Nephrology Flashcards
What are the causes of minimal change disease?
Idiopathic - majority of cases 10-20% a cause is demonstrated: NSAIDs Rifampicin Thymoma Hodgkin's lymphoma Mono
What is the prognosis of minimal change disease?
1/3rd = 1 episode only 1/3rd = infrequent episodes 1/3rd = frequent relapses which stop by childhood
How is minimal change disease managed?
80% = steroid-responsive –> cyclophosphamide = the next step for steroid-resistant cases
How does IgA nephropathy classically present?
It classically presents as macroscopic haematuria in young people following an upper respiratory tract infection
How does post-strep glomerulonephritis present?
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
How is Goodpasture’s syndrome diagnosed?
Presence of anti-glomerular basement membrane antibodies
In what condition is immune complex deposition seen?
IgA nephropathy
In what condition is splitting of the basement membrane seen?
Alport’s syndrome - abnormality in type IV collagen
In what condition is wire looping of capillaries seen?
Diffuse membranous glomerulonephritis
What is the role of the PCT?
Sodium resorption
Which type of testicular cancer is a raised AFP associated with?
Seminoma
What is IgA nephropathy also known as?
Berger’s disease
When should ESWL be used to treat renal calculi
Asymptomatic calculi, <1.5cm, with normal renal anatomy
How should large staghorn calculi be treated (in normally functioning kidneys)?
Percutaneous nephrolithotomy
When should nephrectomy be performed?
When the kidney is functioning at <10% and is symptomatic
What should be used if ESWL fails?
Flexible ureterorenoscopy with holmium laser
How do cystine calculi usually present?
Ground glass appearance
Recurrent
How should cystine calculi be treated?
Alkaline diuresis
How does acute interstitial nephritis present?
Eosinophillia, arthralgia, fever - commonly caused by NSAIDS
What condition is PSC associated with?
IBD, esp. UC
What may complicate PSC?
Cholangiocarcinoma
Which type of germ cell tumour responds well to chemo?
Seminomas
What is the most common nephrotic syndrome seen in children?
Minimal change disease
A renal biopsy fluoresces bright green under polarized light after Congo red staining - what is the diagnosis?
Renal amyloidosis
What is the most sensitive test for identifying a colovesical fistula?
CT abdo/pelvis
What is the commonest type of renal stone?
Calcium oxalate
When there are abnormalities of the urinary tract, what are the most common causative organisms?
- Pseudomonas aerguinosa
2. Staph epidermis
How may urethral injuries be classified?
Anterior or posterior
What is an anterior urethral injury?
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
What is a posterior urethral injury?
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
What is haemolytic uraemic syndrome?
- Acute renal failure
- Microangiopathic haemolytic anaemia
- Thrombocytopenia
What is the most common cause of acute renal failure in children?
Haemolytic uraemic syndrome
What are >90% of cases of HUS secondary to?
Infection
What is the classical presenting feature of HUS?
Profuse diarrhoea that turns bloody in 1-3 days
There is often fever, abdominal pain and vomiting
What type of UTI might cause green/blue urine?
Pseudomonas UTI
How do you differentiate with ATN and hypovolaemia?
ATN = raised urinary sodium Hypovolaemia = very low urinary sodium
What are the non-cystic presentations of adult polycystic kidney disease?
- Mitral valve prolapse
- Intracranial berry aneurysms
- Colonic diverticula
- Renal cell carcinoma
How long a course of Abx is given if catheterised?
7 days
How long of a course of Abx is given if pregnant?
7 days
What is the most common cause of nephrotic syndrome in adults?
Focal Segmental Glomerulosclerosis
What procedure should be offered to symptomatic men with BPH with a prostate volume <30g
TUIP - transurethral incision of the prostate
When should open prostatectomy be offered?
As an alternative to TURP, TUVP or HoLEP, and only when prostate volume >80g
What should be offered to men with prostate cancer whom wish to retain their sexual function?
Bicalutamide - with the trade offs of gynaecomastia and reduced survival
