Nephro Flashcards

1
Q

Causes of Acute interstitial nephritis

A
  1. drugs: the most common cause, particularly antibiotics

penicillin

rifampicin

NSAIDs

allopurinol

furosemide

  1. systemic disease: SLE, sarcoidosis, and Sjögren’s syndrome
  2. infection: Hanta virus , staphylococci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of Acute interstitial nephritis

A

fever, rash, arthralgia

eosinophilia

mild renal impairment

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Investigations of acute interstitial nephritis

A

sterile pyuria

white cell casts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tubulointerstitial nephritis with uveitis(TINU) usually occurs in ……?

A

young females.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Criteria to diagnose AkI

A
  1. rise in serum creatinine of >= 26 micromol/litre within 48 hours
  2. 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
  3. urine output < 0.5 ml/kg/hourfor > 6 hours in adults and more than
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stage 1 of AKI

A
  1. urine output to<0.5mL/kg/hour for≥ 6 hours

Or
2. Increase in creatinine to1.5-1.9times baseline

Or

  1. Increase in creatinine by ≥26.5 µmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stage 2 of AKI

A
  1. urine output to<0.5mL/kg/hour for≥12 hours

Or

  1. Increase in creatinine to2.0 to 2.9times baseline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stage 3 of AKi

A
  1. urine output <0.3mL/kg/hour for≥24 hours

Or

  1. Increase in creatinine to≥ 3.0times baseline

Or

  1. Increase in creatinine to ≥353.6 µmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ADPKD type 1 vs ADPKD type 2

Which Chromosome ….?

A

Type 1 : Chromosome 16

Type 2: Chromosome 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ultrasound diagnostic criteria of ADPKD (in patients with positive family history)

A
  1. Age < 30 years ; 2 cysts uni/ bilateral
  2. Age 30 - 59 years ; 2 cysts in each kidneys
  3. Age > 60 ; 4 cysts in each kidneys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of ADPKD

A

tolvaptan(vasopressin receptor 2 antagonist) may be an option. For select patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Extra-renal manifestations of ADPKD

A
  1. Liver cysts may cause hepatomegaly
  2. berry aneurysms (8%): rupture can cause subarachnoid haemorrhage
  3. cardiovascular system:mitral valve prolapse, mitral/tricuspid incompetence, aortic root dilation, aortic dissection
  4. cysts in other organs: pancreas, spleen; very rarely: thyroid, oesophagus, ovary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of a raised anion gap metabolic acidosis

A

lactate: shock, hypoxia

ketones: diabetic ketoacidosis, alcohol

urate: renal failure

acid poisoning: salicylates, methanol

5-oxoproline: chronic paracetamol use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of a normal anion gap or hyperchloraemic metabolic acidosis

A

gastrointestinal bicarbonate loss:diarrhoea, ureterosigmoidostomy, fistula

renal tubular acidosis

drugs: e.g. acetazolamide

ammonium chloride injection

Addison’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ARPKD is due to a defect in a gene located on chromosome ….. which encodes ………

A

Chromosome 6

encodes fibrocystin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Autosomal recessive polycystic kidney disease (ARPKD) on biopsy

A

Renal biopsy typically shows multiple cylindrical lesions at right angles to the cortical surface.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The time taken for an arteriovenous fistula to develop is …….?

A

6 to 8 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Calciphylaxis presents with ……?

A

painful necrotic skin lesions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The risk of developing calciphylaxis is linked with

A

hypercalcaemia,

hyperphophataemia and

hyperparathyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of calciphylaxis

A

reducing calcium and phosphate levels, controlling hyperparathyroidism and avoiding contributing drugs such as warfarin and calcium containing compounds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common presenting feature of Retroperitoneal fibrosis?

A

Lower back/flank pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Retroperitoneal fibrosis is associated with (4)

A

Riedel’s thyroiditis

previous radiotherapy

sarcoidosis

inflammatory abdominal aortic aneurysm

drugs: methysergide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications for plasma exchange

A

Guillain-Barre syndrome

myasthenia gravis

Goodpasture’s syndrome

ANCA positive vasculitis if rapidly progressive renal failure or pulmonary haemorrhage

TTP/HUS

cryoglobulinaemia

hyperviscosity syndrome e.g. secondary to myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complications of plasma exchange

A

hypocalcaemia: due to the presence of citrate used as an anticoagulant for the extracorporeal system

metabolic alkalosis

removal of systemic medications

coagulation factor depletion

immunoglobulin depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Contrast media nephrotoxicity may be defined as a .......%..... increase in creatinine occurring ........days after administration.
25% increase in creatinine occurring 2 -5 days after administration.
26
5 Risk factors of Contrast media nephrotoxicity
known renal impairment (especially diabetic nephropathy) age > 70 years dehydration cardiac failure the use of nephrotoxic drugs such as NSAIDs
27
Prevention of Contrast media nephrotoxicity 
Iv 0.9% sodium chloride at a rate of 1 mL/kg/hour for 12 hours pre- and post- procedure
28
Patients who are high-risk for contrast-induced nephropathy should have  metformin  withheld for ..............
metformin  withheld for a minimum of 48 hours and until the renal function has been shown to be normal.
29
Spironolactone is an aldosterone antagonist  which acts in ......
the  cortical collecting duct.
30
Causes of lactic acidosis type A
sepsis, shock, hypoxia, burns
31
Causes of lactic acidosis type B
metformin
32
the Modification of Diet in Renal Disease (MDRD) equation, which uses the following 4 variables:
serum creatinine age gender ethnicity
33
3 Factors which may affect s. Creat
pregnancy muscle mass (e.g. amputees, body-builders) eating red meat 12 hours prior to the sample being taken
34
Amyloidosis: types
1. AL AMYLOIDOSIS 2. AA AMYLOIDOSIS 3. Beta 2 microglobulin AMYLOIDOSIS
35
Causes of AL amyloidosis
myeloma, Waldenstrom's, MGUS
36
Causes of AA amyloid
chronic infection/inflammation e.g. TB, bronchiectasis, rheumatoid arthritis
37
Beta-2 microglobulin amyloidosis is associated with
patients on renal dialysis
38
4 Risk factors for urothelial (transitional cell) carcinoma of the bladder include:
1. Smoking 2. Exposure to aniline dyes 3. Rubber manufacture 4. Cyclophosphamide
39
2 Risk factors for squamous cell carcinoma of the bladder include:
Schistosomiasis Smoking
40
What is the investigation of choice of Renal vascular disease?
MR angiography
41
Management of Wilms' nephroblastoma
nephrectomy chemotherapy radiotherapy if advanced disease
42
Renal cell cancer  is associated with (3)
von Hippel-Lindau syndrome tuberous sclerosis autosomal dominant polycystic kidney disease
43
Features of which condition? haematuria loin pain abdominal mass paraneoplastic hepatic dysfunction syndrome Stauffer syndrome typically presents as cholestasis/hepatosplenomegaly
Renal cell cancer
44
Which type of renal stones is radio lucent
Urate stones Xanthine stones
45
stag-horn calculi  are composed of...
struvite (ammonium magnesium phosphate, triple phosphate).
46
Renal stones: risk factors
dehydration hypercalciuria, hyperparathyroidism, hypercalcaemia cystinuria high dietary oxalate renal tubular acidosis medullary sponge kidney, polycystic kidney disease beryllium or cadmium exposure
47
2 Risk factors for urate stones
gout ileostomy: loss of bicarbonate and fluid results in acidic urine, causing the precipitation of uric acid
48
4 drugs that promote calcium stones
steroids, acetazolamide, loop diuretics, theophylline * SALT
49
alpha blockers  recommend in renal stones
for  distal ureteric stones < 10 mm in size
50
ultrasound should be used in renal stones for ......
pregnant women and children
51
Which drugs can be used to prevent Oxalate stones?
cholestyramine reduces urinary oxalate secretion pyridoxine reduces urinary oxalate secretion
52
In Pre renal uremia 1. Urine sodium 2. Urine osmolality 3. Fractional Na excretion 4. Fractional Urea excretion 5. Serum Urea: creatinine ratio 6. Urine:plasma urea 7. Urine:plasma osmolality 8. Specific gravity
1. Urine sodium : < 20 2. Urine osmolality >500 3. Fractional Na excretion < 1 % 4. Fractional Urea excretion < 35% 5. Serum Urea: creatinine ratio : raised 6. Urine:plasma urea > 10:1 7. Urine:plasma osmolality > 1.5 8. Specific gravity > 1020
53
In ATN 1. Urine sodium : 2. Urine osmolality 3. Fractional Na excretion 4. Fractional Urea excretion 5. Serum Urea: creatinine ratio 6. Urine:plasma urea 7. Urine:plasma osmolality 8. Specific gravity
1. Urine sodium : > 40 2. Urine osmolality < 350 3. Fractional Na excretion > 1 % 4. Fractional Urea excretion > 35 % 5. Serum Urea: creatinine ratio : normal 6. Urine:plasma urea < 8:1 7. Urine:plasma osmolality < 1.1 8. Specific gravity < 1010
54
fractional sodium excretion =
*fractional sodium excretion = (urine sodium/plasma sodium) / (urine creatinine/plasma creatinine) x 100
55
fractional urea excretion =
fractional urea excretion = (urine urea /blood urea ) / (urine creatinine/plasma creatinine) x 100
56
corticomedullary scarring with atrophy of tubules Seen in ...?
Chronic pyelonephritis is
57
Risk factors of Chronic pyelonephritis
vesicoureteral reflux in children obstruction e.g. recurrent renal stones
58
Red cell casts present in: 4 conditions
1. Acute glomerulonephritis 2. Renal vasculitis 3. Accelerated hypertension and 4. Interstitial nephritis.
59
Alport'S SYNDROME is due to a defect in the gene which codes for ......
type IV (4) collagen resulting in an abnormal glomerular-basement membrane
60
Alport'S SYNDROME is more severe in .......
Males
61
In Alport'S SYNDROME, deafness occurs......
Before the onset of renal failure
62
90% of Alport’s syndrome develop renal failure by the age of....
40 years
63
Alport's patient with a failing renal transplant. This may be caused by the presence of .....
anti-GBM antibodies leading to a Goodpasture's syndrome like picture.
64
5 features of Alport'S SYNDROME
1. Microscopic haematuria. 2) Progressive renal failure. 3) Bilateral sensorineural deafness. 4. Ocular abnormalities: Lenticonus, corneal ulceration, cataract, retinitis pigmentosa 5. Renal biopsy: splitting of lamina densa seen on electron microscopy, light microscopy may be unremarkable.
65
A definitive diagnosis of Acute interstitial nephritis is established by
Renal biopsy which usually shows interstial oedema with a heavy infiltrate of inflammatory cells and variable tubular necrosis
66
Mechanism of acute interstitial nephritis
delayed T-cell hypersensitivity or cytotoxic T-cell reaction.
67
5 Causes of Papillary necrosis
1. Chronic analgesia use 2. Sickle cell disease 3. TB 4. Acute pyelonephritis 5. DM
68
Retroperitoneal fibrosis is associated with ( 5)
1. Riedel's thyroiditis 2. Previous radiotherapy 3. Sarcoidosis 4. Inflammatory abdominal aortic aneurysm 5. Drugs: methysergide
69
In plasma exchange most conditions 5% albumin is the plasma substitute of choice, except for ................. we should use FFP.
TTP
70
10 Causes of Sterile pyuria
1. Partially treated UTI 2. STD 3. Acute GN 4. Tubular interstitial diseases 5. Renal stones 6. Cancer 7. Adult polycystic kidney disease 8. Analgesic nephropathy 9. Appendicitis 10. Renal TB
71
1) Renal failure 2) Eosinophilia 3) Purpura 4) Livedo reticularis 5) Low C3. 6) ↑ESR. 7) Urine proteinuria. Features of which condition?
Cholesterol embolisation
72
PD fluid WCC of greater than...... is diagnostic of PD peritonitis
100/mm3
73
In PD peritonitis, which is the most common organism?
coagulase negative Staphylococcus (CoNS) Staphylococcus epidermidis is the most common cause.  Staphylococcus aureus is another common cause
74
Treatment of PD peritonitis i
1. vancomycin (or teicoplanin) + ceftazidime added to dialysis fluid OR 2. vancomycin added to dialysis fluid + ciprofloxacin by mouth * aminoglycosides are sometimes used to cover the Gram negative organisms instead of ceftazidime
75
basket-weave' appearance in biopsy Can be seen in ?
Alport's syndrome
76
7 Side-effects of erythropoietin
1. accelerated hypertension potentially leading to encephalopathy and seizures 2. bone aches 3. flu-like symptoms 4. skin rashes, urticaria 5. pure red cell aplasia* (due to antibodies against erythropoietin) 6. raised PCV increases risk of thrombosis (e.g. Fistula) 7. iron deficiency 2nd to increased erythropoiesis
77
5 reasons why patients may fail to respond to erythropoietin therapy:
iron deficiency inadequate dose concurrent infection/inflammation hyperparathyroid bone disease aluminium toxicity
78
3 Features of Renal papillary necrosis
visible haematuria loin pain proteinuria
79
Primary HUS ('atypical') is due to
complement dysregulation
80
Typical HUS secondary to ( 6 )
1. classically Shiga toxin-producing Escherichia coli (STEC) 0157:H7 2. Pneumococcal infection 3. HIV 4. SLE 5. Drugs 6. Cancer
81
indications for plasma exchange in HUS
severe cases of HUS not associated with diarrhoea
82
eculizumab has evidence of greater efficiency than plasma exchange alone in the treatment of .....??
adult atypical HUS
83
eculizumab is .....
C5 inhibitor monoclonal antibody
84
Causes of Fanconi syndrome 
cystinosis (most common cause in children) Sjogren's syndrome multiple myeloma nephrotic syndrome Wilson's disease
85
6 Features of Fanconi syndrome
1. Type 2 RTA 2. Polyuria 3. Glycosuria 4. Aminoaciduria 5. Phosphaturia 6. Osteomalacia
86
Fanconi syndrome describes a
generalised reabsorptive disorder of renal tubular transport in the proximal convoluted tubule
87
Thin basement membrane disease is An inherited disorder of type .... collagen
type IV collagen
88
Vesicoureteric reflux (VUR) is normally diagnosed by .......
a  micturating cystourethrogram
89
Cystinuria is due to a defect in the membrane transport of .....?
cystine, ornithine, lysine, arginine (mnemonic = COLA)
90
chromosome 2: SLC3A1 gene, chromosome 19: SLC7A9
Cystinuria
91
Diagnosis of cystinuria
cyanide-nitroprusside test
92
Management of cystinuria
hydration D-penicillamine urinary alkalinization
93
8 Causes of cranial DI
1. idiopathic 2. post head injury 3. pituitary surgery 4. craniopharyngiomas 5. DIDMOAD 6. histiocytosis X 7. sarcoidosis 8. haemochromatosis
94
6 Causes of nephrogenic DI
1. genetic, mutation in the gene that encodes the aquaporin 2 channel 2. hypercalcaemia 3. hypokalaemia 4. lithium 5. demeclocycline 6. tubulo-interstitial disease: obstruction, sickle-cell, pyelonephritis
95
Investigations of DI
high plasma osmolality, low urine osmolality a urine osmolality of >700 mOsm/kg excludes diabetes insipidus water deprivation test
96
Management of DI
1. nephrogenic diabetes insipidus - thiazides - low salt/protein diet 2. central diabetes insipidus can be treated with desmopressin
97
Risk factors of Benign prostatic hyperplasia
1. Age - around 50% of 50-year-old men will have evidence of BPH and 30% will have symptoms - around 80% of 80-year-old men have evidence of BPH 2. ethnicity: black > white > Asian
98
Causes of minimal changes disease
drugs: NSAIDs, rifampicin Hodgkin's lymphoma, thymoma infectious mononucleosis
99
Management of Minimal changes disease
oral corticosteroids: majority of cases (80%) are steroid-responsive cyclophosphamide is the next step for steroid-resistant cases
100
What is the third most common cause of end-stage renal failure (ESRF).
Membranous glomerulonephritis
101
electron microscopy: the basement membrane is thickened with subepithelial electron dense deposits. This creates a 'spike and dome' appearance
Membranous glomerulonephritis
102
Management of membranous GN
1. ACEi/ ARBs 2. immunosuppression combination of corticosteroid + another agent such as cyclophosphamide is often used many patients spontaneously improve only patient with severe or progressive disease require immunosuppression
103
3 Good prognostic features of Membranous glomerulonephritis
1. female sex, 2. young age at presentation and 3. asymptomatic proteinuria of a modest degree at the time of presentation.
104
Causes of FSGS
idiopathic secondary to other renal pathology e.g. IgA nephropathy, reflux nephropathy HIV heroin Alport's syndrome sickle-cell
105
Focal segmental glomerulosclerosis & renal transplants
Focal segmental glomerulosclerosis is noted for having a high recurrence rate in renal transplants.
106
renal biopsy focal and segmental sclerosis and hyalinosis on light microscopy effacement of foot processes on electron microscopy
FSGS
107
Treatment of FSGS
steroids +/- immunosuppressants
108
Types of organ rejection
1. Hyperacute: This occurs immediately through presence of pre formed antibody (such as ABO incompatibility). 2. Acute: Occurs during the first 6 months and is usually T cell mediated. Usually tissue infiltrates and vascular lesions 3. Chronic: Occurs after the first 6 months. Vascular changes predominate.
109
In Nephrotic syndrome, increased risk of  thromboembolism related to loss of
antithrombin III  and plasminogen in the urine
110
What's the most common cause of Epididymo-orchitis 1. in sexually active younger adults ? 2. In adults with a low-risk sexual history ?
1. Chlamydia trachomatis  and  Neisseria gonorrhoeae 2. E. Coli
111
Membranoproliferative glomerulonephritis Causes of Type 1 Causes of Type 2 Type 3
type 1: cryoglobulinaemia, hepatitis C type 2: partial lipodystrophy Type 3: hepatitis B & C
112
4 Disorders associated with glomerulonephritis and low serum complement levels
1. post-streptococcal glomerulonephritis 2. subacute bacterial endocarditis 3. systemic lupus erythematosus 4. mesangiocapillary glomerulonephritis
113
Post-streptococcal glomerulonephritis typically occurs ............. days following a ....................... infection
Post-streptococcal glomerulonephritis typically occurs 7-14 days following a group A beta-haemolytic Streptococcus infection
114
Post-streptococcal glomerulonephritis is caused by 
immune complex (IgG, IgM and C3) deposition in the glomeruli
115
electron microscopy: subepithelial 'humps' caused by lumpy immune complex deposits immunofluorescence: granular or 'starry sky' appearance
post-streptococcal glomerulonephritis
116
renal biopsy electron microscopy: subendothelial and mesangium immune deposits of electron-dense material resulting in a 'tram-track' appearance
Type 1 MPGN
117
renal biopsy electron microscopy: intramembranous immune complex deposits with 'dense deposits'
Type 2 MPGN
118
Treatment of MPGN
Steroids
119
IgA nephropathy is associated with (3)
alcoholic cirrhosis coeliac disease/dermatitis herpetiformis Henoch-Schonlein purpura
120
mesangial hypercellularity, positive immunofluorescence for IgA & C3
IgA nephropathy
121
Treatment of Ig A nephropathy
if there is active disease (e.g. falling GFR) or failure to respond to ACE inhibitors immunosuppression with corticosteroids
122
1 marker of good prognosis of Ig A nephropathy
frank haematuria
123
6 markers of poor prognosis of IgA nephropathy
1. male gender, 2. proteinuria (especially > 2 g/day), 3. hypertension, 4. smoking, 5. hyperlipidaemia, 6. ACE genotype DD
124
4 Causes of transient or spurious non-visible haematuria
1. UTI 2. Menstruation 3. Vigorous e exercise 4. Sexual intercourse
125
6 Causes of persistent non-visible haematuria
1. cancer (bladder, renal, prostate) 2. stones 3. benign prostatic hyperplasia 4. prostatitis 5. urethritis e.g. Chlamydia 6. renal causes: IgA nephropathy, thin basement membrane disease
126
Spurious causes - red/orange urine, where blood is not present on dipstick
foods: beetroot, rhubarb drugs: rifampicin, doxorubicin
127
Urgent cancer referral (i.e. within 2 weeks)
- Age >= 45 years and 1. unexplained visible haematuria without urinary tract infection, or 2. visible haematuria that persists or recurs after successful treatment of urinary tract infection - Aged >= 60 years AND have unexplained nonvisible haematuria and either dysuria or a raised white cell count on a blood test
128
persistent non-visible haematuria is often defined as
blood being present in 2 out of 3 samples tested 2-3 weeks apart
129
Causes of RPGN
Goodpasture's syndrome Wegener's granulomatosis others: SLE, microscopic polyarteritis
130
Anti-glomerular basement membrane (GBM) disease is associated with
both pulmonary haemorrhage and RPGN
131
Anti-glomerular basement membrane (GBM) disease is caused by anti-glomerular basement membrane (anti-GBM) antibodies against type ..... collagen
IV
132
Anti GBM disease is associated with HLA ......
HLA DR2.
133
renal biopsy: linear IgG deposits along the basement membrane
Anti GBM disease
134
Treatment of anti GBM disease
plasma exchange (plasmapheresis) steroids cyclophosphamide
135
One of the main complications of anti GBM disease is pulmonary haemorrhage. 5 Factors that increase the likelihood of this include:
1. Smoking 2. LRTI 3. pulmonary oedema 4. inhalation of hydrocarbons 5. young males
136
What is the most common type of lupus nephritis
Class IV (diffuse proliferative glomerulonephritis) 
137
Treatment of lupus nephritis
1. treat hypertension 2. glucocorticoids with either mycophenolate or cyclophosphamide
138
glomeruli shows endothelial and mesangial proliferation, 'wire-loop' appearance electron microscopy shows subendothelial immune complex deposits granular appearance on immunofluorescence
Class IV lupus nephritis ( DPGN )
139
Xanthogranulomatous pyelonephritis is a Chronic/subacute infection by organisms such as ................. predispose to ..........
1. Proteus mirabilis 2. renal stones including staghorn calculi.
140
5 features of HIV-associated nephropathy
1. massive proteinuria resulting in nephrotic syndrome 2.normal or large kidneys 3. FSGS 4. Elevated urea and creatinine 5. Normotension
141
PSA levels may also be raised by ( 6 )
1. benign prostatic hyperplasia (BPH) 2. prostatitis and urinary tract infection (NICE recommend to postpone the PSA test for at least 1 month after treatment) 3. ejaculation (ideally not in the previous 48 hours) 4. vigorous exercise (ideally not in the previous 48 hours) 5. urinary retention 6. instrumentation of the urinary tract
142
HLA is coded on chromosome ....
chromosome 6.
143
Post op renal transplant problems
ATN of graft vascular thrombosis urine leakage UTI
144
when HLA matching for a renal transplant the relative importance of the HLA antigens are as follows 
DR > B > A
145
Stones < ....... mm will usually pass spontaneously.
Stones < 5 mm
146
percutaneous nephrolithotomy if renal stone > .....
> 20 mm
147
Hydroceles may develop secondary to:
epididymo-orchitis testicular torsion testicular tumours
148
Epididymal cysts associated with
polycystic kidney disease cystic fibrosis von Hippel-Lindau syndrome
149
seminomas: hCG may be elevated in around .....%
20%
150
non-seminomas:  AFP and/or beta-hCG are elevated in ......%
80-85%
151
IgG deposits on renal biopsy anti-GBM antibodies
Goodpasture's syndrome ( anti GBM disease)
152
Patients who have received an organ transplant are at risk of ….. cancer
Skin cancer particularly Squamous cell carcinoma
153
Which type of complement is likely to be low in lipodystrophy ?
C3
154
Mechanism of DI due to alcohol
ADH inhibition
155
Renal biopsy showed basket weave appearance?
Alport’s syndrome
156
HTN High aldosterone & renin Hypokalemia Features of….?
Bilateral renal artery stenosis
157
Finasteride treatment of BPH may take….. before results are seen
6 months
158
5 features of HIV associated nephropathy
FSGS High urea & creat Massive proteinuria Normotension Normal or large kidneys
159
5 features of HIV associated nephropathy
FSGS High urea & creat Massive proteinuria Normotension Normal or large kidneys
160
Bicalutamise is
Androgen receptor blocker
161
Causes of large kidneys
1. Stage 1 diabetic nephropathy 2. Amyloidosis 3. Hydronephrosis 4. Acromegaly 5. Renal vein thrombosis 6. APCKD 7. HIV nephropathy
162
Risk factors of Dialysis disequilibrium syndrome If serum urea ……
> 60 mmol/l
163
What is the lipid abnormalities most likely to be seen in CKD?
High TG , LDL Low HDL
164
What is the percentage of patients with ATN recover renal function to the level where dialysis is not required ?
Approximately 95 % of patients
165
Lung biopsy findings in anti GBM
Haemosiderin laden macrophages
166
Risperidone is associated with which urinary dysfunction?
Pollakiuria ( increased daytime urinary frequency )
167
Ciclosporin & azole can cause
Ciclosporin toxicity
168
Lithium can cause……, Which type of GN?
Minimal changes disease
169
Thiazides & lithium
Thiazides cause the greatest retention of lithium
170
Medullary sponge kidney Complication during pregnancy
High risk of kidney stone formation
171
What is the most frequent complication and cause of death in acute renal tubular necrosis?
Infection Gram -ve septicemia