miscellaneous

Question 1

what measurement is used to assess tubular function

Answer 1

urine osmolality

Question 2

what would indicate tubules are functioning in terms of osmolality

Answer 2

urine osmolality is very different to serum osmolality

Question 3

what would indicate tubules aren’t functioning in terms of osmolality

Answer 3

if urine osmolality is exactly the same as serum osmolality

Question 4

what is the earliest expression of diabetic nephropathy

Answer 4

microalbuminuria

Question 5

what are the 2 main situations which result in significant proteinuria and which is most common

Answer 5

glomerular !!
overflow

Question 6

what are our 2 main tools for investigating glomerular function

Answer 6

GFR and proteinuria

Question 7

what 3 factors are estimated glomerular filtration rate based on

Answer 7

serum creatine, age and gender

Question 8

what does eGFR estimate

Answer 8

the rate at which fluid is filtered from the blood into bowman’s capsule

Question 9

how do we quantify proteinuria

Answer 9

urine albumin : creatine ratio (ACR)

Question 10

how do we assess haematuria

Answer 10

urine dipstick or microscopy

Question 11

what are the 2 things that can be identified with a renal ultrasound

Answer 11

obstructions and polycystic kidney disease

Question 12

what is diffusion

Answer 12

process of movement from an area of high concentration to low concentration across a partially permeable membrane

Question 13

what are the 4 main solutes that ‘move in dialysis’ and which way

Answer 13

K, urea and Na out
HCO3 in

Question 14

what is ultrafiltration

Answer 14

movement of water and all solutes dissolved in it across a semi-permeable membrane in response to a pressure gradient

Question 15

what is adsorption

Answer 15

molecules/ions/particles adhere to the surface of a solid or a liquid, rather than dissolving into it

Question 16

what is the gold standard for dialysis vascular access

Answer 16

arteriovenous fistula

Question 17

what vessel is most commonly used for a central venous catheter

Answer 17

internal jugular vein

Question 18

what is a major complication or an AV fistula for dialysis

Answer 18

steal syndrome

Question 19

what is steal syndrome

Answer 19

excessive blood flow diversion away from the distal limb, leading to ischaemia

Question 20

time scale of an AV fistula for dialysis

Answer 20

needs 6-12 weeks before dialysis for the fistula to mature

Question 21

what is the next best option for dialysis, following an AV fistula

Answer 21

arteriovenous graft

Question 22

how does haemodialysis mainly remove solutes

Answer 22

diffusion

Question 23

how does haemofiltration mainly remove solutes

Answer 23

convection

Question 24

name some factors that can affective convective transport

Answer 24

membrane pore size, pressure difference, viscosity of fluid, molecular size and charge

Question 25

what is the main difference between haemodialysis and haemofiltration

Answer 25

ultrapure replacement is added to compensate for fluid loss in haemofiltration

Question 26

how does peritoneal dialysis mainly remove solutes

Answer 26

diffusion and osmosis

Question 27

what is the main complication for haemodialysis

Answer 27

hypotension

Question 28

what is the most common organism associated with a central venous catheter infection

Answer 28

staph aureus

Question 29

management of a central venous catheter infection

Answer 29

vancomycin and gentamycin line removal or exchange

Question 30

what are the 2 main complications of a central venous catheter infection

Answer 30

endocarditis and discitis

Question 31

what are the 3 main complications of peritoneal dialysis

Answer 31

peritonitis, peritoneal membrane failure, hernias

Question 32

what are some acute indications for starting dialysis

Answer 32

AEIOU acidosis, electrolyte abnormalities - severe hyperkalaemia, intoxications, overload (fluid), uraemia (severe and symptomatic)

Question 33

chronic indication for starting dialysis

Answer 33

CKD 5

Question 34

what can be a complication of building up dialysis too quickly

Answer 34

disequilibrium syndrome

Question 35

name some restrictions for patients on dialysis

Answer 35

fluid restriction of 1L low salt, potassium and phosphate diet

Question 36

what is the most effective option for donor transplantation

Answer 36

living donor !!

Question 37

what are the 3 main types of transplant rejection and what causes them

Answer 37

hyperacute - due to preformed antibodies - unsalvageable acute - cellular or antibody mediated - can be treated with immunosuppression chronic - antibody mediated, slowly progressive decline

Question 38

induction treatment for a kidney transplant

Answer 38

prednisolone IV during operation mab to prevent T-cell activation

Question 39

what infection do we need to watch out for in the first 3 months following a kidney transplant

Answer 39

CMV

Question 40

management of CMV infection in a patient with a transplant

Answer 40

IV ganciclovir

Question 41

investigation for suspected CMV infection in transplant patient

Answer 41

IgM antibodies and PCR

Question 42

what should we always suspect in patients with haematuria

Answer 42

malignancy

Question 43

what causes joggers haematuria

Answer 43

vasoconstriction of blood supply to the kidneys -> hypoxia and constriction of the efferent glomerular arterioli -> increased filtration pressure

Question 44

initial haematuria indicates pathology where

Answer 44

urethra and prostatic area

Question 45

terminal haematuria indicates pathology where

Answer 45

bladder neck

Question 46

name some drugs that can cause spurious contamination of urine

Answer 46

rifampicin, chloroquine, senna containing laxatives

Question 47

most common scan for the bladder

Answer 47

ultrasound

Question 48

what is used to assess the urethra in males

Answer 48

urethrogram

Question 49

what is used to assess the urethra in females

Answer 49

MRI

Question 50

what is used to assess tubal patency (infertility) in females

Answer 50

hysterosalpingogram