MRCP Renal

Question 1

Patient following renal transplant with hirsutism, what drug most likely culprit?

Answer 1

Ciclosporin

Question 2

AKPD type 1 chromosome

Answer 2

Chromosome 16

Question 3

Most common lithium induced glomerulonephritis

Answer 3

Minimal change disease

Question 4

Main nephrotoxic agent in rhabdomyolysis

Answer 4

Myoglobin

Question 5

Blood tests in nephrotic syndrome

Answer 5

Decreased antithrombin III, protein C & S (increased urinary excretion)
Subsequent increase in fibrinogen
Decreased TOTAL thyroxine levels (normal free thyroxine) (increased urinary excretion of thyroxine-binding globulin)

Question 6

Polyuria, mild proteinuria, basophilic stippling on bloods

Answer 6

Lead poisoning

Question 7

Renal biopsy findings in granulomatosis with polyangitis

Answer 7

Necrotising granulomas and small vessel vasculitis, without complement or immunoglobulin deposition

Question 8

Acute transplant rejection; timings and cell mediator

Answer 8

Common in first 2 weeks
Can happen up to 6 months
T-cell mediated alloimmune reaction

Question 9

Urine dipstick result in acute tubular necrosis

Answer 9

Usually nothing

Question 10

Which type of amyloidosis is associated with myeloma?

Answer 10

AL amyloid

Question 11

What is Berger’s disease

Answer 11

IgA nephropathy

Question 12

Commonest biochemical abnormality in cholesterol emboli

Answer 12

Eosinophilia

Question 13

Commonest composition of renal stones in a person with Crohns disease

Answer 13

Calcium oxalate

Increased colonic absorption of oxalate. Esp people with short bowel syndrome following bowel resection

Question 14

Kidney disease + SNHL

Answer 14

Alports syndrome

Question 15

Pathophysiology of metabolic bone disease

Answer 15

PTH increased
Vit D decreased
Phosphate excretion decreased

Question 16

Pathophysiology of hepatorenal syndrome

Answer 16

Sphlanchnic vasodilation leading to renal vasoconstriction

Question 17

Describe features of fabry disease

Answer 17

X-linked lysosomal storage disorder

Peripheral paraesthesia, skin angiokeratoma, proteinuria, early cardiovascular disease

Question 18

Most common cause of secondary amyloidosis

Answer 18

Rheumatoid arthritis

Question 19

Most common HIV associated nephropathy

Answer 19

FSGS

Question 20

Which protein is associated with the development of ADPKD?

Answer 20

Polycystin

Question 21

Renal complications of medullar sponge kidney in pregnancy

Answer 21

Increased risk renal stones, UTI, asymptomatic bacteruria

Question 22

Indications for emergency dialysis

Answer 22

Refractory hyperakalaemia
Refractory metabolic acidosis
Refractory pulmonary oedema
Uraemic complications eg pericarditis, encephalopathy

Question 23

Alternative name for cANCA

Answer 23

anti-serine protease 3 (PR3)

Question 24

Wilm’s tumour associated with which chromosomal abnormality?

Answer 24

Deletion on short arm of chromosome 11

Question 25

Where in the kidney is EPO produced?

Answer 25

Interstitial fibroblasts

Question 26

Principal mode of inheritance for Alport’s syndrome

Answer 26

X-linked dominant (85%)

Rest are autosomal recessive

Question 27

Within what timeframe does contrast nephropathy present

Answer 27

2-3 days

Question 28

What is the screening test for ADPKD (eg for family member)

Answer 28

US abdomen

Question 29

Hb target in renal disease

Answer 29

110g/L

Question 30

Initial treatment of myeloma

Answer 30

Haematopoietic stem cell transplantation

Question 31

What type of renal stones are seen in people with previous bowel resection?

Answer 31

Oxalate stones (oxalate usually absorbed through small bowel)

Question 32

GPA ANCA

Answer 32

c-ANCA

protinease 3

Question 33

Most common stones associated with infection?

Answer 33

Magnesium-ammonium-phosphate stones (struvite)
- caused by Proteus, Klebsiella or Serratia infection

(staghorn calculi)

Question 34

Which chromosome is the defect found in in ADPKD?

Answer 34

SHORT arm of chromosome 6

Question 35

Antistreptolysin-O titre is useful in which condition?

Answer 35

Post-streptococcal GN

Question 36

Empirical antibiotics for SBP secondary to continuous ambulatory peritoneal dialysis

Answer 36

Intraperitoneal vanc and gent