Learnmed Questions

Question 1

How does Post-Strep GN commonly present?

Answer 1

• 1-2 weeks post strep throat infection
• 3-6 weeks following strep skin infection

Sudden onset gross haematuria
Proteinuria + Oedema
Hypertension
Renal insufficiency
LOW C3

Question 2

Indications for MCUG?

Answer 2

• Recurrent UTI with VUR
• Stress incontinence
• Urethral Stricture

Question 3

What is ‘Prune Belly Syndrome’

Answer 3

Deficient abdominal muscles with undescended testes and congenital urinary tract anomalies

• massive ureteral dilatation
• large bladder
• patent urachus
• most have VUR

Question 4

Physical findings at 28 weeks gestation

Answer 4

Thick layer of vernix 
Thin, translucent skin, visible abdominal veins
Lanugo covering entire body
Eye brows and eye lashes present 
Flat and shapeless ears, no cartilage 
No anterior sole creases
Nipples barely visible 
Tested palpable in inguinal canal, minimal scrotal rugae

Question 5

Physical findings at 38 weeks gestation

Answer 5

Vernix on back and scalp only
Pink skin
Lanugo on shoulders only 
Ears have incurving present at upper 2/3, thin cartilage which springs back when folded
Heel creases visible 
Breast nodules 
Testes palpated in upper scrotum

Question 6

Where is the main site of K+ reabsorption in the nephron?

Answer 6

Proximal convoluted tubule

Question 7

Urinary creatinine clearance overestimated GFR when the GFR is low, why is this?

Answer 7

When GFR is normal, creatinine clearance closely resembles inulin clearance.
With a dropping GFR, more creatinine is secreted by the tubules leading to an overestimation of creatinine clearance.

Question 8

How would you assess VUR? What is the grading system of VUR?

Answer 8

Micturating cystourethrogram

Grade 1: reflux of the ureters without dilatation
Grade 2: reflux in ureters and collecting system
Grade 3: mild dilatation of the ureters and collecting system, mild calyceal blunting
Grade 4: gross dilatation of the ureters and collecting system, some ureteral tortuosity
Grade 5: massive reflux with gross dilatation of the collecting system, significant ureteral dilatation

Question 9

How do you calculate resistance in the cardiovascular system?

Answer 9

P=Q x R

So PVR/SVR
= change in pressure/ flow

Question 10

ECG findings of hypokalaemia?

Answer 10

U waves
Prolonged QT interval
ST segment depression
T wave flattening

Question 11

Juvenile Myoclonic Epilepsy?

Answer 11

Presents between 12-16 years
Myoclonic jerks on waking initially, over years progress to generalised Tonic clonic seizures.
Absence episodes

EEG shows 4-6s irregular spike and wave pattern, increased with photic stimulation

Treated with Sodium Valproate

Question 12

How do you calculate compliance?

Answer 12

Change in volume/ change in pressure