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FINALS: Passmed > nephro > Flashcards

nephro Flashcards

1
Q

adult fluid/e-/glucose requirements a day

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

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2
Q

in AKI, urine osmolality ____, urine sodium ____

A

low, high

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3
Q

How do you work out the urea:creatinine ratio?

A

plasma urea (mmol/L) / (plasma creatinine (μmol/L) divided by 1000)

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4
Q

How can you use urea:creatinine ratio to work out cause of AKI?

A

> 100 – pre-renal cause (urea absorption increased compared to creatinine)

40-100: – normal or post renal cause of AKI

<40 - intrinsic renal damage (urea unable to be absorbed -> become like creatinine -> ratio gets closer to 1)

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5
Q

This patient presents with the classical symptoms and history of the disease: a young child with recurrent episodes of macroscopic haematuria, typically associated with a recent respiratory tract infection and mild proteinuria.

A

IgA nephropathy

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6
Q

how to differentiate IgA nephropathy and post-strep glomerulonephritis

A

It is important to not confuse IgA nephropathy with post-streptococcal glomerulonephritis, which is caused by immune complex (IgG, IgM, and C3) deposition in the glomeruli. This happens more slowly, typically 7-14 days following a group A beta-hemolytic Streptococcus infection and causes proteinuria. To remember the different presentations you can think that IgA is a shorter word so presents after a few days, whereas post-streptococcal is a longer word so presents after many

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7
Q

__________________is an indication for dialysis

A

Uraemia (encephalopathy or pericarditis)

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8
Q

1st line tx in minimal change disease

A

prednisolone

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9
Q

stages of churg-strauss + what serology is it associated with?

A
  1. rhinitis/asthma, nasal polyps
  2. eosinophilia
  3. vasculitis: AKI

p-ANCA

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10
Q

Tricyclic antidepressants can cause ________incontinence (anticholinergic effect)

A

overflow

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11
Q

Type 1 renal tubular acidosis (distal) complication -

A

renal stones

also associated with autoimmune conditions

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12
Q

Bartter’s syndrome -

A

autosomal recessive disorder which causes renal tubular disease

hypokalemia, hypochloraemic, renal stones

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13
Q

Fanconi syndrome

A

RTA T2, osteomalacia

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14
Q

asymptomatic bacteria in catheterised Pts?

A

don’t treat?

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15
Q

Tx for HUS?

A
  • supportive
  • eculizumab
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16
Q

what is HSP? Px?

A
  • IgA mediated small vessel vasculitis
  • seen in children after infection

Haematuria
Surfaces - arms, legs, buttockd
Palpabile purpuric rash, polyarthritis

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17
Q

hyperK features on ECG?

A
  • tall tented T waves
  • broad QRS complexes
  • loss of P waves
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18
Q

hypoK features on ECG?

A
  • U waves
  • small/absent T waves
  • prolonged PR intervals
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19
Q

hypoK predisposes Pts to _______ toxicity

A

digoxin

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20
Q

post-streptococcal glomerulonephritis is associated with low ____________ levels

A

complement

21
Q

‘tram track’ appearance of kidneys on electron microscopy indicates

A

T1 membranoproliferative glomerulonephritis

22
Q

what does MCD show on renal biopsy?

A

fusion of podocytes and effacement of foot processes

23
Q

Tx for MCD?

A
  1. oral corticosteroids
  2. cyclophosphamides
24
Q

nephrotic syndrome - extrarenal effcts?

A
  1. loss of antithrombin-lll –> fibrinogen levels rise, more thrombosis
  2. loss of thryoxine-binding globulin –> total thryoxine levels decreased
  3. hyperlipidaemia
25
Q

how to minimise risk of nephrotoxicity due to contrast media?

A
  1. use of 0.9% NaCl for 12h before and after procedure
26
Q

most common cause of peritonitis in peritoneal dialysis? + Tx

A

staph epidermis
vancomycin

27
Q

what biopsy finding do rapidly progressing glomerulonephritis cause? What are some causes?

A

crescents in glomeruli
Goodpastures, Wegner’s, SLE

28
Q

features of RAS (triad)

A
  • HTN
  • CKD
  • flash pulmonary oedema
29
Q

hyperacute, acute and chronic graft rejection in renal transplant

A
  1. hyperacute: minutes to hours
    - pre-exisitng ABO/HLA Ab
    - no tx, remove graft
  2. acute: <6 months
    - reversible with steroids or immunosuppressants
  3. chronic: >6 months
30
Q

immunosuppression for renal transplant

A

ciclosporin, tacrolimud, monoclonal antibodies

31
Q

which 2 drugs when co-prescribed can cause rhabdomyolsis?

A

statin + clarithryomcyin

32
Q

causes of rhabdo?

A

seizure, coma/collapse, crush injury, drugs, ecstasy

33
Q

7Ps of Signs and Sx of CKD

A
  1. Pallor - anaemia
  2. Pruritus - uraemia
  3. Paraythyroid overactivity - hypoC
  4. Pulmonary oedema - fluid overload
  5. Pericarditis - fluid overload
  6. Peripheral Nueropathy
  7. Painful big toe (gout)
34
Q

Acute interstitial nephritis causes an ‘allergic’ type picture consisting usually of raised urinary

A

WCC and eosinophils, alongside impaired renal function

35
Q

‘Muddy’ brown casts represent

A

secretions of necrotic cells in the urine

36
Q

Renal transplant + infection =

A

CMV

37
Q

All patients with chronic kidney disease should be started on a ____

A

statin

38
Q

All diabetic patients with a urinary ACR of 3 mg/mmol or more should be

A

started on an ACE inhibitor or angiotensin-II receptor antagonist

39
Q

Henoch-Schönlein purpura presents with

A

the triad of purpuric rash, joint pain, and abdominal pain. There is also often renal involvement, causing haematuria.

40
Q

IgA nephropathy classically presents as

A

visible haematuria following a recent URTI

41
Q

NSAIDs should be stopped in AKI except

A

aspirin at cardio-protective dose

42
Q

The patient is deficient in the enzyme porphobilinogen deaminase - Tx?

A

acute attack of acute intermittent porphyria (AIP)

Intravenous haem arginate

43
Q

Mx of renal stones

A

Stone <5mm = expectant treatment
Stone <2cm = lithotripsy (wave to break stone)
Stone <2cm + pregnant = uteroscopy
Stone complex = nephrolithotomy (invasive)
hydronephrosis/infection = nephrostomy

44
Q

Most patients presenting with symptomatic renal cell carcinoma have stage _________ disease

A

stage IV

45
Q

Post-streptococcal glomerulonephritis: ________________are used to confirm the diagnosis of a recent streptococcal infection

A

raised anti-streptolysin O titres

46
Q

Pt with microscopic haematuria with +blood, +leukocytes on MC&S - Mx?

A

old patient: refer to urology
young patient: refer to nephro

47
Q

___________________is frequently associated with malignancy (protein in urine)

A

Membranous nephropathy

48
Q
A

FINALS: Passmed (40 decks)

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