N Flashcards
What’s the main cause of anaemia in ckd
Reduced EPO ( hormone made in kidneys released during hypoxia to increase RBC production in the bone marrow)
Why can you get Pruitt is in ckd
Secondary to uraemia
How does CKD cause osteomalacia
Phosphate and calcium have a counterfeit relationship as phosphate binds to calcium reducing the amount of free calcium in the bloodstream
Therefore as calcium is low in ckd patients (due to kidneys not able to hydroxylate vit d) the phosphate levels become high which ‘drags’. Calcium out of the bones resulting in osteomalacia
What is minimal change disease and how is it treated
Nephrotic syndrome in kids (75% in kids) usually idiopathic
Features - nephrotic syndrome, normotensive, albumin in urine
Manage with oral corticosteroids
What is epididymo-or hit is usually spread from
STI - e.g. chlamydia, gonorrhoea (usually sexually active younger males)
Or the bladder - e.coli (the latter)
Features of multiple myeloma ?
Mm= Plasma cell proliferation
Features
CRABBI
C- hypercalcaemia due to osteoclastic bone resorption
R- renal damage presents as dehydration and thirst
A- anaemia - bone marrow crowding suppressing epo
B- bleeding - bone marrow crowding results in thrombocytopenia (low platelets i.e. less clotting)
B- bones- lyric bone lesions from osteoclasts presents as pain particularly back
I- infection, reduced immunoglobins
What is the triad of nephrotic syndrome
Protinuria >3g/24hr
Hypoalbuminaemia
Oedema
Causes of nephritic syndrome
Rapidly progressive glomerulonephritis
IGA nephropathy
Alport syndrome - genetic disorder of glomerular basement membrane main affecting kids
Does nephrotic syndrome cause blood clots or bleeding disorders
Blood clots due to loss of antithrombin III and plasminogen (breaks down fibrin in clots)
What causes a false positive PSA - > 4NG/ML when determining if raised PSA is due to cancer?
Prostatitis, UTI, BPH, vigorous DRE
What’s the most common type of prostate cancer
95% are adenocarcinoma (cancer originating from glandular tissue)
Often multifocal and lie in the peripheral zone of prostate
What’s the sentinel lymph node for prostate cancer ?
Obturator nodes and Local prostatic spread to the seminal vesicles is associated with distant disease
What would urinalysis of acute interstitial nephritis show?
White cell casts with sterile Pyuria (presence of raised white cells in absence of bacteria)
How long to anticoagulate in provokes vs unprovoked pe
Provoked- 3 months e.g. surgery
Unprovoked 6 months
What is the most appropriate investigation for renal stones
Non-contrast CT of abdomen and pelvis is gold standard
Following radiotherapyy for prostate cancer, which cancers have an increased risk?
Bladder, colon, rectal
Are NSAIDs safe to use in an AKI
No as they may worsen renal function EXCEPT- aspirin if at cardiac dose e.g. 75mg od
If a patient presents with anaemia on a background of ckd what should be looked at?
Despite EPO deficiency being common in those with ckd you must rule out other causes prior to starting EPO such as iron or b12 deficiency
What is the investigation of choice for cluster eadachers
MRI with gadolinium contrast
Define henoch-schonlein purpura and its presentation
IgA small vessel vasculitis typically seen in children following viral infection
Presents with rash from legs to buttox linked to burgers disease (IgA nephropathy), polyarthritis abdo pain
What is the characteristic rash associated with sarcoidosis
Lupus pernio - bluish-red nodules and plaques over nose and cheeks
What cancer is myasthenia gravis associated with
Thymoma
