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Renal > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What is polycystic kidney disease?

A

Chronic condition characterised by numerous fluid-filled cysts in the kidney

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2
Q

What is the mode of inheritence of polycystic kidneys?

A

Autosomal dominant

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3
Q

How do polycystic kidneys present?

A

Haematuria

Abdominal pain

Polyuria/Nocturia/Oliguria

HTN

Recurrent UTIs

Renal stones

Features of chronic kidney disease

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4
Q

What investigations are used in polycystic kidney disease diagnosis?

A

FBC

  • Anaemia

CT

US

  • Screening
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5
Q

How is polycystic kidneys managed?

A

Patient education/genetic counselling

HTN treatment

Tolvaptan (vasopressin receptor 2 antagonist)

Transplant

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6
Q

What are the extra-renal manifestations of polycystic kidney disease?

A

Liver cysts and hepatomegaly

Pancreatic and spleen cysts

Cerebral artery berry aneurysm/subarachnoid haemorrhage

Mitral valve prolapse

Mitral/tricuspid incompetence

Aortic root dilation

Aortic dissection

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7
Q

What is the most common exta-renal manifestation of polycystic kidney disease?

A

Liver cysts

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8
Q

What is renal artery stenosis?

A

Narrowing of the artery supplying the kidney

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9
Q

What causes renal artery stenosis?

A

Atherosclerosis

Fibromuscular dysplasia

Scar formation

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10
Q

What are the risk factors for renal artery stenosis?

A

Carotid artery disease

Coronary artery disease

Smoking

Peripheral vascular disease

Diabetes

Obesity

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11
Q

How does renal artery stenosis present?

A

Difficulty to control BP and renal failure with ACEI

>BP

Renal bruit

Flash pulmonary oedema

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12
Q

What investigations are used in renal artery stenosis diagnosis?

A

Renal US

MRA

Renal Doppler

Angiogram

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13
Q

How is renal artery stenosis managed?

A

BP control

Renal balloon angioplasty and stenting

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14
Q

Give complications of renal artery stenosis?

A

Malignant HTN

Chronic renal failure

Pulmonary oedema

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15
Q

What can cause urethral strictures?

A

Iatrogenic

  • traumatic placement of indwelling urinary catheters

STI

Hypospadias

Lichen sclerosus

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16
Q

What causes metabolic acidosis with a normal anion gap?

A

Gastrointestinal bicarbonate loss/diarrhoea

Renal tubular acidosis

Drugs

  • Acetazolamide

Ammonium chloride injection

Addison’s disease

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17
Q

What causes metabolic acidosis with a raised anion gap?

A

Lactate

  • Shock
  • Hypoxia
  • Sepsis

Ketones

  • Diabetic ketoacidosis
  • Alcohol

Urate

  • Renal failure

Acid poisoning

  • Salicylates
  • Methanol
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18
Q

What causes metabolic alkalosis?

A

Vomiting/aspiration

Diuretics

Liquorice, Carbenoxolone

Hypokalaemia

Primary hyperaldosteronism

Cushing’s syndrome

Bartter’s syndrome

Congenital adrenal hyperplasia

19
Q

What causes respiratory acidosis?

A

COPD

Decompensation in other respiratory conditions

  • Life-threatening asthma
  • Pulmonary oedema

Sedative drugs

  • Benzodiazepines
  • Opiate overdose
20
Q

What causes respiratory alkalosis?

A

Anxiety leading to hyperventilation

Pulmonary embolism

Salicylate poisoning

CNS disorders

  • Stroke
  • Subarachnoid haemorrhage
  • Encephalitis

Altitude

Pregnancy

21
Q

Give medical indications for circumcision

A

Phimosis

Recurrent balanitis

Balanitis xerotica obliterans

Paraphimosis

Reduced risk of UTI, penile cancer and STIs

22
Q

What is a contraindication for circumcision?

A

Hypospadias is a contraindication in infancy as the foreskin is used in the repair

23
Q

What injury can also be seen in pelvic fractures?

A

Urethral injury

24
Q

Give post op complications of renal transplant

A

ATN of graft

vascular thrombosis

urine leakage

UTI

25
Q

When does hyperacute rejection of renal transplant occur?

A

Minutes to hours

26
Q

When does acute graft failure of renal transplant occur?

A

Less than 6 months

27
Q

When does chronic graft failure of renal transplant occur?

A

Over 6 months

28
Q

What is the NICE guidelines for IV maintenance fluids?

A

25-30 ml/kg/day of water and

Approximately 1 mmol/kg/day of potassium, sodium and chloride and

Approximately 50-100 g/day of glucose to limit starvation ketosis

29
Q

Give complications of haemodialysis

A

Site infection

Endocarditis

Stenosis at site

Hypotension

Arrythmia

Air embolus

Anaphylactic reaction to sterilising agents

Disequilibration syndrome

30
Q

Give complications of peritoneal dialysis

A

Peritonitis

  • Staph epidermis
  • Staph aureus

Catheter infection

Catheter blockage

Constipation

Fluid retention

Hyperglycaemia

Hernias

Back pain

Malnutrition

31
Q

Give complications of renal transplant

A

DVT/PE

Opportunistic infection

Lymphoma

Bone marrow suppression

Recurrence of original disease

Urinary tract obstruction

Cardiovascular disease

Graft rejection

32
Q

What is the NICE guidlines for resucitation fluids?

A

500mls 0.9% NaCl bolus over 15 minutes

33
Q

How is the anion gap calculated?

A

(sodium + potassium) - (bicarbonate + chloride)

34
Q

How is hyperacute rejection of renal transplant managed?

A

Removal of graft

35
Q

Give features of Alport’s syndrome

A

Haematuria/nephritis

Bilateal sensorineural hearing loss

Visual problems

36
Q

What is the preferred method of access for haemodialysis and why?

A

Arteriovenous fistulas, due to lower rate of complications

37
Q

How long do arteriovenous fistulas take to develop?

A

6-8 weeks

38
Q

Give complications of arteriovenous fistulas

A

Infection

Thrombosis, detected by absence of bruit

Stenosis, presenting with acute limb pain

Steal syndrome

39
Q

What do hyaline casts in urine suggest?

A

Normal urine

Post exercise

Fever

Loop diuretics

40
Q

What do brown granular casts in urine suggest?

A

ATN

41
Q

What does bland urinary sediment suggest?

A

Prerenal uraemia

42
Q

What do red cell casts in urine suggest?

A

Nephritis/nephritic syndrome

43
Q

What do white cell casts in urine suggest?

A

AIN

Renal (10 decks)

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