Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Revision > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What do muscles release when they are dying

A

Myoglobin
Potassium
Creatine Kinase

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

Elderly man with frequent falls presents with complaints of tea coloured urine and AKI
CK found to be very high
Dx?

A

Rhambdomyolysis

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

Features of rhabdomyolysis

A

Hematuria- reddish brown or tea coloured urine
=false positive no RBC on dipstick, red because of myoglobin

Hypotension
AKI
Very high CK

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

Uncommon side effect of statins

A

Rhabdomyolysis

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

How does myoglobin cause an AKI

How do you manage it ?

A

It is nephrotoxic

Rehydration with IV fluid - essential!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ECG of patient with rhambdomyolysis shows tall tent t waves and wide qrs
Next step of management ?

A

Hyperkalemia

IV calcium gluconate or calcium chloride
Protect the heart!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Initial investigation + management of rhabdomyolysis

To confirm dx?

A

ECG
IV fluids

Dx - CPK level - it indicates muscle necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hematuria + hemoptysis + impaired RFTs
Initial investigation?
Most accurate investigation?

A

Goodpasture syndrome
Initial - Anti- glomerular basement membrane antibodies

Most accurate - lung or kidney biopsy = crescenteric glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Goodpasture syndrome?

A

Acute rapidly progressive glomerulonephritis +

Pulmonary alveolar hemorrhage

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

CXR of Goodpasture will show

A

Patchy interstitial infiltration ( intrapulmonary bleeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hemoptysis + hematuria
+ cannot hear (SNHL)
Diagnosis?

A

Alport syndrome

X linked

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

Jaundice + hemoptysis

Diagnosis?

A

Jaundice - due to the liver being affected

Alpha-antitrypsin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antibody in eosinophilia Granulomatosis with polyangiitis

A

Churg Strauss

P - ANCA

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

Features of Granulomatosis with polyangiitis

Antibody present?

A

Wegener Granulomatosis
URT problems - sinusitis/ nasal septum perforation/ epistaxis
+ hematuria

C-ANCA

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

Hematuria + diarrhoea
With AKI
Diagnosis?

A

HUS

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

Pale skin + itching, worse after hot bath + peripheral oedema and increased skin pigmentation
Dx?

A

Chronic renal failure
Itching - due to uraemia seen in late stage renal failure
Pallor due to anemia (decreased erythropoietin)

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

Features of liver failure

A

Ascites
Jaundice
Bleeding

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

Red skin*/flushed + itching, worse after hot bath + gout + high hb + burning sensation in fingers and toes
Dx?

A

Polycythemia rubra Vera

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

Polycythemia rubra Vera vs chronic renal failure

A

PRV - flushed skin vs pallor in CRF, high hb vs anemia in CRF

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

Itching worse after hot bath + linear tracks/burrows

Dx?

A

Scabies

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

IV fluid allowed in sepsis

A

RL or NS 0.5% NaCl

= don’t cause dilutional hyponatremia

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

Commonest renal cause of AKI

A

Acute tubular necrosis

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

Massive hemorrhage + hypotensive shock + high creatinine

Dx?

A

Acute tubular necrosis

= low perfusion to kidneys due to prolonged ischemia

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

Drug intake + rash fever + hematuria

Dx?

A

Interstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where does 25-alpha hydroxylation occur?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does 1-alpha hydroxylation occur?

A

Kidney

Converts 25-hydroxy vitamin D to active form = 1,25 dihyroxyvitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes vitamin D deficiency in renal failure?

A

Reduced 1-alpha hydroxylase in kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Repeated UTI + hypertension

Possible dx?

A

Repeated UTI - renal scarring - Chronic pyelonephritis - hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Loin/back pain + UTI

Dx?

A

Acute pyelonephritis

30
Q

Repeated UTI + sudden loin/back pain + fever + rigors
Urine = nitrites , leukocyte esterase +ve
Dx?

A

Acute pyelonephritis

**chronic has NO active infection

31
Q

Risk factors of pyelonephritis

A

pregnancy
stones
VUR
DM

32
Q

Treatment of lower UTI

A

Trimethoprim , nitrofurantoin

33
Q

Treatment of upper UTI

A

Cipro

Co amoxiclav

34
Q

Investigations of pyelonephritis

A

Urinalysis
Urine c&s - before you start antibiotics

Adults , older children - mid stream
Young Children - clean catch / catheter/ suprapubic aspirate

35
Q

When should antibiotics be started in acute pyelonephritis

A

Start empirical ABx immediately

36
Q

Most common causing organism of UTI

A

E.Coli = gram negative

37
Q 
Management of pyelonephritis 
Men 
Women - pregnant and non pregnant 
Indwelling catheters 
Children
A 
Admission - often 
Antibiotics =
Men, non pregnant women and patients  with indwelling Caths
=== cipro 500 mg bid 7 days
=== co-amoxiclav 625 mg tid for 14 days

Children
= 1. Co amoxiclav
=2. Cefixime

Pregnant women - cefalexin -500mg bid 10- 14 days PO (if not admitted)

38
Q

Small kidneys + HTN

Possible Dx?

A

Bilateral artery stenosis or

Chronic pyelonephritis

39
Q

What medications are contraindicated in bilateral artery stenosis?

A

ACEi

40
Q

Normal cause of mild proteinuria

A

Excercise

+1

41
Q

Proteinuria (mild) + healthy individual

Next step?

A

Repeat test

If still high protein:creatinine ratio

42
Q

What is nephrotic syndrome

What is the peak incidence in children?

A

Proteinuria >3g/24hr
Hypoalbuminemia <30g/L
Oedema

2-5 years old

43
Q

Majority of cases of nephrotic syndrome in children are due to ?

A

Minimal change glomerulonephritis

  • microscopic hematuria seen in 10%
  • good prognosis = 90% respond to steroids (high dose)
44
Q

Features of minimal change disease?

Definitive dx test?

A

Nephrotic syndrome
Normal tension
Selective proteinuria

Dx - renal biopsy - electron microscopy shows fusion of podocytes

45
Q

What causes hyperlipidemia and hypercoagulable state in nephrotic syndrome

A

Loss of anti thrombin III

46
Q

What causes liability to infections in nephrotic syndrome

A

Loss of immunoglobulins

47
Q

Most common cause of AKI

Metabolic imbalances seen

A

Pre-renal causes - dehydration “hypovolemia”

HyperK, raised serum urea and creatinine

AKI - decreased eGFR - unable to excrete the above

48
Q

What can be done to reduce the risk of contrast induced nephropathy ?

A

Drink plenty fluids

IV NS .9% NaCl pre and post procedure esp in high risk pts

49
Q

What medication needs to be stopped before any contrast study?

A

Metformin

=nephron - harmful

50
Q

HTN + CKD
GFR > 30
ACR >30
What meds should be given?

A

ACEi - prils or. ARBs - sartans
They slow progression of CKD
ACEi = preferred

51
Q

Situations ACEi and ARBs can be used in renal impairment

A

ACR = urinary albumin:creatinine
>=70
>= 30 if there is HTN
>= 3 if there is DM

52
Q

Most common nephrotic syndrome in adults

A

Caucasian or unspecified ethnicity - membranous
African/black/Hispanic = focal segmental GN

** for plab - adult >40 = membranous

53
Q

Causes &

Prognosis of membranous glomerulonephritis

A

Cause - mainly idiopathic
Infections rheumatoid drugs, malignancy

Prognosis-
30% remission , 30% partial remission, 30% progress to ESRD

54
Q

Types of glomerulonephritis

A

2- nephrotic nephritic
Nephritic - rapidly progressive - Goodpasture, igA

IgA- mesangioproliferative
Goodpasture - crescenteric

55
Q

Causes of minimal change disease

A

Idiopathic mainly
Hodgkin
NSAIDs

56
Q

Causes of focal segmental glomerulosclerosis

A

Idiopathic / 2ry to HIV or heroin

57
Q

Anemia + hypocalcemia + small kidneys (<9mm) on US
What do you suspect?
What is the reason for the hypocalcemia

A

CKD

HypoCa = decreased 1-alphahydroxylase

58
Q

What causes a dynamic bone disease?

A

=Reduced bone turnover - causes msk pain and immobility
It is due to 1,25 dihydrocycholecalciferol over-replacement

There will be hypoca + inappropriately normal PTH

59
Q

Hematuria + HTN + loin/flank pain
Suspect?
What is an important association

A

ADPKD

Intracranial aneurysm

60
Q

How is the dx of ADPKD made?

A

Ultrasound

61
Q

What is haemolytic uremic syndrome? (HUS)

Features, organism

A

Haemolytic anemia
Uraemia - low urea and creatinine
thrombocytopenia(acute renal failure)

*E.Coli
Diarrhoea (bloody) + renal failure + anemia

62
Q

Treatment HUS

A

IV fluids +/- blood transfusion
Dialysis if required

ABX NEVER GIVEN

63
Q

HUS triad + fever + neurological manifestations

Dx?

A

thrombotic thrombocytopenic purpura

64
Q

IgA(bergers ) vs post strept glomerulonephritis
Organism
Treatment

A

IgA - 1-2 days after URTI with hematuria and usually young males

PSGN _ 1-2 weeks, proteinuria +decreased complement C3
Rena; biopsy shows humps on electron microscopy

O— group A beta- hemolytic streptococci usually strept pyogenes

Tx - supportive mainly (resolves spontaneously)

65
Q

Causes of small kidneys

A

Chronic glomerulonephritis
Chronic pyelonephritis
Hypertensive renal disease
Bilateral renal artery stenosis

66
Q

Causes of large kidneys

A

ADPKD
Obstructive Uropathy
Reflux nephropathy

67
Q

Indications of haemodialysis (5)

A 
Persistently high K >6.5 (refractory hyperk)
Severe metabolic acidosis
Fluid overload with anuria 
Uremic pericarditis , pulm oedema
Uremic encephalopathy
68
Q

Treatment of reflux nephropathy

A

Low dose trimethoprim daily

If fails or there is parenchymal damage - surgery

69
Q

What 4 meds should be stopped if patient presents with diarrhoea/vomiting and there is risk of dehydration/AKI?

A 
DAMN Drugs
Diuretics
ACEi and ARBs
Metformin
NSAIDs
70
Q

Pt with ESRD + MSK pain + hypocalcemia + low vit D+ high PTH

Dx?

A

2ry hyperparathyroidism or vitamin D deficiency

Revision (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions