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MSRA > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What are the causes of minimal change disease?

A 
Idiopathic - majority of cases
10-20% a cause is demonstrated:
NSAIDs
Rifampicin
Thymoma
Hodgkin's lymphoma
Mono
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2
Q

What is the prognosis of minimal change disease?

A 
1/3rd = 1 episode only
1/3rd = infrequent episodes
1/3rd = frequent relapses which stop by childhood
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3
Q

How is minimal change disease managed?

A

80% = steroid-responsive –> cyclophosphamide = the next step for steroid-resistant cases

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4
Q

How does IgA nephropathy classically present?

A

It classically presents as macroscopic haematuria in young people following an upper respiratory tract infection

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5
Q

How does post-strep glomerulonephritis present?

A

While this would also produce a nephritic syndrome, it is more likely in younger patients and occurs 7-14 days after upper respiratory tract infection

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6
Q

How is Goodpasture’s syndrome diagnosed?

A

Presence of anti-glomerular basement membrane antibodies

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7
Q

In what condition is immune complex deposition seen?

A

IgA nephropathy

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8
Q

In what condition is splitting of the basement membrane seen?

A

Alport’s syndrome - abnormality in type IV collagen

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9
Q

In what condition is wire looping of capillaries seen?

A

Diffuse membranous glomerulonephritis

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10
Q

What is the role of the PCT?

A

Sodium resorption

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11
Q

Which type of testicular cancer is a raised AFP associated with?

A

Seminoma

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12
Q

What is IgA nephropathy also known as?

A

Berger’s disease

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13
Q

When should ESWL be used to treat renal calculi

A

Asymptomatic calculi, <1.5cm, with normal renal anatomy

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14
Q

How should large staghorn calculi be treated (in normally functioning kidneys)?

A

Percutaneous nephrolithotomy

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15
Q

When should nephrectomy be performed?

A

When the kidney is functioning at <10% and is symptomatic

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16
Q

What should be used if ESWL fails?

A

Flexible ureterorenoscopy with holmium laser

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17
Q

How do cystine calculi usually present?

A

Ground glass appearance

Recurrent

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18
Q

How should cystine calculi be treated?

A

Alkaline diuresis

19
Q

How does acute interstitial nephritis present?

A

Eosinophillia, arthralgia, fever - commonly caused by NSAIDS

20
Q

What condition is PSC associated with?

A

IBD, esp. UC

21
Q

What may complicate PSC?

A

Cholangiocarcinoma

22
Q

Which type of germ cell tumour responds well to chemo?

A

Seminomas

23
Q

What is the most common nephrotic syndrome seen in children?

A

Minimal change disease

24
Q

A renal biopsy fluoresces bright green under polarized light after Congo red staining - what is the diagnosis?

A

Renal amyloidosis

25
Q

What is the most sensitive test for identifying a colovesical fistula?

A

CT abdo/pelvis

26
Q

What is the commonest type of renal stone?

A

Calcium oxalate

27
Q

When there are abnormalities of the urinary tract, what are the most common causative organisms?

A
  1. Pseudomonas aerguinosa

2. Staph epidermis

28
Q

How may urethral injuries be classified?

A

Anterior or posterior

29
Q

What is an anterior urethral injury?

A

Injuries distal to the membranous urethra - most commonly related to blunt trauma to the perineum, e.g. straddle injuries - may present many years later as a stricture

30
Q

What is a posterior urethral injury?

A

In the membranous or prostatic urethra - most commonly related to major blunt trauma - e.g. RTAs and falls - and are commonly associated with pelvic fractures

31
Q

What is haemolytic uraemic syndrome?

A
  1. Acute renal failure
  2. Microangiopathic haemolytic anaemia
  3. Thrombocytopenia
32
Q

What is the most common cause of acute renal failure in children?

A

Haemolytic uraemic syndrome

33
Q

What are >90% of cases of HUS secondary to?

A

Infection

34
Q

What is the classical presenting feature of HUS?

A

Profuse diarrhoea that turns bloody in 1-3 days

There is often fever, abdominal pain and vomiting

35
Q

What type of UTI might cause green/blue urine?

A

Pseudomonas UTI

36
Q

How do you differentiate with ATN and hypovolaemia?

A 
ATN = raised urinary sodium
Hypovolaemia = very low urinary sodium
37
Q

What are the non-cystic presentations of adult polycystic kidney disease?

A
  1. Mitral valve prolapse
  2. Intracranial berry aneurysms
  3. Colonic diverticula
  4. Renal cell carcinoma
38
Q

How long a course of Abx is given if catheterised?

A

7 days

39
Q

How long of a course of Abx is given if pregnant?

A

7 days

40
Q

What is the most common cause of nephrotic syndrome in adults?

A

Focal Segmental Glomerulosclerosis

41
Q

What procedure should be offered to symptomatic men with BPH with a prostate volume <30g

A

TUIP - transurethral incision of the prostate

42
Q

When should open prostatectomy be offered?

A

As an alternative to TURP, TUVP or HoLEP, and only when prostate volume >80g

43
Q

What should be offered to men with prostate cancer whom wish to retain their sexual function?

A

Bicalutamide - with the trade offs of gynaecomastia and reduced survival

MSRA (18 decks)

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