibodies are indicative of which vasculitis?

Answer 22

GPA

Question 23

Anti-MPO antibodies are indicative of which vasculitis?

Answer 23

Microscopic polyangiitis

Question 24

How is small vessel vasculitis managed?

Answer 24

Steroids

Cyclophosphamide

Question 25

What is the classic presentation of SLE?

Answer 25

Young women with malar rash and joint pain

Question 26

What is the commonest sign of lupus nephritis?

Answer 26

Proteinuria

Question 27

How can lupus nephritis be diagnosed?

Answer 27

Renal biopsy