MRCP Nephro Flashcards
Rabdomyolosis tx
Vigorous hydration with isotonic crystalloid
OBstructive uropathy 1st inve
Renal and pelvic USG - To rule out hydronephrosis
RTA 1 vs RTA 2
MC- 1>2
1 Distal , 2 proximal
Both hypo kalemia but 1>2
1- Stone
2- osteomalacia and rickets
Met acidosis( high Cl) severity 1>2
1- alpha intercalated cells in CD and DT fail to absorb K and secrete h
2- PCT fail to absorb HCO3
RTA 3?
Mixed proximal and distal , either dominant
RTA 4
Hyperkalemia , minelarocorticoid deficiency
Aso - CKD
Cholestrol emboli picture
BG- DM/ CKD with pre existing arterial ds and recent arterial manipulation eg angiogram
DX- Eosinophilia, High ESR, worsening kidnry ds and low levels of compliment
Liddle syndrome
Clinical Features
Liddle syndrome is a rare genetic disorder AD characterized by early-onset hypertension , hypokalemia , and metabolic alkalosis . Symptoms often appear before the age of 35 and can include headaches, fatigue, muscle weakness, and frequent urination2.
Pathophysiology
The syndrome results from increased activity of the epithelial sodium channels (ENaC) in the kidneys. These channels are responsible for sodium reabsorption and potassium excretion2. Mutations in the genes encoding the ENaC subunits (SCNN1B or SCNN1G) lead to enhanced sodium reabsorption, causing fluid retention and hypertension1.
Blood Investigations
Diagnosis typically involves measuring urine sodium levels, plasma renin activity, and aldosterone levels. Patients with Liddle syndrome usually have low urine sodium, low plasma renin, and low aldosterone levels2. Genetic testing can confirm the diagnosis by identifying mutations in the relevant genes.
Treatment typically involves potassium-sparing diuretics such as amiloride or triamterene, which help reduce sodium reabsorption and restore electrolyte balance
Conn syndrome fts
High aldosterone, low K+
Barter syndrome
High all urine- Na, K , Ca
Blood- High renin and aldostreone
Low- K
Met alkalosis
Gilteman synd
Normotensive
Low urinary Ca
Blood- High renin and aldostreone
Low- K , Low Mg
Met alkalosis
KIdney transplant acute inv
Renal biopsy with BG of normal serum Cyclosporin
Obs pyelonephritis with urate stone imaging
CT > Usg
urine nitrite negative UTI
Acinetobactor, enterococci, s saprophyticus
skin and soft tissue thickening in ckd pat
nephrogenic fibrosis
Risk - BG of gadolinium exposure
AL amyliodosis seen in
Malignancy eg Mutliple myeloma
Light chain
AA amyloidosis asociated with
AI - RA, SLE
serum A protein
Beta 2 microglobulin amyloidosis
Seen in CKD on chronic dialysis
B2 mg- Deposit in joints
Young african with proteinuria, vague joint pain and b/l pedal edema?
SLE to rule out
R- Joint pain and nephrotic in African women
Contrast nephropathy scenario
AKI following 48 to 72 hrs exposure
eosinophilia due to acute interstitial inflammation
Iga nephropathy with well established sclerosis Tx
ACE inhibitors
BX- Focal prolifertive glomerulonephritis with mesangial IGA deposition
IGA nephropathy
cANCA with ENT symptoms
Granulomatosis with polyangitis
Loss of phosphate in whichRTA
Proximal aka Fanconi syndr
Metormin min eGFR
30
2ndary vs tertiary hyperparathyroidism
ca low in 2nday , high in tertiary
Tertiary tx
cinacalcet
Scnario Ckd anemia
1st correct Fe, if ferritin normal then EPO with target hb110
Amyloidisis types
AA- Rhuematic
al- myleomo
Beta 2 microglobulin- Convention chronic ckd
Long term cellulose acetate dialysis, hand pain , tingling
B2 micro amyloidisis
Beta 2 microglobulin amy- Xray
destructive arthropathy with peri articular cystic bone radiolucency
